As addiction professionals and lawmakers across the United States continue to wage war against prescription medications, a new study suggests that a therapy technique called Motivational Interviewing can be an inexpensive way to cut risky use of these drugs by people who have a high chance of overdosing.
What is Motivational Interviewing?
Motivational Interviewing is a brief intervention that helps people understand the risks that accompany drug use as well as factors that can increase that risk, such as drinking alcohol or taking certain other drugs while they are on pain medications. This therapy goes beyond merely educating people on the dangers of drug use, but utilizes techniques that are designed to help individuals increase their desire and commitment to changing their behavior and making different choices than before. Additionally, with Motivational Interviewing, people are able to focus on what they need to do in order to reach the goals that they lay out for themselves.
According to a 2016 study conducted by the University of Michigan, results from a six-month study show that using Motivational Interviewing during a patient's stay in an emergency room setting can reduce the likelihood of addiction to pain medications. Lead researcher Amy Bohnert M.C., an Assistant Professor of Psychiatry in UM-Medical School and member of the VA Center for Clinical Management Research, and her associates screened more than 2,700 emergency patients that came through an emergency care facility that served patients from urban, suburban and rural areas of southeast Michigan.
This setting was chosen for the research due to the fact that nearly one-third of emergency room patients in the United States receive treatment with prescription painkillers. Another recent study has also found this environment conducive to providing a “teachable moment” during a health crisis, which has been thought to be valuable for changing behavior.
The age range of those who were screened between the ages of 18 and 60, which are the peak years for opioid misuse and overdoses. Of the 2,700 people screened, 206 became part of the study after they answered a questionnaire in which they stated they took prescription pain medication for non-medical reasons. Within this group, two-thirds had a prescription for painkillers in the last six months.
The subjects were then split into two groups. One group received the usual emergency room care, and also received brochures about how to prevent or respond to overdoses as well as other resources. The other group took part in a motivational interviewing session with a trained therapist in addition to receiving these resources that were provided to the other group.
The researchers then followed up with all the patients six months later. Most of the 206 people who took part in both groups agreed to fill out a follow-up survey.
The results of the survey showed those who went through a motivational interview session had over a 40 percent reduction in behaviors that raised their risk of an overdose on average, compared with a 14.7 percent reduction among those who didn't get the session. Additionally, those who underwent motivational interviewing as part of emergency room treatment also had a 50 percent average reduction in non-medical use of opioids, compared with 39.5 percent reduction in the comparison group.
Researchers noted that motivational interviewing techniques were effective in this study due to the fact that the intervention focuses on reducing harm and risk, and therefore was more well-received by patients. The results of this current study are encouraging in regards to finding effective, yet inexpensive ways to curb painkiller abuse—especially in an ER setting. “It’s very promising that we see a reduction in risky behavior with this brief, one-time intervention, among people who weren’t seeking treatment for their opioid use but had a history of non-medical use of these drugs,” Bohnert states. “Further research is needed to understand if this leads to longer term impact on health.” Since this study was a pilot project, researchers now hope that they can launch a larger study to further look into the effectiveness of motivational interviewing.