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.

Comments:

“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

Reference:

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.