Brief motivational intervention at a clinic visit reduces cocaine and heroin use

Background: 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 ow-of-treatment cocaine and heroin users screened in the context of a routine medical visit. Methods: 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. Results: 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 M.. 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%),, vith 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%). Conclusions: Brief motivational intervention may help patients achieve abstinence from heroin and cocaine. (C) 2004 Elsevier Ireland Ltd. All rights reserved.