Several key questions were addressed in the review (numbers follow those in the report for ease of reference).
1. Was there direct evidence that screening for drug misuse reduced morbidity and/or mortality.
4. Did treatment for drug misuse among individuals identified through screening improve morbidity and/or mortality?
5. Did treatment for drug misuse among individuals identified through screening result in decreased drug misuse?
5a. Did treatment for drug misuse reduce risk behaviours or improve social and legal outcomes?
7. Was decreased use or abstinence following drug misuse reliably associated with reduced morbidity and mortality?
Included studies had to meet criteria for the key question and meet the following criteria:
Randomised controlled trials (RCTs), controlled clinical trials (CCTs) and prospective and observational studies (the last two types for key questions 1 and 7) of opiate, cocaine, marijuana and mixed drug use among adolescents/teens (12 to 17 years), young adults (18 to 25 years) and adults (over 25 years) or pregnant women were eligible for inclusion. Eligible health outcomes were morbidity (infant outcomes, injuries, medical conditions, mental health disorders, quality of life, sexually transmitted disease transmission, utilisation, violence/unintentional) and mortality. Intermediate outcomes eligible for inclusion were abstinence, decreased use, time to relapse, risk behaviours and social/legal. The studies also had to be conducted in a USA-applicable country and be primary care feasible or referable (described in the report). Studies were excluded if they did not meet US Preventative Services Task Force (USPSTF) criteria for study quality.
No evidence was found that addressed key question 1. Studies that addressed questions 4, 5 and 5a were mostly conducted in adult or young adult populations. Treatments varied according to type of drug, but included psychosocial intervention, counselling, prescription drug treatments and acupuncture. Most trials were carried out in treatment-seeking populations (rather than primary-care screened populations).
Studies were selected by two reviewers. Disagreements were resolved by consensus.