Does this patient really want treatment? Factors associated with baseline and evolving readiness for change among hospitalized substance using adults interested in treatment

Abstract

Little is known about motivation for treatment and readiness for change during an acute medical event. We present data from a cohort of 353 actively substance abusing adults assessed at baseline and every three days during their hospital admission for readiness to change substance use behaviors (URICA), self-reported motivations for substance abuse treatment, and pain and withdrawal symptoms. Factors independently associated with being in a higher (i.e., contemplation or action) stage of change included female sex (AOR = 2.33; 95% CI: 1.42, 3.81), being on probation or parole (AOR = 2.55; 95% CI: 1.32, 4.93), bipolar disorder (AOR 2.60; 95% CI: 1.20, 5.63), believing they would get sick again if drug use continued (AOR = 2.24; 95% CI: 1.36, 3.70), being “tired of using” (AOR = 2.91; 95% CI: 1.21, 6.96) and family concerns (AOR = 1.78; 95% CI: 1.08, 2.96). During their hospitalization 43.6% increased from precontemplation or contemplation to a higher stage or remained in the action stage. Believing one would get sick again if substance use continued (AOR = 2.42; 95% CI: 1.07, 5.48), physical health concerns (AOR = 5.28; 95% CI: 1.36, 20.44) and citing “tired of using” as a primary motivator (AOR = 2.88; 95% CI: 1.10, 7.54) were independently associated with increased stage of change.