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 1026 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.

Trial registration: ClinicalTrials.gov NCT01124591.

Keywords: Adult; Emergency medical services/methods; Emergency service; Motivational interviewing; Substance-related disorders/therapy; Treatment outcome.

Conflict of interest statement

Conflict of Interest

No conflict declared

Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Figures

Fig. 1

Enrollment and follow-up during the Brief Intervention for Drug Misuse in the Emergency Department (BIDMED) study

Fig. 2

Changes and differences in the Inventory of Drug Use Consequences (InDUC) scores overtime (unadjusted data)