Brief Motivational Interviewing for Substance Use by Medical Students Is Effective in the Emergency Department

Efficacy of medical student substance use interventions in the emergency department (ED) setting remains unstudied.

In this pilot study, we set out to determine whether medical students could perform a brief motivational interview for substance use in the ED.

At two hospitals, medical students utilized motivational interviewing skills taught by their medical school curriculum and administered a substance use intervention to ED patients who met the study definition of unhealthy substance use.

In 6 weeks, medical students gave a brief intervention to 102 subjects. The mean age of the subjects was 46.9 (standard deviation 15.6) years. The majority, 86 (86.3%) identified as white. Fifty-four (52.9%) identified as male. Eighty of 102 (78.4%) participants completed a phone follow-up assessment. Of the 69 smokers, 11 (15.9%) reported attempting to quit or quitting completely. Of the 33 with high-risk alcohol use, 11 (33.3%) were abstaining completely from alcohol use and an additional 12 (36.4%) reported a decrease in alcohol daily consumption (measured in drinks per day). Warm hand-off success for street drugs or at-risk alcohol use was 13.6% for those who received an intervention.

It is feasible for medical students to perform a substance use intervention in the ED setting. Medical student contributions as a part of the team response to this public health crisis provide an opportunity for further discussion and research.