Safety and Health Intervention Project

Use of opioid medications for treatment of pain has increased greatly in the U.S., with the
average quantity of prescribed opioids increasing 700% in a decade, from ~100 morphine
milligram equivalents (MME) per person to ~700 MME per person from 1997 to 2007. There have
been concurrent increases in opioid-related adverse outcomes, such as extramedical use,
opioid use disorders, and overdose. As a result, there were more unintentional poisoning
deaths than deaths due to motor vehicle crashes among adults in 2010 (32,723 vs. 32,640).
Additionally, the number of Americans seeking treatment for opioid use disorders has
increased; in SAMHSA's Treatment Episode Data Set, prescription opioids were the primary
substance of abuse for 142,782 individuals in 2009, compared to 22,637 in 1999, a 530%
increase.

The specific aims of this project are to: (1) Refine a motivational enhancement prevention
intervention for prescription opioid overdose risk reduction and improved witnessed overdose
response for at-risk patients in addictions treatment; (2) Conduct a pilot randomized
controlled trial comparing the prescription opioid overdose prevention intervention to a
supportive educational control condition for patients in addictions treatment in order to:
(a) obtain information about the feasibility of randomized controlled procedures; and (b)
determine the distribution and variability of the primary (overdose risk behaviors) and
mediating/secondary (witnessed overdose response, self-efficacy to reduce overdose risk,
knowledge of overdose risk factors and symptom recognition) outcomes; and (3) Determine the
distribution and variability in changes in HIV risk behaviors (e.g., reductions in injection
of prescription opioids) over follow-up.