Interview as intervention: The case of young adult polydrug users

Aims: To examine changes in substance use and sexual risk behaviors – without intervention – among a sample of young adult polydrug users in Miami's nightclub culture. Data are drawn from a natural history study of substance use and health and social consequences among adults ages 18 to 39 who completed baseline (N=600), 6-month (N=480) and 12-month (N=365) follow-up assessments. Methods: Computer-assisted personal interviews included well-tested, comprehensive measures of substance use, sexual behaviors, economic status, social environment, mental health, criminal justice involvement, and victimization history. Results: Median age was 24; 40% were female, 51% Hispanic, 21% White, and 25% Black. At the 6 month assessment, large numbers of participants reported fewer days' use of cocaine (74% of cocaine users), MDMA (82%) prescription sedatives (74%), prescription opioids (77%), and marijuana (46%). At 12 months, an additional 6-8% of participants reported reduced use of each of these most common substances. Unprotected sex was similarly reduced. Reductions in risk behaviors did not vary by age, gender or other demographics; extent of lifetime or current drug use at baseline; criminal justice involvement; or mental health or substance abuse treatment history. Study completers who participated in focus groups attributed the observed behavioral changes to their participation in the study interviews more than to any other factor, including aging out of the scene and other life changes. Conclusions: Comprehensive health and social risk assessments appear to produce quite strong risk reduction effects among this population of young adult polydrug users. Implications for intervention research are explored.