A randomized controlled trial of brief interventions to reduce drug use among adults in a low-income urban emergency department: the<i>Healthi</i>ER You study

Background and Aims Despite their high comorbidity, the effects of brief interventions (BI) to reduce cannabis use, alcohol use and anxiety symptoms have received little empirical attention. The aims of this study were to examine whether a therapist‐delivered BI (TBI) or computer‐guided BI (CBI) to address drug use, alcohol consumption (when relevant) and HIV risk behaviors, relative to enhanced usual care (EUC), was associated with reductions in parallel trajectories of alcohol use, cannabis use and anxiety symptoms, and whether demographic characteristics moderated reductions over time. Design Latent growth curve modeling was used to examine joint trajectories of alcohol use, cannabis use and anxiety symptoms assessed at 3, 6 and 12 months after baseline enrollment. Setting Hurley Medical Center Emergency Department (ED) in Flint, MI, USA. Participants The sample was 780 drug‐using adults (aged 18–60 years; 44% male; 52% black) randomly assigned to receive either a TBI, CBI or EUC through the HealthiER You study. Interventions and comparator ED‐delivered TBI and CBIs involved touchscreen‐delivered and audio‐assisted content. The TBI was administered by a Master's‐level therapist, whereas the CBI was self‐administered using a virtual health counselor. EUC included a review of health resources brochures in the ED. Measurements Assessments of alcohol use (10‐item Alcohol Use Disorders Identification Test), cannabis use (past 30‐day frequency) and anxiety symptoms (Brief Symptom Inventory‐18) occurred at baseline and 3‐, 6‐ and 12‐month follow‐up. Findings TBI, relative to EUC, was associated with significant reductions in cannabis use [B = –0.49, standard error (SE) = 0.20, P < 0.05) and anxiety (B = –0.04, SE = 0.02, P < 0.05), but no main effect for alcohol use. Two of 18 moderation tests were significant: TBI significantly reduced alcohol use among males (B = –0.60, SE = 0.19, P < 0.01) and patients aged 18–25 years in the TBI condition showed significantly greater reductions in cannabis use relative to older patients (B = –0.78, SE = 0.31, P < 0.05). Results for CBI were non‐significant. Conclusions Emergency department‐based therapist‐delivered brief interventions to address drug use, alcohol consumption (when relevant) and HIV risk behaviors may also reduce alcohol use, cannabis use and anxiety over time, accounting for the overlap of these processes.

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“…Both TBI and CBI contributed to fewer cannabis use days compared with EUC. The effects of boosters were non‐significant .…”

Section: Introductionmentioning

confidence: 90%

Therapist and computer‐based brief interventions for drug use within a randomized controlled trial: effects on parallel trajectories of alcohol use, cannabis use and anxiety symptoms

et al. 2019

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“…Data were obtained from a screening survey of a randomized controlled trial examining the efficacy of brief interventions to reduce drug use among adult ED patients (Blow et al, 2017). The study occurred at a Level 1 Trauma Center in Flint, Michigan called Hurley Medical Center (HMC).…”

Section: Methodsmentioning

confidence: 99%

Overdose and adverse drug event experiences among adult patients in the emergency department

Bohnert

Walton

Cunningham

et al. 2018

Addictive Behaviors

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“…In pharmaceutical opioid using patients in the ED with elevated risk for overdose, patients receiving a brief behavioural intervention had decreased overdose risk behaviours 13. Additionally, brief intervention has been used to decrease drug use among patients in the ED 14. However, these studies did not specifically target illicit opioid use and did not combine brief behaviour change counselling with take-home naloxone.…”

Section: Introductionmentioning

confidence: 99%

Impacts of an opioid overdose prevention intervention delivered subsequent to acute care

et al. 2018

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A randomized controlled trial of brief interventions to reduce drug use among adults in a low-income urban emergency department: theHealthiER You study

Abstract: An emergency department-based motivational brief intervention, delivered by a therapist and guided by computer, appears to reduce drug use among adults seeking emergency department care compared with enhanced usual care.

Cited by 60 publications

References 62 publications

Therapist and computer‐based brief interventions for drug use within a randomized controlled trial: effects on parallel trajectories of alcohol use, cannabis use and anxiety symptoms

Therapist and computer‐based brief interventions for drug use within a randomized controlled trial: effects on parallel trajectories of alcohol use, cannabis use and anxiety symptoms

Overdose and adverse drug event experiences among adult patients in the emergency department

Impacts of an opioid overdose prevention intervention delivered subsequent to acute care

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