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Challenges in motivating treatment enrollment in community syringe exchange participants

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Abstract

Participants of syringe exchange programs (SEPs) exhibit high rates of substance use disorder but remain extremely ambivalent about seeking treatment. This study evaluated the effectiveness of motivational interviewing (MI) for encouraging SEP participants to enroll in substance abuse treatment. New opioid-dependent registrants to the Baltimore Needle Exchange Program (BNEP) (n=302) completed the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), and the Addiction Severity Index (ASI) and were randomly assigned to one of three treatment referral conditions: (1) MI, (2) job readiness (JR) (attention control), or (3) standard referral. Participants in each condition who expressed interest in treatment were referred to a treatment readiness group that provided further encouragement and referral to programs that were accepting new admissions. Participants were observed for 1 year following the intervention. The results showed that 10.9% of study participants enrolled in substance abuse treatment, although no condition effects were observed. White participants and those diagnosed with major depression were most likely to enter treatment. The results suggest that a single motivational interview is insufficient to motivate changes in treatment seeking in this population, whereas the identification of predictors of treatment enrollment is worthy of further investigation.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, 5510 Nathan Shock Drive, Suite 1500, 21224, Baltimore, Maryland

    Michael Kidorf PhD,  Elizabeth Disney,  Van King,  Ken Kolodner &  Robert K. Brooner

  2. Baltimore City Health Department, Baltimore, Maryland

    Peter Beilenson

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  1. Michael Kidorf PhD
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  2. Elizabeth Disney
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  3. Van King
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  4. Ken Kolodner
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  5. Peter Beilenson
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  6. Robert K. Brooner
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Correspondence to Michael Kidorf PhD.

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Kidorf, M., Disney, E., King, V. et al. Challenges in motivating treatment enrollment in community syringe exchange participants. J Urban Health 82, 456–467 (2005). https://doi.org/10.1093/jurban/jti091

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