title: Brief motivational intervention at a clinic visit reduces cocaine and heroin use.
abstract: 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 out-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 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%).
  
  
  CONCLUSIONS
  Brief motivational intervention may help patients achieve abstinence from heroin and cocaine.
authors.affiliation: Department of Emergency Medicine, Boston University School of Medicine, 818 Harrison St. (Dowling 1), Boston, MA 02118, USA.
authors.forename: Judith
authors.initials: J
authors.lastname: Bernstein
authors.forename: Edward
authors.initials: E
authors.lastname: Bernstein
authors.forename: Katherine
authors.initials: K
authors.lastname: Tassiopoulos
authors.forename: Timothy
authors.initials: T
authors.lastname: Heeren
authors.forename: Suzette
authors.initials: S
authors.lastname: Levenson
authors.forename: Ralph
authors.initials: R
authors.lastname: Hingson
mesh_terms: D000328:Adult; D019970:Cocaine-Related Disorders / Q000517:prevention & control / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006556:Heroin Dependence / Q000517:prevention & control / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010044:Outpatient Clinics, Hospital