ER visits offer a ‘teachable moment’ to reduce drug use

Emergency room doctor physician stethoscope scrubs Getty/gordonsaunders
Providers can use brief interventions in the emergency room to help patients begin reducing their drug use. (Photo credit: Getty/gordonsaunders)

A visit to the emergency room can be the springboard that’s needed to help drug-addicted patients reduce their drug use if providers use it as a ‘teachable moment.’

Researchers at the University of Michigan took a group of 780 drug-using ER patients, most of whom were adults in their 30s, and assigned about two-thirds to different interventions designed to encourage them to set goals to reduce their drug use. Some met with a “virtual health counselor” via an app, while others used an app to guide conversations with in-person therapists. The researchers then followed up with the participants at least three times in the year after the initial ER visit.

The participants that met with therapists in person at the ER reported 21% fewer days of drug use after the year, while those that saw a “virtual therapist” saw 16% fewer drug abuse days. The findings, according to the researchers, indicate that types of interventions can work when performed well. The digital solutions were customizable to each participating person’s needs, which likely made the efforts more effective.

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"Our results show that this approach can work if it's done well, and that the perception that people won't change their use based on motivational approaches is nonsense," Frederic Blow, Ph.D., director of the University of Michigan Addiction Center and the study’s lead author, said in an announcement. "The findings especially support engaging computer-based aids that help therapists deliver this brief intervention in a way that tailors it to the individual patient and works with them to make a plan for reducing their substance use."

Blow said that patients who come to the emergency department may be more open to conversations about their drug use and ways they can reduce it. Even the control group saw modest reductions in drug use days, according to the study, likely because they were asked about drug use at the ER and subsequent check-ins.

Blow and the other researchers noted that another area for study is follow-up interventions, as additional meetings with a therapist at later check-ins did not yield significant results. They want to test other tools that may be more effective after the initial ER visit, like peer support or text messaging.