Evaluation of a brief intervention to reduce the negative consequences of drug misuse among adult emergency department patients

Abstract

Objectives Determine if a brief intervention (BI) reduces the negative consequences of drug use/misuse among adult emergency department (ED) patients, and identify patients more likely to benefit from the BI. Methods This randomized, controlled trial enrolled 1,026 18–64 year-old ED patients whose drug misuse indicated a needed for a BI. Differences in total Inventory of Drug Use Consequences (InDUC) scores between the treatment (BI) and control arms (no BI) were assessed every 90 days over a one-year period. Regression models were constructed to identify demographic and clinical factors associated with greater reductions in total InDUC scores. Results Although total InDUC scores decreased for both the treatment and control arms, there were no differences in scores between the treatment and the control arms at baseline at each follow-up. In the regression analyses, participants who were not using drugs or received drug treatment in the past 90 days generally had lower InDUC scores at each follow-up. Conclusions Although negative consequences decreased in both study arms over time, receiving a BI did not lead to a greater reduction in the negative consequences of drug misuse than not receiving a BI. Of importance in the design of future ED drug misuse interventions, participants who were successful in stopping their drug misuse or receiving drug treatment did show fewer negative consequences of drug use/misuse.

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

“…Drug‐focused SBIRTs delivered in primary care settings have mixed results. While some studies have not been shown to affect drug use significantly , a recent study of a drug‐focused, primary care‐delivered SBIRT found a significant decrease in the use of psychoactive drug use .…”

Project Save Lives: Rapid treatment protocol using peer recovery specialists in the emergency department

“…There have been numerous studies in the use of naloxone, both in the community and in the ED and its effectiveness in the reversal of respiratory depression [15][16][17][18] but that is only the fi rst step in addressing major harm from opioid addiction. Additionally, there have been a few studies that show brief intervention/ counseling of patients who self-report opioid addiction or misuse in the ED resulting in the reduction of opioid overdose risk behaviors [19][20][21]…”

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

“…The efficacy of SBIRT in health‐care settings, including the ED, however, has been mixed. Prior studies have supported the efficacy of alcohol brief interventions (BI) , although BIs targeting drug use have yielded inconsistent results and the inclusion of boosters has shown no effect . Further, the impact of alcohol and drug BIs on comorbid mental health problems (e.g.…”

“…Alcohol and drug misuse quadruple the risk of emergency department (ED) injury-related admissions world-wide [1,2]. Thus, the ED provides an invaluable setting for use have yielded inconsistent results [6][7][8][9][10][11] and the inclusion of boosters has shown no effect [12,13]. Further, the impact of alcohol and drug BIs on comorbid mental health problems (e.g.…”