Clinical and Laboratory ObservationsA randomized clinical trial of a brief motivational intervention for alcohol-positive adolescents treated in an emergency department
Section snippets
Baseline recruitment
Adolescents 13 to 17 years old inclusive treated in the ED were eligible for the study if they had evidence of alcohol in blood, breath, or saliva (N = 142), or if they reported drinking alcohol in the 6 hours before the injury that required treatment in the ED (N = 10). Patients who were suicidal, were in police custody, did not speak English, or had suffered serious traumatic injury requiring admission were excluded. The study was described to 287 eligible patients, but 134 (47%) declined to
SC condition
This condition was designed to be consistent with general medical practice guidelines for treating alcohol-involved adolescents in an ED setting. Research interventionist contact with physicians was minimal. SC took approximately 5 minutes and included brief advice to stop drinking and a handout on avoiding drinking and driving.
MI condition
The MI protocol included the following 6 components: (1) emphasis on personal responsibility for change and that any decisions made about changing their drinking would
Preliminary analyses
Participants (N = 152) were not significantly different in sex or age from the 134 families approached who did not agree to participate. Further analyses comparing the two conditions (MI vs SC) on demographic variables are presented in Table I. There were no significant differences on any variables including BAC; MI (M = 149.8 mg/dL, SD = 82.5) or SC (M = 129.0 mg/dL, SD = 78.8). There were also no differences at baseline on alcohol measures (Table II). Of the driving age subjects, there was no
Discussion
The major clinical finding of this study was that those who screened positive for potential alcohol problems on the ADI at baseline had significantly lower average number of drinking days per month and high-volume drinking days if they received an MI rather than SC. There was no effect on frequency of intoxication or negative alcohol-related consequences. Nonetheless, the positive effects appear clinically significant with average number of drinking days per month about 4 in the MI group
Acknowledgements
Sincere appreciation is expressed to Cheryl Eaton, MA, for her assistance in data analyses, and William Miller, PhD, and Steven Rollnick, PhD, for training and feedback on this project's Motivational Interviewing protocol.
References (18)
- et al.
Adolescent alcohol use development and young adult outcomes
Drug Alcohol Depend
(1997) - et al.
Age of onset of alcohol use and its association with DSM-IV alcohol abuse and dependence. Results from the National Longitudinal Alcohol Epidemiologic Survey
J Sub Abuse
(1997) - et al.
Risks associated with alcohol-positive status among adolescents in the ED: a matched case-control study
J Pediatr
(2001) - et al.
Informativeness of child and parent reports on substance use disorders in a sample of ADHD probands, control probands, and their siblings
J Am Acad Child Adolesc Psychiatry
(1998) - et al.
Exploring the effects of age and alcohol use initiation and psychosocial risk factors on subsequent alcohol misuse
J Stud Alcohol
(1997) - et al.
Relative effectiveness of comprehensive community programming for drug abuse prevention with high-risk and low-risk adolescents
J Consult Clin Psychol
(1990) - et al.
A comprehensive and comparative review of adolescent substance abuse treatment outcome
Clin Psychol Sci Prac
(2000) Broadening the base of treatment for alcohol problems
(1990)- et al.
Predictors of motivation to change after medical treatment for drinking-related events in adolescents
Psychol Addict Behav
(2002)
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Supported by grant number AA09892 from the National Institute on Alcohol Abuse and Alcoholism.