• Amy S B Bohnert, Erin E Bonar, Rebecca Cunningham, Mark K Greenwald, Laura Thomas, Stephen Chermack, Frederic C Blow, and Maureen Walton.
• Department of Psychiatry, University of Michigan Medical School, 4250 Plymouth Rd., Ann Arbor, MI 48109, USA; VA Center for Clinical Management Research (CCMR), Department of Veterans Affairs Healthcare System, 2800 Plymouth Rd., Bldg. 16, Ann Arbor, MI 48109, USA; University of Michigan Injury Center, University of Michigan Medical School, 2800 Plymouth Rd., Bldg. 10, Ann Arbor, MI 48109, USA; Institute for Healthcare Policy and Innovation, University of Michigan, 2800 Plymouth Rd., Bldg. 16, Ann Arbor, MI 48109, USA. Electronic address: amybohne@med.umich.edu.
• Drug Alcohol Depend. 2016 Jun 1; 163: 40-7.

Background And AimsPrescription opioid overdose is a significant public health problem. Interventions to prevent overdose risk behaviors among high-risk patients are lacking. This study examined the impact of a motivational intervention to reduce opioid misuse and overdose risk behaviors.MethodsThis study was a pilot randomized controlled trial set in a single emergency department (ED) in which, 204 adult, English-speaking patients seeking care who reported prescription opioid misuse during the prior 3 months were recruited. Patients were randomized to either the intervention, a 30-minute motivational interviewing-based session delivered by a therapist plus educational enhanced usual care (EUC), or EUC alone. Participants completed self-reported surveys at baseline and 6 months post-baseline (87% retention rate) to measure the primary outcomes of overdose risk behaviors and the secondary outcome of non-medical opioid use.FindingsParticipants in the intervention condition reported significantly lower levels of overdose risk behaviors (incidence rate ratio [IRR]=0.72, 95% CI: 0.59-0.87; 40.5% reduction in mean vs. 14.7%) and lower levels of non-medical opioid use (IRR=0.81, 95% CI: 0.70-0.92; 50.0% reduction in mean vs. 39.5%) at follow-up compared to the EUC condition.ConclusionsThis study represents the first clinical trial of a behavioral intervention to reduce overdose risk. Results indicate that this single motivational enhancement session reduced prescription opioid overdose risk behaviors, including opioid misuse, among adult patients in the ED.Published by Elsevier Ireland Ltd.

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