Brief MI in Emergency Rooms Reduces Problem Drinking in Young Adults

Brief MI in Emergency Rooms Reduces Problem Drinking in Young Adults
January 2008

Research Summary and Comments

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 studied whether a brief motivational interview (MI) in the emergency department could reduce drinking and later harm.

Researchers randomized 198 young-adult, emergency-department patients with a positive alcohol screen* to receive either (1) an MI session 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, the MI group (versus the feedback only group),

drank on fewer days in the past month (5 versus 7);
had fewer heavy drinking days (≥5 drinks in a day for men, ≥4 for women) in the past month (3 versus 4);
drank fewer drinks per week in the past month (6 versus 9).

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.

*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.

Comments by James Harrison, MHS, CADC:
This study highlights the need for early recognition of problem drinkers and emphasizes the effectiveness of brief motivational interviewing in the emergency-department setting. Each admission suspected to be alcohol-related should be treated as an opportunity to reduce drinking and prevent further harm among young adults. To achieve these outcomes, treatment counselors should consider offering brief motivational interviewing and follow-up.

Comments by Peter D. Friedmann, MD, MPH, Associate Editor of Alcohol, Other Drugs, and Health: Current Evidence:
“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.

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.

This summary and the physician's comments were adapted/reproduced from text previously published in Alcohol, Other Drugs, and Health: Current Evidence.