Brief motivational interviewing interventions targeting substance abuse in the acute care medical setting.

Nearly half of injured trauma survivors suffer from substance use disorders, particularly alcohol and stimulants. Substance abuse screenings and brief interventions are essential components of collaborative care for trauma patients. If provided by trauma centers, brief interventions can reduce drinking and injury recidivism for up to 1 year after hospital discharge. First, this report explains the rationale for such a service as well as the theoretical underpinnings of brief behavior change interventions. Next, a literature review is presented regarding the outcomes of brief interventions for substance abuse, both in general medical settings and in trauma centers. Finally, a description is provided of a level 1 trauma center's screening and brief intervention service that uses motivational interviewing, has developed over a decade, and has been evaluated in a randomized trial. The inpatient and outpatient intervention protocols for this service are detailed, as well as the specific clinical challenges encountered. Copyright 2003 Elsevier Inc. All rights reserved.