The American College of Surgeons (ACS) recently established requirements for Level I Trauma Centers to provide screening and brief intervention (SBI) for alcohol problems. The impetus for this mandate was the evidence base supporting the effectiveness of brief alcohol interventions with injured patients on reducing alcohol use, risk of future injury, DUI and cost savings. However, there is a lack of evidence regarding the effectiveness of screening and brief intervention for drug use. In addition, there is little evidence on the effectiveness of drug screening and brief interventions on HIV risk, which is strongly associated with drug use.
This study uses a randomized clinical trial to evaluate the effectiveness of brief advice (BA), brief motivational intervention with feedback (BMI), and brief motivational intervention with feedback and booster (BMI+B) among injured patients with drug problems in the trauma unit at Brackenridge Hospital in Austin, Texas. Brackenridge is the only trauma hospital in Central Texas, and serves a large and diverse patient population. The primary outcome of interest will be subsequent drug use. Other outcomes of interest include: (a) HIV related risk behaviors, (b) improved health outcomes including injury reduction, (c) increased employment, (d) decreased engagement in illegal behavior (e) reduction in increased substance abuse treatment utilization, and (e) increased quality of life at three, six, and twelve month follow-ups. Funding of the proposed study will increase the knowledge base with regard to the effectiveness of brief intervention among injured patients with drug use problems and, thereby, provide the ACS with the necessary evidence base to encourage screening, brief intervention and referral for treatment for drug use problems in the trauma care setting.