Brief ED interventions may reduce alcohol and marijuana abuse

By Stephanie Leveene, medwireNews Reporter

Identifying emergency department (ED) patients who may be at high risk for alcohol and/or marijuana misuse may help reduce binge drinking and conjoint alcohol and marijuana consumption.

This could be achieved by offering a brief therapeutic intervention (BI) in the ED setting, results from the Project REDUCE program show.

The program determined the effectiveness of a face-to-face BI given to patients in the ED who reported both alcohol and marijuana use compared with patients who received an assessment only and standard emergency medical care.

The findings are reported by Robert Woolard (Texas Tech University Health Sciences Center, El Paso, USA) and colleagues in Addictive Behaviors. Patients in the BI group had significantly lower binge-drinking rates and significant reductions in conjoint alcohol and marijuana at both 3 and 12 months after treatment.

Patients randomly assigned to receive the BI attended two sessions. In the first session, the interviewers engaged the patients in reflecting upon the pros and cons of alcohol and marijuana use, provided direct feedback, and developed a change plan; in the second session, the change plan was reviewed and reinforced.

Overall negative consequences and the negative consequences associated with alcohol and marijuana use significantly decreased from baseline to 3 months and from 3 months to 12 months in the patients. However, there was no significant difference in outcomes between the two patient groups; rates of injury related to alcohol and marijuana use decreased in all patients.

Woolard and colleagues say they are encouraged by the reduction in binge drinking. However, they speculate that study participants "considered binge drinking more problematic and focused their efforts on reducing this behavior. Similarly, it may be that social and peer support for the participant favor changing binge drinking rather than moderating overall levels of alcohol or marijuana use."

The authors note that they excluded patients who were critically ill or injured or who required hospital admission. Also, nearly two-thirds of those they asked to participate in the project declined, so these results may be that of a specific, partially self-selected group.

Nevertheless, the authors conclude that " identifying high-risk patients in the ED by asking them about their alcohol and marijuana use and offering BI should be encouraged."

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