CoChat
Sign Up
Cited by 118Substance Abuse Treatment and OutcomesOpioid Use Disorder TreatmentEmergency and Acute Care Studies

Brief Intervention for Patients With Problematic Drug Use Presenting in Emergency Departments: A Randomized Clinical Trial

Open access
Bogenschutz, Michael P., Donovan, Dennis M., Mandler, Raul N., Perl, Harold I., Forcehimes, Alyssa A., Crandall, Cameron, Lindblad, Robert, Oden, Neal L. +6 more·2014·JAMA Internal Medicine
DOI 10.1001/jamainternmed.2014.4052PMC PMC4238921
Open this paper in CoChat — free account

Abstract

IMPORTANCE: Medical treatment settings such as emergency departments (EDs) present important opportunities to address problematic substance use. Currently, EDs do not typically intervene beyond acute medical stabilization. OBJECTIVE: To contrast the effects of a brief intervention with telephone boosters (BI-B) with those of screening, assessment, and referral to treatment (SAR) and minimal screening only (MSO) among drug-using ED patients. DESIGN, SETTING, AND PARTICIPANTS: Between October 2010 and February 2012, 1285 adult ED patients from 6 US academic hospitals, who scored 3 or greater on the 10-item Drug Abuse Screening Test (indicating moderate to severe problems related to drug use) and who were currently using drugs, were randomized to MSO (n = 431), SAR (n = 427), or BI-B (n = 427). Follow-up assessments were conducted at 3, 6, and 12 months by blinded interviewers. INTERVENTIONS: Following screening, MSO participants received only an informational pamphlet. The SAR participants received assessment plus referral to addiction treatment if indicated, and the BI-B participants received assessment and referral as in SAR, plus a manual-guided counseling session based on motivational interviewing principles and up to 2 "booster" sessions by telephone during the month following the ED visit. MAIN OUTCOMES AND MEASURES: Outcomes evaluated at follow-up visits included self-reported days using the patient-defined primary problem drug, days using any drug, days of heavy drinking, and drug use based on analysis of hair samples. The primary outcome was self-reported days of use of the patient-defined primary problem drug during the 30-day period preceding the 3-month follow-up. RESULTS: Follow-up rates were 89%, 86%, and 81% at 3, 6, and 12 months, respectively. For the primary outcome, estimated differences in number of days of use (95% CI) were as follows: MSO vs BI-B, 0.72 (-0.80 to 2.24), P (adjusted) = .57; SAR vs BI-B, 0.70 (-0.83 to 2.23), P (adjusted) = .57; SAR vs MSO, -0.02 (-1.53 to 1.50), P (adjusted) = .98. There were no significant differences between groups in self-reported days using the primary drug, days using any drug, or heavy drinking days at 3, 6, or 12 months. At the 3-month follow-up, participants in the SAR group had a higher rate of hair samples positive for their primary drug of abuse (265 of 280 [95%]) than did participants in the MSO group (253 of 287 [88%]) or the BI-B group (244 of 275 [89%]). Hair analysis differences between groups at other time points were not significant. CONCLUSIONS AND RELEVANCE: In this sample of drug users seeking emergency medical treatment, a relatively robust brief intervention did not improve substance use outcomes. More work is needed to determine how drug use disorders may be addressed effectively in the ED. TRIAL REGISTRATION: clinicaltrials.gov Identifier:NCT01207791.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1001/jamainternmed.2014.4052

Cites

26 of 26 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Bogenschutz, M. P., Donovan, D. M., Mandler, R. N., Perl, H. I., Forcehimes, A. A., Crandall, C., Lindblad, R., Oden, N. L., Sharma, G., Metsch, L., Lyons, M. S., McCormack, R., Konstantopoulos, W. M., & Douaihy, A.
Affiliations
  • University of New Mexico (US)
  • University of Washington (US)
  • National Institute on Drug Abuse, Bethesda, Maryland
  • National Institute on Drug Abuse (US)
  • University of New Mexico Health Sciences Center (US)
  • Emmes (United States) (US)
  • University of Miami (US)
  • University of Cincinnati (US)
  • New York University (US)
  • Department of Emergency Medicine, Massachusetts General Hospital, Boston12Harvard Medical School, Boston, Massachusetts
  • University of Pittsburgh (US)
Corresponding author
Bogenschutz, Michael P.
ORCID
Venue
JAMA Internal Medicine
Publisher
American Medical Association (AMA)
Published
2014-11-01
Volume
174
Issue
11
Pages
1736
ISSN
2168-6106 (ISSN-L)
DOI
10.1001/jamainternmed.2014.4052
PMC
PMC4238921
OpenAlex
W2171651771
Cited by
118
References
25
Citations by year
2026: 1 · 2025: 3 · 2024: 10 · 2023: 4 · 2022: 8 · 2021: 7 · 2020: 10 · 2019: 15 · 2018: 10 · 2017: 21 · 2016: 14 · 2015: 13 · 2014: 1
FWCI
12.37
Type
journal article
Language
en
Open access
Locations
  • JAMA Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (5u10da020036-10)
  • National Institute on Drug Abuse (U10DA013720, U10DA013035, K24DA022412, U10DA013046, U10DA013732, U10-DA020036, U10DA013714, HHSN271200900034C, U10DA015831, U10DA015833, UG1DA013714)
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
Keywords
brief intervention, problematic drug use, emergency department patients, motivational interviewing, screening and referral, Drug Abuse Screening Test, substance use outcomes, heavy drinking, hair analysis, primary care follow-up, substance use disorder treatment access, treatment engagement, treatment completion, treatment discontinuation
MeSH terms
Adult, Emergency Medical Services, Emergency Service, Hospital, Female, Hair, Humans, Male, Middle Aged, Referral and Consultation, Treatment Outcome, Substance-Related Disorders, Needs Assessment, Young Adult, Motivational Interviewing

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review