Kmiec J, Suffoletto B. (2019). Implementations of text-message intervention to increase linkage from the emergency department to outpatient treatment for substance use disorders. Journal of Substance Abuse Treatment. 100: 39-44. doi: 10.1016/j.jsat.2019.02.005
Preventing and Interrupting Early Relapse 2 (PIER2) is a text-messaging intervention to support emergency department (ED) patients’ motivation for referral to, and initiation of, substance use treatment. Daily text messages promote positivity about recovery and daily ecological momentary assessments (EMAs) evaluate cravings (severity and cause) and past-day substance use. Patients can request additional messages when experiencing cravings. Researchers offered PIER2 to 377 ED patients with opioid, benzodiazepine, or alcohol use disorders in a pilot quality improvement study evaluating feasibility and acceptability of PIER2. Researchers examined SUD treatment attendance as recorded in medical records from all 377 ED patients and PIER2 engagement data from 167 patients who opted to receive PIER2. A text message assessing intervention helpfulness and acceptability was sent to 87 participants after 7 days of intervention participation. Most participants responded to at least one EMA assessing cravings (67.7%) and past day substance use (71.3%). About a third of all EMAs (32.9% craving; 34.2% substance use) received responses. Participants who responded to messages about intervention helpfulness (n=53) and acceptability (n=43) rated the helpfulness of PIER2 8/10, on average and mostly agreed they would recommend PIER2 to a friend (36/43; 83.7%). Participants who opted to receive PIER2 were 3.95 times more likely to attend treatment than participants who refused PIER2. Participants with opioid use disorder had lower rates of enrollment in PIER2, lower EMA response rates, and lower rates of treatment attendance compared to participants with alcohol or benzodiazepine use disorders.