Short counseling session in ER can reduce opioid abuse, trial shows

By Stephen Feller  |  April 20, 2016 at 2:17 PM
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ANN ARBOR, Mich., April 20 (UPI) -- Motivational interviews conducted with patients in the emergency room reduced their amount of prescription opioid misuse, as well as the risky behaviors that make them more likely to use the drugs, according to a recent study.

Researchers at the University of Michigan report in the study that just one interview had a dramatic effect on patients identified as being at high risk for misuse or abuse of the drugs.

Motivational interviewing is a therapy technique that has previously been shown to help patients reduce the use of tobacco, drugs and alcohol, as well as to lose weight, but researchers say this is the first time it has been employed to reduce risk of drug overdoses.

Hospital treatment is often where opioid misuse problems begin, based on about half of all emergency room visits involving pain and one-third of patients leaving an emergency room with a prescription for opioids, researchers say.

Misuse and abuse problems have largely been misunderstood by doctors, both experts and doctors say, because of difficulty balancing the need to manage pain while not causing unnecessary long-term dependency on a painkiller.

"This intervention was about reducing risk and harm, not necessarily the amount of use, which may have meant the messages were better-received among those who weren't actively seeking treatment for opioid use," Dr. Amy Bohnert, an assistant professor of psychiatry at the University of Michigan, said in a press release.

For the study, published in the journal Drug and Alcohol Dependence, researchers recruited 204 adult patients who had reported opioid misuse in the previous three months, randomly applying either motivational interviewing by a therapist, along with standard care, or standard educational care alone.

Patients who had a motivational interview reported a 40.5 percent reduction in risky behavior and about a 50 percent decrease in non-medical use of opioids, as opposed to just 14.7 percent reduction in risky behavior for patients with standard educational care and a drop of use by 39.5 percent.

"It's very promising that we see a reduction in risky behavior with this brief, one-time intervention, among people who weren't seeking treatment for their opioid use but had a history of non-medical use of these drugs," Bohnert said. "Further research is needed to understand if this leads to longer term impact on health."

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