Brief MI in Emergency Rooms Reduces Problem Drinking in Young Adults
American adults aged 18 to 25 years have the highest rates of alcohol consumption, problem drinking, and alcohol-related traumatic fatalities. In this study, researchers sought to determine whether a brief motivational interview in the emergency department could reduce drinking and subsequent harm.
They randomized 198 young-adult, emergency-department patients with a positive alcohol screen* to receive either (1) a session of motivational interviewing (MI) with a counselor that included personalized written feedback or (2) feedback only. Both groups received a booster telephone call 1 and 3 months later.
At the 12-month follow-up (81% response rate) and in adjusted analyses, the MI group, compared with the feedback only group,
- drank on fewer days in the past month (4.5 versus 6.5);
- had fewer heavy drinking days (≥5 drinks in a day for men, ≥4 for women) in the past month (2.7 versus 3.5);
- drank fewer drinks per week in the past month (6.1 versus 8.8).
Both groups had fewer driving violations and alcohol-related injuries, and were more likely to seek alcohol treatment at follow-up. However, no differences between groups were detected.
“Near misses” and other nonfatal events that lead young people to seek emergency care represent “teachable moments” that could lead to lasting behavioral change. Without a no-intervention control group, this study could not determine whether these low-intensity interventions reduced harms beyond the assessments or the events themselves; therefore, the findings beg replication. However, brief counseling appeared to have helped young adults to reduce their drinking. Insofar as reduced problem drinking is a worthwhile goal for young people, these findings suggest that recent mandates for brief interventions in trauma centers merit consideration for young adults in other emergency settings.Peter D. Friedmann, MD, MPH
*Blood alcohol concentration of >0.01%, reported drinking alcohol in the 6 hours before the event that caused their visit, or a score of ≥8 on the Alcohol Use Disorders Identification Test
Monti PM, Barnett NP, Colby SM et al. Motivational interviewing versus feedback only in emergency care for young adult problem drinking. Addiction. 2007;102(8):1234–1243.