Although screening, brief intervention, and referral to treatment (SBIRT) approaches are effective in reducing alcohol misuse and its associated risk-taking behaviors and negative consequences, there is little research demonstrating the effectiveness of SBIRT for illicit and/or prescription drug misuse. Misusers of illicit and/or prescription drugs frequently seek medical care in emergency departments (EDs), particularly for reasons related to their misuse. As a result, the ED is well suited as a site to conduct an analysis of the effectiveness of SBIRT for this population. The Brief Intervention for Drug Misuse for the Emergency Department (BIDMED) study is a randomized, controlled, trial that will include adult ED patients at a large, academic, trauma center (Rhode Island Hospital) and a community hospital (The Miriam Hospital) who have a subcritical illness or injury and whose screening indicates illicit and/or prescription drug misuse. BIDMED participants will be randomized to receive screening only (SO) or brief intervention (BI) with appropriate referral to treatment. Participants will complete a battery of blinded baseline assessments using standardized instruments as well as adapted instruments specific to the aims of this study. All participants will undergo blinded follow-up assessments at three, six, and twelve months post-randomization. The primary hypotheses addressed in the BIDMED study are that, compared to participants in the SO arm, participants in the BI arm will show a significantly greater reduction in: (1) drug misuse within the prior 30 days at three months post-randomization, (2) behaviors associated with drug misuse at six months post-randomization;and (3) negative physical health, psychosocial health, and socioeconomic consequences at twelve months post-randomization. As a secondary aim, the impact of BI compared to SO will be assessed on participants contacting, enrolling in, and completing a drug treatment program. In addition, the impact of BI compared to SO on increasing uptake of HIV and hepatitis B/C screening will be measured. A mechanisms of change model that addresses the expected mediators and moderators of change to explain the effects of SBIRT in this setting will also be developed and tested. Further, the epidemiology of illicit and/or prescription drug misuse will be assessed in a random sample of ED patients.

Public Health Relevance

Given the intersection of emergency medical care and drug misuse, the ED could serve as a significant contributor in reducing the public health problem of drug misuse if SBIRT is shown to be effective for this population. SBIRT in the ED for drug misuse has the potential for reaching people during a teachable moment during an ED visit that might be related to drug misuse.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Research Project (R01)
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Special Emphasis Panel (ZDA1-JXR-D (12))
Program Officer
Aklin, Will
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Rhode Island Hospital
United States
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Merchant, Roland C; Romanoff, Justin; Zhang, Zihao et al. (2017) Impact of a brief intervention on reducing alcohol use and increasing alcohol treatment services utilization among alcohol- and drug-using adult emergency department patients. Alcohol 65:71-80
Merchant, Roland C; Baird, Janette R; Liu, Tao (2015) Short-term Efficacy of a Brief Intervention to Reduce Drug Misuse and Increase Drug Treatment Utilization Among Adult Emergency Department Patients. Acad Emerg Med 22:1172-80
Beaudoin, Francesca L; Baird, Janette; Liu, Tao et al. (2015) Sex Differences in Substance Use Among Adult Emergency Department Patients: Prevalence, Severity, and Need for Intervention. Acad Emerg Med 22:1307-15
Guan, Wentao; Liu, Tao; Baird, Janette R et al. (2015) Evaluation of a brief intervention to reduce the negative consequences of drug misuse among adult emergency department patients. Drug Alcohol Depend 157:44-53
Merchant, Roland C; DeLong, Allison K; Liu, Tao et al. (2015) Factors Influencing Uptake of Rapid HIV and Hepatitis C Screening Among Drug Misusing Adult Emergency Department Patients: Implications for Future HIV/HCV Screening Interventions. AIDS Behav 19:2025-35
Bernardino, Vera L; Baird, Janette R; Liu, Tao et al. (2014) Comparison of substance-use prevalence among Rhode Island and The Miriam Hospital Emergency Department patients to state and national general population prevalence estimates. R I Med J (2013) 98:30-4
Merchant, Roland C; Baird, Janette R; Liu, Tao et al. (2014) HCV among The Miriam Hospital and Rhode Island Hospital Adult ED Patients. R I Med J (2013) 97:35-9
Trillo, Alexis D; Merchant, Roland C; Baird, Janette R et al. (2013) Interrelationship of alcohol misuse, HIV sexual risk and HIV screening uptake among emergency department patients. BMC Emerg Med 13:9
Trillo, Alexis D; Merchant, Roland C; Baird, Janette R et al. (2012) Sex differences in alcohol misuse and estimated blood alcohol concentrations among emergency department patients: implications for brief interventions. Acad Emerg Med 19:924-33