Challenges in Motivating Treatment Enrollment in Community Syringe Exchange Participants

While participants in needle-exchange programs exhibit high rates of substance abuse disorder, they remain very ambivalent about seeking treatment. In the current study, researchers evaluated the effectiveness of motivational interviewing (MI) for encouraging needle-exchange program participants to enroll in programs for substance abuse treatment.

In the Baltimore Needle Exchange Program, 302 new opioid-dependent registrants completed the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (fourth edition), and the Addiction Severity Index. The participants were randomly assigned to one of the following: MI; job readiness (attention control); or standard referral. In each of the three conditions, participants who expressed an interest in treatment were referred to a treatment readiness group that offered encouragement and provided referrals to programs that were accepting new admissions.

Researchers tracked the participants for one year following the intervention. While follow-up found that 10.9 percent of study participants were enrolled in treatment for substance abuse, no condition effects were observed. Among those most likely to enter treatment were white patients and those diagnosed with major depression. The results suggest that although a single motivational interview is insufficient to motivate this population to seek treatment, identifying the predictors of treatment enrollment merits further investigation.

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