Improving substance abuse treatment enrollment in community syringe exchangers.
OBJECTIVE
The present study evaluated the effectiveness of an intervention combining motivational enhancement and treatment readiness groups, with and without monetary incentives for attendance and treatment enrollment, on enhancing rates of substance abuse treatment entry among new registrants at the Baltimore Needle Exchange Program (BNEP).


METHODS
Opioid-dependent study participants (n = 281) referred by the BNEP were assigned randomly to one of three referral interventions: (i) eight individual motivational enhancement sessions and 16 treatment readiness group sessions (motivated referral condition--MRC); (ii) the MRC intervention with monetary incentives for attending sessions and enrolling in treatment--MRC+I); or (iii) a standard referral condition which directed participants back to the BNEP for referral (standard referral-SRC). Participants were followed for 4 months.


RESULTS
MRC+I participants were more likely to enroll in any type of treatment than MRC or SRC participants (52.1% versus 31.9% versus 35.5%; chi(2) = 9.12, P = 0.01), and more likely to enroll in treatment including methadone than MRC or SRC participants (40.4% versus 20.2% versus 16.1%; chi(2) = 16.65, P < 0.001). MRC+I participants also reported less heroin and injection use than MRC and SRC participants.


CONCLUSIONS
Syringe exchange sites can be effective platforms to motivate opioid users to enroll in substance abuse treatment and ultimately reduce drug use and number of drug injections.
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA. mkidorf@jhmi.edu
Michael
M
Kidorf
Van L
VL
King
Karin
K
Neufeld
Jessica
J
Peirce
Ken
K
Kolodner
Robert K
RK
Brooner
D000328:Adult; D015142:Baltimore / Q000453:epidemiology; D055030:Drug Users; D005260:Female; D040261:Harm Reduction; D006801:Humans; D008297:Male; D009042:Motivation; D018671:Needle-Exchange Programs / Q000458:organization & administration*; D009293:Opioid-Related Disorders / Q000628:therapy*; D012201:Reward; D016320:Substance Abuse Treatment Centers / Q000458:organization & administration*; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000628:therapy*