Providing brief addictions treatment in an emergency department: Experiences of University of New Mexico hospital research interventionists in the SMART-ED trial.

Hospital emergency departments (EDs) are receiving increased attention as venues for addiction treatment (Cherpitel et al., 2010; Vaca et al., 2011). Brief interventions in the ED may be effective and economical and reach those who might not seek treatment in traditional addiction treatment settings. However, provision of brief intervention in the ED requires consideration of several factors in order to be implemented successfully. This poster offers the interventionists’ perspectives on the complexities of providing a brief intervention in a medical ED setting. The University of New Mexico Hospital Emergency Department served as one of six sites in the National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN) Screening, Motivational Assessment, Referral and Treatment (SMART-ED) (protocol CTN-0047). Following completion of the active phase of treatment, the interventionists described the unique challenges and lessons learned. Three themes emerged in our exploration of the challenges involved in conducting screening, assessment, and brief intervention using motivational interviewing (MI). (1) Challenges inherent in the nature of the emergency department including patient flow, availability of space, frequent interruptions, privacy and confidentiality, and patient acuity. (2) Maintaining focus on addictions in the face of competing priorities, including medical reasons for ED visit and other psychosocial/ mental health needs. (3) Using MI techniques appropriately during intervention, and not using them during screening and assessment. There are many complexities involved in providing brief addiction intervention in the ED. Understanding and preparing for these challenges is critical to the successful implementation of addiction treatment programs or research aiming to implement brief interventions in this environment.

Related protocols: CTN-0047