EFFECTIVE SCREENING, INTERVENTION, AND TREATMENT STRATEGIES FOR SUBSTANCE USE DISORDERS WITHIN PRIMARY CARE SETTINGS: A SYSTEMATIC REVIEW

Abstract

Background: Substance use disorders (SUDs) remain underdiagnosed and undertreated within primary care, despite being a major contributor to global morbidity and mortality. Integrating screening, brief intervention, and treatment referral (SBIRT) models into primary care can bridge gaps between detection and specialized care.

Objectives: This systematic review aimed to synthesize empirical evidence from 2004–2024 examining screening, intervention, and treatment strategies for SUDs in primary care, focusing on effectiveness, implementation barriers, and treatment outcomes.

Methods: Following PRISMA 2020 guidelines, ten studies were analyzed, including randomized controlled trials, cross-sectional, and implementation studies. Data were extracted on screening tools, intervention types, and patient outcomes. Quality was appraised using the Cochrane Risk of Bias 2 and Newcastle-Ottawa scales.

Results: Studies consistently demonstrated the efficacy of integrated approaches. SBIRT interventions reduced heavy drinking and stimulant use, while recovery management checkups (RMC-PC) enhanced treatment linkage. Technology-supported tools, such as SUSIT, improved provider adherence to screening. Implementation trials like SPARC and PROUD highlighted systemic facilitators of adoption.

Conclusions: Evidence supports embedding structured SUD interventions in primary care to enhance early detection, treatment access, and sustained abstinence. Addressing workforce barriers, policy limitations, and technological integration gaps is crucial for scalability and long-term effectiveness.