Randomized controlled trial of a brief intervention for problematic prescription drug use in non-treatment-seeking patients

Aims: Dependence on or problematic use of prescription drugs (PD) is estimated to be between 1 and 2% in the general population. In contrast, the proportion of substance-specific treatment in PD use disorders at 0.5% is comparatively low. With an estimated prevalence of 4.7%, PD-specific disorders are widespread in general hospitals compared to the general population. Brief intervention delivered in general hospitals might be useful to promote discontinuation or reduction of problematic prescription drug use. Design: A randomized, controlled clinical trial. Setting: Internal, surgical and gynaecological wards of a general and a university hospital. Participants: One hundred and twenty-six patients fulfilling criteria for either regular use of PD (more than 60 days within the last 3 months) or dependence on or abuse of PD, respectively, were allocated randomly to two conditions. Intervention: Subjects received two counselling sessions based on Motivational Interviewing plus an individualized written feedback (intervention group, IG) or a booklet on health behaviour (control group, CG). Measurements: The outcome was measured as reduction (>25%) and discontinuation of PD intake in terms of defined daily dosages (DDD). Findings: After 3 months, more participants in the IG reduced their DDD compared to the participants in the CG (51.8% versus 30%; χ² = 6.17; P = 0.017). In the IG 17.9%, in the CG 8.6% discontinued use of PD (χ² = 2.42; P = 0.17). Conclusions: Brief intervention based on Motivational Interviewing is effective in reducing PD intake in non-treatment-seeking patients.