A motivational interviewing intervention (REBOOT) delivered by trained counselors reduced the rate of opioid overdose in participants with opioid use disorder, according to the result of recent research published in PLoS One.
In this single-blinded randomized controlled trial, 63 adults with opioid use disorder were enrolled to receive the REBOOT intervention or treatment as usual. The REBOOT intervention was delivered at 0, 4, 8, and 12 months. REBOOT consists of a 45-minute session with counselors, during which risk factors for overdoses are reviewed; counselors also discuss overdose events with participants to help them identify risk behaviors; inquire about their interest in pharmacologic treatments for substance use disorders; and assist in developing a plan to reduce the risk for future overdoses.
A total of 33.3% of trial participants had experienced an overdose in the 4 months preceding the study; during the 16-month follow-up period, 29% of patients overdosed. Most patients completed their visits (92%) and their counseling sessions (93%).
In the intention-to-treat analysis, the REBOOT intervention was associated with a lower rate of any overdose event (incidence rate ratio [IRR], 0.62; 95% CI, 0.41-0.92; P =.02) and a lower number of events (IRR, 0.46; 95% CI, 0.24-0.90; P =.02). No difference was noted for days of opioid use, substance use treatment, or naloxone carriage between the two groups.
The researchers noted that “REBOOT enrolled with a low screening to enrollment ratio, maintained remarkably high visit completion for a study of such duration in a substance-using population, and was well-received by subjects.” They concluded that the reduction in overdose events “[supports] the implementation of REBOOT in a full, formal efficacy trial.”
Coffin PO, Santos GM, Matheson T, et al. Behavioral intervention to reduce opioid overdose among high-risk persons with opioid use disorder: A pilot randomized controlled trial. PLoS One. 2017;12(10):e0183354.