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Brief motivational intervention at a clinic visit reduces cocaine and heroin use. Drug Alcohol Depend 77: 49-59

Department of Emergency Medicine, Boston University School of Medicine, 818 Harrison St. (Dowling 1), Boston, MA 02118, USA.
Drug and Alcohol Dependence (Impact Factor: 3.42). 02/2005; 77(1):49-59. DOI: 10.1016/j.drugalcdep.2004.07.006
Source: PubMed

ABSTRACT

Brief intervention is effective for alcohol misuse, but not adequately tested in the clinical setting with drug using patients. This study tested the impact of a single, structured encounter targeting cessation of drug use, conducted between peer educators and out-of-treatment cocaine and heroin users screened in the context of a routine medical visit.
A randomized, controlled trial was conducted in inner-city teaching hospital outpatient clinics with 3 and 6 months follow-up by blinded observers. Drug abstinence was documented by RIA hair testing. Analysis was limited to enrollees with drug-positive hair at baseline.
Among 23,669 patients screened 5/98-11/00, 1232 (5%) were eligible, and 1175 enrolled. Enrollees (mean age 38 years) were 29% female, 62% non-hispanic black, 23% hispanic, 46% homeless. Among those with positive hair at entry, the follow-up rate was 82%. The intervention group was more likely to be abstinent than the control group for cocaine alone (22.3% versus 16.9%), heroin alone (40.2% versus 30.6%), and both drugs (17.4% versus 12.8%), with adjusted OR of 1.51-1.57. Cocaine levels in hair were reduced by 29% for the intervention group and only 4% for the control group. Reductions in opiate levels were similar (29% versus 25%).
Brief motivational intervention may help patients achieve abstinence from heroin and cocaine.

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