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Motivational Interventions May Improve SUD Recovery

A randomized clinical trial in JAMA Network Open found that motivational interventions in emergency room settings may improve outcomes and recovery for substance use disorders (SUD).

On October 21, 2022, JAMA Network Open published the results of a randomized clinical trial on the effects of emergency room motivational interventions on substance use disorders (SUD). Using a cohort of over 300 patients between 18 and 35 from Switzerland, researchers looked at the number of heavy drinking days from one month to one year after a brief motivational intervention, finding improved SUD recovery.

Patients were divided into motivational and control intervention groups. The primary endpoints were the number of heavy drinking days and the prevalence of alcohol-related problems at 1, 3, 6, and 12 months after a motivational intervention.

According to the article, those who were given the motivational intervention were more likely to have fewer heavy drinking days. Specifically, the experimental group had an average of 1.8 fewer heavy drinking days per month than the control group.

Despite the collected data on the impacts of a motivational intervention on the number of heavy drinking days (HDD), the researchers found little correlation between the intervention and other alcohol-related problems.

“Young adults in the brief motivational intervention group might not have decreased their alcohol use overall (weekly drinking amount) but might have changed their drinking pattern to avoid or limit intoxication (HDD). Alternatively, the observed changes in HDD might not have been sufficient to affect related consequences, would have required more time to have this effect, or were not captured by the measures used,” reasoned the researchers in the study.

In addition, the researchers attempted to enroll participants with significant substance use issues in specialized treatment. While only 17 of the 306 trial participants enrolled in specialized treatment, over 75% of those enrolled were a part of the experimental group.

Investigators in the study concluded, “as our ultimate goal is to improve the impact of brief MI through optimization of training and implementation, an important next phase will be to identify treatment effect mediators to better understand intervention mechanisms and moderators to identify patients’ subgroups, particularly benefiting from the intervention. This will allow us to refine the intervention, better tailored to engage young adults into reconsidering their heavy drinking while in the ED with alcohol intoxication and afterward.”

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