Facilitating treatment entry among out-of-treatment injection drug users

Objectives, High risk injection practices are common among injecting drug u sers (IDUs), even following intervention efforts. Moreover, relapse to risk behaviors has been reported among those who initiate risk reduction. Subst ance abuse treatment offers the potential to reduce or eliminate injecting risk behaviors through drug cessation, We report on the effectiveness of tw o intervention strategies in facilitating treatment entry among out-of-trea tment IDUs: motivational interviewing (MI), an intervention developed to he lp individuals resolve their ambivalence about behavior change, and free tr eatment for 90 days, These conditions were compared with an intervention fo cusing on a hierarchy of safer injecting practices, referred to here as ris k reduction (RR), and no free treatment. Methods. Nearly 200 out-of-treatment IDUs were randomly assigned to one of four experimental conditions: Ml/free treatment, Ml/no free treatment, RR/f ree treatment, and RR/no free treatment. Regardless of assignment, we assis ted anyone desiring treatment by calling to schedule the appointment, provi ding transportation, and waiving the intake fee, Results. Overall, 42% of study participants entered treatment. No significa nt differences were found between MI and RR; however, 52% of those assigned free treatment entered compared with 32% for those who had to pay. Other p redictors of treatment entry included prior treatment experiences, perceive d chance of contracting acquired immunodeficiency syndrome (AIDS) greater t han 50%, "determination" stage of change, greater frequency of heroin injec ting, and fewer drug-using friends. Conclusion. These findings support the importance of removing barriers to t reatment entry.