Medical Office Intervention for Adolescent Drug Use
Condition: Substance-Related Disorders
MeSH terms: Substance-Related Disorders
Study type: Interventional
Phase: Phase 2

Summary: 
      The goal of this study is to assess the efficacy of a new intervention based on motivational
      enhancement therapy among adolescents with a history of substance use.
    

Detailed description: 
      In many parts of the U.S. adolescent substance abuse treatment is scarce. Several studies
      have shown that brief interventions increase the likelihood of patients' completion of
      referrals to alcohol counseling or treatment. Other studies have shown a direct effect of
      brief interventions on patients' alcohol consumption. Although brief interventions have been
      widely recommended for adolescents, fewer studies have been conducted in this age group. If
      the current study confirms the effectiveness of the Motivational Enhancement Therapy
      approach, this will add another outpatient treatment option for adolescent patients with drug
      problems.

      The specific aims of the project are to:

        1. Test the effect of the brief intervention on drug use. We hypothesize that, among 12-18
           year old medical patients who use drugs, the experimental intervention (two 60-minute
           motivational interviewing sessions) administered by a trained clinician will be at least
           25% more effective than "standard care" (assessment/referral only) in decreasing drug
           use as measured by a 90-day Timeline Followback (6) (TLFB) calendar.

        2. Test the effect of the brief intervention in increasing engagement in substance abuse
           treatment. We hypothesize that, among 12-18 year old patients who are referred to drug
           counseling or other treatments, the experimental intervention administered by a trained
           clinician will result in at least 25% more patients entering treatment compared to
           standard care, as measured by the numbers of patients who complete referrals to
           treatment providers.

        3. Test the effect of the intervention on other substance-related outcomes. We hypothesize
           that the intervention will result in similar reductions in alcohol use, as measured by
           the TLFB, and in driving/riding while impaired (DRWI) risks as measured by the score of
           a 4-item self-reported scale. Other outcomes of interest include readiness to change,
           school performance, and experience of other harmful consequences of substance use and
           associated risk behaviors.

        4. Identify factors that moderate and/or mediate the effect of the experimental
           intervention on our outcomes of interest (drug use, engagement in treatment), and
           estimate their effect sizes. Identifying moderating variables will help us to identify
           subgroups of optimal responders to the brief intervention. Based on our previous
           experience, we theorize that girls may respond more strongly to the intervention than
           boys, and that those who participate in other treatments (outpatient counseling) and/or
           a laboratory drug testing program will also have greater response.
    

Intervention name(s): Motivational Enhancement Therapy
Intervention type(s): Behavioral
Intervention description(s): Three 60 minute counseling sessions using a structured, developmentally appropriate approach to identification of drug- and alcohol- related risks and problems, and establishment of goals for behavioral change.
Other intervention name(s): MET
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Substance use disorders; Substance abuse; Alcohol abuse; Drug abuse