Motivational Interviewing for Drug Overdose

(MI-CHANCE Trial)

Overseen By Alicia Harvey-Vera, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, San Diego

Disqualifiers: Other trial, CheckSD, MI-CHANCE, others

Compensation: Varies

Number of Visits: Unknown

Duration: 30 months

588 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new counseling approach to promote drug checking and safer drug use among people who use drugs, specifically targeting those at risk for overdose and infections like HIV and Hepatitis C. Participants will either receive standard care with educational materials or engage in a motivational session (MI-CHANCE) to encourage safer drug practices and the use of drug checking services. The goal is to determine if this intervention can increase the adoption of safer drug use behaviors. Individuals who have used opiates like heroin or fentanyl within the last week and live in San Diego County may be eligible to participate. As an unphased trial, this study offers a unique opportunity to contribute to innovative strategies for safer drug use and overdose prevention.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It focuses on drug checking services and safer drug use behaviors, so it's best to ask the trial coordinators for more details.

What prior data suggests that this intervention is safe for promoting drug checking services and safer drug use behaviors?

Research has shown that motivational interviewing, such as the MI-CHANCE treatment, is generally well-received by participants. A study in Canada found that individuals who engaged in motivational interviewing were more likely to plan on using smaller amounts of drugs, which can help lower the risk of overdose. This suggests that the approach may encourage safer behaviors, reducing potential harm. Additionally, a review found that up to 87% of people who used drug checking services intended to use drugs more safely after seeing their test results.

These findings highlight that motivational interviewing can effectively promote safety and reduce risks for people who use drugs. However, as this method continues to be studied, participants should remain aware of their own comfort and safety throughout the process. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the MI-CHANCE intervention because it offers a fresh approach to preventing drug overdoses by focusing on personalized counseling and harm reduction strategies. Unlike standard care, which typically involves distributing naloxone and educational pamphlets, MI-CHANCE engages participants in motivational interviewing, encouraging them to reflect on their drug use and consider safer behaviors. This method empowers individuals to identify their own goals and develop actionable plans to reduce overdose risks, which could lead to more sustainable behavior changes.

What evidence suggests that the MI-CHANCE intervention could be effective for reducing drug overdose and related infections?

Research has shown that motivational interviewing (MI) can lower the risk of overdose for people who use drugs. A study in Canada found that individuals who planned to reduce drug use after MI sessions were less likely to overdose. MI encourages people to consider the pros and cons of their drug use, fostering safer habits. This method also enhances motivation and involvement in treatment, leading to better outcomes. In this trial, the MI-CHANCE program, provided to participants in the MI-CHANCE Intervention group, aims to increase the use of drug-checking services and promote safer drug use, potentially reducing overdoses. ^{1 2 3 4 6}

Are You a Good Fit for This Trial?

This trial is for adults over 18 in San Diego who've used opiates or methamphetamine within the last week and haven't used CheckSD drug checking service. They must be willing to follow study procedures, not planning to move from San Diego soon, and consent to participate. Most participants will likely be opiate users due to higher overdose risk.

Inclusion Criteria

I have signed a consent form for the trial.

I am willing and able to follow all study rules and attend all appointments.

I have used drugs like heroin or meth within the last week.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either the MI-CHANCE intervention or standard of care, including drug checking services and educational sessions

30 months

Semi-annual visits

Follow-up

Participants are monitored for safety and effectiveness after treatment, including overdose rates and infection rates

30 months

Semi-annual follow-up

What Are the Treatments Tested in This Trial?

Interventions

• MI-CHANCE

Trial Overview The study tests a new intervention called MI-CHANCE aimed at increasing the use of drug checking services (TS + FTIR) and promoting safer drug habits among people using drugs. It combines education on Flu/Hepatitis A with motivational interviewing techniques.

How Is the Trial Designed?

Group I: MI-CHANCE Intervention (Group 2) - TS+FTIR+MI. Experimental Treatment 1 Intervention

Participants will receive naloxone, overdose prevention pamphlets and MI in a 30-minute counseling session. Trained peer-support specialists will engage participants in discussion on the drug supply, ask to rate how certain they are about their drugs' content, how they perceive their OD risk, and shown a brief video about FTIR. Using "decisional balance", participants will identify pros and cons of regularly using DCS prior to drug use and modifying drug use behaviors based on their own potential safer alternatives. Once the balance shifts towards positive change, they will be offered to get their own drug tested by CheckSD's technician and provided with results highlighting drug potency and purity. If they decline, a dummy sample containing fentanyl will be used. Participants will develop an action plan with harm reduction principles to problem-solve specific challenges, identify their goals to use DCS and prevent OD.

