028 Injury-related risk behaviors among adolescents and young adults in the emergency department enrolled in an opioid prevention randomized controlled trial

Statement of Purpose

The emergency department (ED) visit provides an opportunity for initiating opioid prevention interventions. This presentation describes baseline injury-related characteristics among a sample of adolescents and young adults in the ED enrolled in an opioid prevention trial.

Methods/Approach

Patients (ages 16–30) in the ED complete a screening survey, and those with past-year opioid (prescription or illicit) misuse or opioid use plus a risk factor (e.g., recent substance use, depression, suicidality) are eligible for the randomized controlled trial (RCT) comparing motivational interviewing-based interventions (telemedicine session, 1-month of portal messaging, or both) to a resource brochure, with follow-ups over 12-months.

Results

Thus far, 22.8% (n=436/1912) of patients screened positive (29.8% male; Mage= 24.0; 16.5% African American; 7.3% Latinx): 78.9% for prescription opioid use plus a risk factor and 21.1% for opioid misuse. Among those enrolled in the RCT (n=287), recent substance use and mental health concerns were: 66.9% cannabis use, 49.5% binge drinking, 38.7% positive depression screen, 5.2% recent suicide ideation, and 3.8% past-year suicide attempt. Regarding impaired driving, 7.0% drove within an hour of using opioids, 10.5% drove when felt sleepy or less alert because of using opioids, 10.5% drove within an hour of having 3 or more drinks, and 23% drove while high on cannabis. In the past 3 months, 11.9% reported aggression and 13.6% experienced victimization. Finally, 41.1% reported a lifetime overdose experience (i.e., taking more than your body could handle). Engagement in the interventions is high: >85% completed the telemedicine session and >90% engaged in the portal (mean number of participant messages = 13.6). Follow-up rates at 3 and 6 months exceed 80.0%.

Significance

Findings support the need for opioid misuse prevention efforts, with interventions addressing other substance use, mental health, and injury prevention. ED-based telemedicine approaches are feasible and acceptable, with future work examining efficacy. Funded by: National Institute on Drug Abuse UG3/UH3 DA050173