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Implementing the Alcohol, Smoking, Substance Involvement Screening Test and linked brief intervention service in primary care in Thailand.

BACKGROUND
This paper reports findings on the implementation, acceptability and uptake of the screening and brief intervention programme based on the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) to help decrease substance misuse in primary care in Thailand.


METHODS
Action research involving selection of suitable study areas; obtaining support for its introduction and corporation at national and local levels; training and monitoring of healthcare providers; delivery of the ASSIST-BI (brief intervention) procedure and assessments of acceptability and uptake of the procedure by patients and staff.


RESULTS
Between October 2011 and October 2012, 5931 patients (2.5% of all patients attending primary care units) were screened with the ASSIST. Of these, 29.6 and 3.4% were in the moderate- and high-risk groups, respectively, and were offered BI or other treatment. The most popular substances used were tobacco and alcohol. Less than 1% screened positively for illicit substances.


CONCLUSION
The ASSIST detected many substance users capable of benefiting from intervention. The programme was well received by patients and staff. The development of the project from conception to inclusion in Thailand's national public health strategy is described and suggested as a model for introducing similar procedures into developing countries.