Motivational Interviewing

Motivational Interviewing, as a technique, has generally been found to be comparable in effectiveness for individuals across diverse backgrounds.

Motivational Interviewing — Evidence Rating: Low to Moderate Quality

There is a paucity of studies testing Motivational Interviewing for Opioid Use Disorder (MI-OUD), particularly compared to the knowledge base for Motivational Interviewing for Substance Use Disorder (MI-SUD). MI-OUD has been studied in both randomized trials and observational studies, but typically only as an adjunctive intervention, and rarely with a comparison condition that enables isolation of its effect. We were only able to identify one pilot randomized trial that found that MI-OUD offered to patients admitted to the emergency department with a recent history of non-medical opioid misuse was more effective than enhanced usual care in reducing overdose risk behaviors and symptoms related to non-medical opioid misuse. We were not able to identify any studies providing convincing data that MI-OUD delivered in combination with medication decreases patient opioid use or promotes opioid abstinence more effectively than medication alone. However, some studies suggest that MI-OUD may have beneficial effects on patient well-being or mental health, or may reduce the risk of other opioid-related consequences. Because we could only find one pilot randomized trial among patients with risky opioid use, indicating that MI-OUD is more effective than enhanced usual care on opioid-related outcomes, and we could not find any trials among patients with opioid use disorder supporting the effectiveness of MI-OUD, we assigned this intervention a rating of yellow.

Evidence-based Scale

The lack of studies evaluating Motivational Interviewing for Opioid Use Disorder (MI-OUD) limits conclusions about its effectiveness with different populations. Some inferences can be drawn from general studies of Motivational Interviewing (MI). A recent systematic review identified 25 studies that tested culturally adapted versions of MI and found that, in 10 of them, a culturally adapted version performed better than standard MI on at least the primary outcome. These data suggest that ensuring the cultural relevance of MI in general and MI-OUD in particular may be valuable.