Statement of Purpose The emergency department (ED) visit provides an opportunity for initiating opioid prevention interventions. This presentation describes baseline injury-related characteristics among a sample of adolescents and young adults in the ED enrolled in an opioid prevention trial.

Methods/Approach Patients (ages 16–30) in the ED complete a screening survey, and those with past-year opioid (prescription or illicit) misuse or opioid use plus a risk factor (e.g., recent substance use, depression, suicidality) are eligible for the randomized controlled trial (RCT) comparing motivational interviewing-based interventions (telemedicine session, 1-month of portal messaging, or both) to a resource brochure, with follow-ups over 12-months.

Results Thus far, 22.8% (n=436/1912) of patients screened positive (29.8% male; Mage= 24.0; 16.5% African American; 7.3% Latinx): 78.9% for prescription opioid use plus a risk factor and 21.1% for opioid misuse. Among those enrolled in the RCT (n=287), recent substance use and mental health concerns were: 66.9% cannabis use, 49.5% binge drinking, 38.7% positive depression screen, 5.2% recent suicide ideation, and 3.8% past-year suicide attempt. Regarding impaired driving, 7.0% drove within an hour of using opioids, 10.5% drove when felt sleepy or less alert because of using opioids, 10.5% drove within an hour of having 3 or more drinks, and 23% drove while high on cannabis. In the past 3 months, 11.9% reported aggression and 13.6% experienced victimization. Finally, 41.1% reported a lifetime overdose experience (i.e., taking more than your body could handle). Engagement in the interventions is high: >85% completed the telemedicine session and >90% engaged in the portal (mean number of participant messages = 13.6). Follow-up rates at 3 and 6 months exceed 80.0%.

Significance Findings support the need for opioid misuse prevention efforts, with interventions addressing other substance use, mental health, and injury prevention. ED-based telemedicine approaches are feasible and acceptable, with future work examining efficacy. Funded by: National Institute on Drug Abuse UG3/UH3 DA050173