Hazardous Drinking in Young Adults: Personal Characteristics Can Help Identify Effective Interventions

Young adults whose drinking lands them in the emergency room respond differently to different interventions to reduce their hazardous drinking, and those differences may be driven by certain personal characteristics. In a study published in Alcohol: Clinical and Experimental Research, researchers found that older people with greater severity and acknowledgment of alcohol problems tended to benefit more than others from brief motivational interviewing. Less intensive interventions showed greater benefit to some younger people. The findings may help identify and tailor cost-effective treatment for young adults at high risk for hazardous drinking.

The study identified personal characteristics associated with reduced heavy drinking days following two different interventions to address alcohol use. ‘Brief advice’ provides information about alcohol risks and recommendations to reduce alcohol consumption. ‘Brief motivational interviewing’ is a more intensive intervention, employing empathic, collaborative counseling to help someone find motivation to change behavior. In this study, on average, the brief motivational interviewing protocol took almost 40 minutes and included follow-up sessions one week, one month, and three months after the initial session, while the brief advice intervention was less than four minutes long with no follow-up. Psychologists trained in motivational interviewing conducted both interventions.

Older young adults who scored higher for alcohol use disorder severity and recognized the need to change but were not confident they could change seemed to benefit most from brief motivational interviewing. Those who fit this profile and had higher depression and anxiety levels reported greater short-term benefits from brief motivational interviewing–two fewer heavy drinking days in the first month than those who received brief advice but did not sustain the benefit at 12 months. Those without depression and anxiety reaped longer-term benefits from brief motivational interviewing, reporting lower levels of heavy drinking at one month and one year compared to those who received brief advice.

Younger study participants who had lower severity of alcohol use disorder and did not consider their alcohol use problematic generally seemed to benefit more from brief advice than those older and recognized they had a problem. Those who fit this profile and received brief advice reported three fewer heavy drinking days per month than those who received brief motivational interviewing.

Data came from a study of three hundred 18- to 35-year-olds who presented to a Swiss hospital emergency room with alcohol intoxication between 2016 and 2019. Participants were randomly assigned to receive brief motivational interviewing or brief advice addressing their alcohol use. Subsequently, they periodically reported the number of days they drank heavily, defined as more than 60 grams of pure alcohol–roughly more than four standard U.S. drinks–in one day.

The study authors suggest that young adults with medium severity of alcohol use disorder and high willingness but low confidence for change might receive optimal benefit from brief motivational interviewing and recommend more intensive motivational interviewing for those with more severe alcohol use disorder and mental health issues to prolong the benefit shown by this study.

Who benefits from Brief Motivational Intervention among young adults presenting to the Emergency Department with alcohol intoxication: A moderation analysis using latent classes. J. Gaume, S. Blanc, M. Magill, J. McCambridge, N. Bertholet, O. Hugli. (p. x-xx)

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