RESEARCH REPORT doi:10.1111/j.1360-0443.2006.01290.x ©2006 The Authors. Journal compilation © 2006 Society for the Study of Addiction Addiction, 101, 1014–1026 Blackwell Publishing LtdOxford, UKADDAddiction0965-2140© 2006 The Authors. Journal compilation © 2006 Society for the Study of Addiction 2006 101•••• Original Article Brief motivational intervention among stimulant users John Marsden et al. Correspondence to: John Marsden, Institute of Psychiatry, PO Box 48, Addiction Sciences Building, 4, Windsor Walk, London SE5 8AF, UK. E-mail: j.marsden@iop.kcl.ac.uk Submitted 16 March 2005; initial review completed 18 July 2005; final version accepted 17 March 2006 RESEARCH REPORT An evaluation of a brief motivational intervention among young ecstasy and cocaine users: no effect on substance and alcohol use outcomes John Marsden 1 , Garry Stillwell 1 , Helen Barlow 1 , Annabel Boys 1 , Colin Taylor 1 , Neil Hunt 2 & Michael Farrell 1 Division of Psychological Medicine, Institute of Psychiatry, King’s College London 1 and Institute of Medical and Health Sciences, University of Kent, UK 2 ABSTRACT Aims To investigate whether a stimulant- and alcohol-focused brief motivational intervention induces positive behaviour change among young, regular users of MDMA (‘ecstasy’), cocaine powder and crack cocaine. Design and measurements A randomized trial of the intervention versus a control group who received written health risk infor- mation materials only. All participants completed a baseline self-assessment questionnaire before randomization. Out- come measures were self-reported period prevalence abstinence from ecstasy, cocaine powder and crack cocaine and the frequency and amount of stimulant and alcohol use in the previous 90 days, recorded at 6-month follow-up via self-completion questionnaire and personal interview. Participants and setting A total of 342 adolescent and young adult stimulant users (aged 16–22 years) were recruited and 87% were followed-up. The intervention was delivered by a team of 12 agency youth drug workers and two researchers at five locations in Greater London and south-east England. Findings There were no significant differences in abstinence for ecstasy, cocaine powder or crack cocaine use between the experimental and control groups. Contrasting follow-up with baseline self-reports, there were no between-group effects for changes in the frequency or amount of stimulant or alcohol use. Participant follow-up data suggested that the baseline assessment was a contributing factor in within-group behaviour change among experi- mental and control condition participants. Conclusions Our brief motivational intervention was no more effective at inducing behaviour change than the provision of information alone. We hypothesize that research recruitment, base- line self-assessment and contact with study personnel are influences that induce positive reactive effects on stimulant use. Keywords Brief intervention, cocaine, controlled trial, crack, ecstasy, motivational interviewing. INTRODUCTION There is long-standing international concern about the use of non-medical stimulant drugs by adolescents and young adults [1]. In the United Kingdom, it is estimated that 5.3% of 16–24-year-olds in England and Wales have used the ring-substituted amphetamine derivative MDMA (3,4-methylenedioxymethamphetamine, com- monly known as ‘ecstasy’) in the past 12 months, and 4.9% and 0.4%, respectively, report using cocaine hydro- chloride (‘cocaine powder’, herein) and ‘crack’ cocaine (the smokeable base form of the drug) [2]. In the United States, ecstasy, cocaine powder and crack cocaine are used by 3.1%, 6.6% and 0.8%, respectively, among those aged 18–25 years over the same recall period [3]. While international estimates of drug markets point to a recent reduction in the consumption of ecstasy, use of cocaine powder and crack cocaine remains stable after a decade of growth [1]. Users of non-medical stimulant drugs are at acute or chronic risk of cardiovascular dysrhythmias, pulmonary complications, myocarditis, temperature dysregulation (hyperthermia) and protracted drug withdrawal ‘hang- over’ effects, which include anxiety, mood disturbance, restlessness and attention difficulty symptoms [4,5]. Early initiation to stimulant use increases the likelihood