A Brief Motivational Intervention in a Trauma Center Did Not Have an Impact on Illicit Substance Use

Alcohol and illicit substance use are associated with traumatic injuries. Trauma center treatment for such injuries may be an opportunity to intervene and reduce further substance use. This study included adults admitted with a traumatic injury to a level 1 trauma center in Texas who had illicit substance use in the last 30 days, measured by self-report or urine drug screen. Participants were randomized to 1 of 3 groups: brief advice (BA), a brief motivational intervention (BMI), or BMI plus telephone booster 4 weeks later (BMI+B). BMI was delivered by trained research staff in a single 30–45 minute face-to-face session. Researchers assessed the mean percentage of days of self-reported abstinence from use of all substances (excluding alcohol) at baseline, 3, 6, 9, and 12 months.

  • During the study period, 5127 admissions were screened; 777 patients met study criteria, 416 agreed to participate, and 395 were included. Of these, 89% completed the 12-month follow-up.
  • Cannabis was the most prevalent substance (88%), followed by cocaine (28%), sedatives (15%), non-medically used prescription opioids (11%), and methamphetamine (9%).
  • All 3 groups reported reductions from baseline in the use of all substances (except alcohol) at all follow-up points, but there were no significant differences between groups.

Comments: This is another study that has failed to find a significant impact of brief intervention on illicit substance use among individuals identified through screening in a health care setting. It is possible that screening and brief advice have some effect, but the more intensive interventions tested so far do not provide additional benefit.

Darius A. Rastegar, MD

Reference: Field CA, Von Sternberg K, Velasquez MM. Randomized trial of screening and brief intervention to reduce injury and substance abuse in an urban level I trauma center. Drug Alcohol Depend. 2020;208:107792.

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