Services Interventions for Injured ED Problem Drinkers

This study will compare three alternative interventions in the ED to promote substance abuse assessment, referral, and treatment entry: 1) a 5 session strengths-based case management model (SBCM); 2) a 2-session motivational enhancement therapy (MET); or 3) a one-time brief informational feedback (BIF) session. The primary outcome variables for this trial include follow-through on receiving an assessment and referral, treatment engagement, degree of treatment completion, alcohol-related measures, healt service utilization, health status changes, and psychosocial factors.

• Behavioral: Strengths Based Case Management
• Behavioral: Motivational Enhancement Therapy
• Behavioral: Brief Informational Feedback

Inclusion Criteria:

• (1) adults age 18 and over presenting to the Emergency Department at Hurley Medical Center within 24 hours of an injury; (2) ability to provide informed consent.

For intervention portion of the project: (1) meets DSM-IV criteria for alcohol abuse or dependence in the following year. (Patients who meet abuse/dependence criteria for alcohol may also be using other drugs. They will be included in the study ONLY if they do not meet criteria for past year drug abuse/dependence).

Exclusion Criteria:

• (1) adult patients who do not understand English; (2) prisoners; (3) pregnant women; (4) institutionalized patients (e.g. nursing home residents); (5) adults classified by medical staff as "Level 1 trauma"; (6) adults deemed unable to provide informed consent (e.g. intoxication, mental incompetence, under guardianship); (7) patients treated in the ED for suicide attempts and sexual assault; (8) patients meeting past year drug abuse/dependence criteria; and (9) patients who have been in treatment for alcohol or other drug abuse/dependence in the previous year.