The impact of a brief motivational intervention with opiate users attending a methadone programme

Abstract

During the 1980s Motivational Interviewing emerged as one of the memes of the addictions field. This occurred despite the lack of scientific evidence supporting its utility. In this paper findings of a controlled trial of a brief motivational intervention with illicit drug users (n = 122) attending a methadone clinic are reported. Clients who met the study's inclusion criteria were randomly allocated to either a motivational (experimental, n = 57) or educational (control, n = 65) procedure. Over the 6-month follow-up period the motivational subjects demonstrated a greater, immediate, commitment to abstention, reported more positive expected outcomes for abstention, reported fewer opiate-related problems, were initially more contemplative of change, complied with the methadone programme longer and relapsed less quickly than the control group. There was, however, no difference in terms of the severity of reported opiate dependence and the control group fared better on reported self-efficacy. It was concluded that motivational interventions of the type investigated are useful adjuncts to methadone programmes.

Alcohol and Other Drug Use during Pregnancy among Women Attending Midwife Obstetric Units in the Cape Metropole, South Africa

“…Research on brief interventions, addressing alcohol and tobacco use, points to the efficacy of this method for these substances [30–33]. There is, however, growing evidence of the effectiveness of brief interventions for other substances such as opiates [34], amphetamines [35], benzodiazepines [36], and cannabis [37]. Most of this work has focused on the general population; however, brief interventions with pregnant women have also been shown to be effective [38–41].…”

Low theoretical fidelity hinders the research on health coaching for opioid reduction: A systematic review of randomized controlled trials

“…A total of 1,699 studies were identified after removing duplicates ( Fig 1 ). After screening 44 full-text articles, eleven trials met the inclusion criteria and were included in this review [ 26 – 36 ]. Reasons for study exclusion included: other study design (n = 10), interventions failed to meet the definition of health coaching (n = 9), the patient population was under 18 years of age (n = 3), or no relevant outcome was measured (n = 11).…”

“…The eleven trials included in this review were conducted in five countries. Seven studies were conducted in the United States [ 27 – 30 , 32 , 33 , 36 ] while single trials were conducted in Norway [ 34 ], Scotland [ 31 ], Australia [ 26 ], and China [ 35 ] ( S5 Appendix ).…”

“…Participants in the studies were 64.24% male with an average age of 38.23 years. Two studies included patients in receiving methadone treatment [ 26 , 28 ], one study examined opioid usage amongst participants with musculoskeletal disorders [ 30 ], two studies included participants with non-acute health problems [ 27 , 36 ], one study included participants with a prior non-fatal overdose [ 32 ], one study included patients seeking psychiatric care [ 34 ], one study included participants who receive naloxone from a naloxone distribution center [ 32 ], and one study included participants who received prescribed methadone from pharmacists [ 31 ]. Two studies included participants from the emergency department [ 29 , 34 ], four studies included participants from outpatient clinics [ 27 , 30 , 33 , 36 ], and three studies included participants in addiction treatment center [ 26 , 28 , 35 ] ( S5 Appendix ).…”

Treatment Readiness, Attitudes Toward, and Experiences with Methadone and Buprenorphine Maintenance Therapy Among People Who Inject Drugs in Malaysia

“…Brief motivational interventions have been successfully deployed in clinical and community outreach (e.g., NSEP) settings to increase patients’ readiness for treatment (Booth, Kwiatkowski, Iguchi, Pinto, & John, 1998; Kidorf, et al, 2005; Strathdee, et al, 2006). Brief cognitive interventions, while originally tested on individuals with alcohol use disorders (Maisto, et al, 2001; Rollnick, Heather, Gold, & Hall, 1992; Wilk, Jensen, & Havighurst, 1997), have been efficacious in increasing treatment entry for cocaine, heroin and amphetamine users (Baker, Boggs, & Lewin, 2001; Bernstein, et al, 2005; Saunders, Wilkinson, & Phillips, 1995). These sessions consist of a single, structured encounter targeting cessation of drug use conducted by a healthcare professional in a primary care setting.…”