Alcohol and Cannabis Misuse Among Assault-Injured Emerging Adults

Alcohol and Cannabis Misuse Among Assault-Injured Emerging Adults NIDA R34 PI: Edouard Coupet Project Summary: Substance misuse and assault injury, defined here as an intentional injury inflicted by another person not considered to be a boy/girlfriend, fiancée, or spouse, both represent substantial public health and safety burdens in the U.S. Emerging adults (18-25 y/o), an age group noted to experience significant neurobiological and psychosocial development, are disproportionately at risk for both substance misuse and assault injury. Assault-injured emerging adults with substance misuse are associated with increased risk of recurrent assault injury, morbidity, and mortality compared to those without substance misuse. Critical knowledge deficits exist in the shared psychosocial risk factors such as both self-efficacy to reduce substance use and perceived peer and familial norms of substance use, in the context of assault injury. Filling this knowledge gap is important because: 1) substance misuse represents a crucial, modifiable risk factor for assault injury and 2) there is a paucity of interventions that target substance use in this high-risk population that can be delivered at sites of acute medical care such as the emergency department (ED). Brief motivational interventions, including the Brief Negotiation Interview (BNI), have been found to be effective in reducing alcohol and cannabis use in the ED setting. The BNI enhances motivation to reduce alcohol and/or cannabis use and engage in treatment referral. The goal of this proposal is to adapt and pilot test the BNI for use among assault-injured emerging adults with alcohol and/or cannabis misuse in the ED. To accomplish this, we will elicit these shared psychosocial risk factors (i.e., self-efficacy and perceived peer and familial norms) that contribute to both alcohol and cannabis misuse in the context of assault injury. Aim 1 will be to assess self-efficacy, perceived peer and familial norms, and motivation to reduce alcohol and/or cannabis use and engage in treatment referral, among assault-injured emerging adults. Aim 2 will be to adapt the BNI for use among assault-injured emerging adults with alcohol and/or cannabis misuse in the ED. Aim 3 will be to determine the feasibility and acceptability of the adapted BNI in the ED through a randomized pilot trial comparing those who have received the adapted BNI and treatment referrals to a referrals-only control group. Overall, the findings of this proposal will provide the necessary pilot data for a fully powered effectiveness trial of the adapted BNI in a subsequent R01 application.