Group II: Standard of Care Control (SOC; Group 1) -TS + FTIR + Flu and Hepatitis A education. Placebo Group 1 Intervention

Participants will receive naloxone, overdose prevention pamphlets and be shown videos (English or Spanish) on how naloxone works. Participants will be offered the services of drug sample testing by CheckSD's technician after their study session. The training videos will be on Flu and Hepatitis A education. Overall, the session for Group 1 as the attention control participants will last 30 minutes.

Who Is Running the Clinical Trial?

University of California, San Diego

Lead Sponsor

Trials

1,215

Recruited

1,593,000+

Harm Reduction Coalition of San Diego (HRCSD)

Collaborator

Trials

1

Recruited

590+

Published Research Related to This Trial

Staff in Swedish prisons who received ongoing training in motivational interviewing (MI) showed significantly greater competency in MI skills compared to those conducting usual prison planning interviews, indicating that continuous training is beneficial.

However, overall competency levels among staff were low, suggesting that even with training, more extensive and ongoing support is necessary to achieve proficiency in MI techniques for effectively helping substance-misusing prisoners.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Learning motivational interviewing in a real-life setting: a randomised controlled trial in the Swedish Prison Service. Forsberg, L., Ernst, D., Farbring, CÅ.[2022]

Training in motivational interviewing (MI) for substance use disorder (SUD) treatment did not consistently lead to sustained practice change, with only 2 out of 20 studies achieving the target of 75% of clinicians reaching proficiency after training.

The review highlighted that ongoing competency monitoring and training are necessary for clinicians to effectively implement MI, and the impact of this training on client outcomes remains unclear, indicating a need for further research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

After 30 years of dissemination, have we achieved sustained practice change in motivational interviewing? Hall, K., Staiger, PK., Simpson, A., et al.[2022]

A survey of 36 motivational interviewing (MI) trainers identified key preferences for the format, duration, and content of beginner-level MI training aimed at addiction treatment, highlighting the need for effective training methods.

The survey also revealed common challenges faced by novice trainers in delivering MI training and provided recommended strategies to overcome these barriers, which is crucial for improving the implementation of evidence-based practices in community treatment settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Guidance for New Motivational Interviewing Trainers When Training Addiction Professionals: Findings from a Survey of Experienced Trainers. Schumacher, JA., Coffey, SF., Walitzer, KS., et al.[2021]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12487341/

Motivational interviewing to increase drug checking and ... A Canadian study found that risk of overdose was significantly lower among participants who intended to use smaller quantities of drugs ...

2. clinicaltrials.gov clinicaltrials.gov/study/NCT06855836?term=%22bacteriophages%22+OR+%22bacteriophage+therapy%22+OR+%22phages%22+OR+%22phage+therapy%22

Study Details | NCT06855836 | Motivational Interviewing to ... Motivational Interviewing to Increase Uptake of Drug Checking and Safe Drug Use Behaviors to Reduce Overdose (MI-CHANCE) · Study Overview · Contacts and Locations.

3. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/41029610/

Motivational interviewing to increase drug checking and ... Motivational interviewing to increase drug checking and reduce overdose rates among people who use drugs: protocol for a hybrid type 1 ...

4. escholarship.org escholarship.org/content/qt6cq5x7kq/qt6cq5x7kq.pdf

Motivational interviewing to increase drug checking and ... Our primary effectiveness outcome variable is combined incidence of fatal and nonfatal overdose, determined by non-nominal record-linked data and self-report.

5. case.edu case.edu/socialwork/centerforebp/sites/default/files/2024-09/MI%20and%20MET%20for%20Opioid%20Use%20Disorders%20Research%20Summary%20Report.pdf

MI and MET for Opioid Use Disorders ... Motivational interviewing and motivational enhancement therapy may enhance motivation, treatment engagement, and improve drug use outcomes when incorporated ...

6. researchgate.net researchgate.net/publication/396010867_Motivational_interviewing_to_increase_drug_checking_and_reduce_overdose_rates_among_people_who_use_drugs_protocol_for_a_hybrid_type_1_effectiveness-implementation_trial_of_an_adjunctive_intervention

Motivational interviewing to increase drug checking and ... We will recruit, consent, conduct a baseline interview, and randomize 588 PWUD who used opioids or stimulants within the week prior to receive ...