Disorders - Alcohol Use
Niederhofer, Helmut, Staffen, Wolfgang, Mair, Alois
AIMS: About 50% of alcoholic patients relapse within 3 months of treatment. Previous studies have suggested that cyanamide may help to prevent such relapse. The aim of our study was to assess the efficacy and safety of long-term cyanamide treatment in alcohol dependence of adolescents. METHODS: In this, double-blind, placebo-controlled study, we recruited 26 patients, aged 16-19 years, with chronic (frequent and regular) or episodic (frequent, but irregular) alcohol dependence. Patients were randomly allocated treatment with cyanamide (200 mg daily) or a placebo for 90 days. Patients were assessed on the day the treatment was started, and on days 30 and 90, by interview, self-report, questionnaire and laboratory screening. Patients were classified as abstinent, relapsing or non-attending. Time to first treatment failure (relapse or non-attendance) was the primary outcome measure. RESULTS: The cyanamide (n = 13) and placebo (n = 13) groups were well matched in terms of baseline demographic and alcohol-related variables. Mean cumulative abstinence duration was significantly greater in the cyanamide group than in the placebo group. Apart from occasional diarrhoea, there was no difference in side effects between groups. CONCLUSIONS: Cyanamide seems to be an effective and well tolerated pharmacological adjunct to psychosocial and behavioural treatment programmes for the treatment of some adolescent alcohol-dependent patients. Because of reported hepatotoxic, haematological and dermatological side effects, patients should be observed continuously by experienced clinicians. Further studies are necessary to prove the efficacy of cyanamide in adolescents.
Alcohol & Alcoholism, 38(1) : 50-3
- Year: 2003
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Medications used to treat substance abuse
Niederhofer, Helmut, Staffen, Wolfgang
About 50% of alcoholic patients relapse within 3 months of treatment. Previous studies have suggested that disulfiram may help to prevent such relapse. The aim of our study was to assess the efficacy and safety of long-term disulfiram treatment in alcohol dependence of adolescents. In this double-blind, placebo-controlled study we recruited 26 adolescents, aged 16-19 years, with chronic or episodic alcohol dependence. Patients were allocated treatment randomly with disulfiram (200 mg daily) or placebo for 90 days. Patients were assessed on the day treatment started and on days 30 and 90 by interview, self-report, questionnaire and laboratory screening. Patients were classified as abstinent, relapsing or non-attending. Time to first treatment failure (relapse or non-attendance) was the primary outcome measure. The disulfiram (n=13) and placebo (n=13) groups were well matched in terms of baseline demographic and alcohol-related variables. Thirteen disulfiram-treated and 13 placebo-treated patients completed the treatment phase; seven (1 vs. 6) relapsed, five (3 vs. 2) refused to continue treatment, three (1 vs. 2) had concurrent illness and two (1 vs. 1) had adverse side effects. At the end of treatment, seven disulfiram-treated and two placebo-treated patients had been abstinent continuously (p=0.0063). Mean cumulative abstinence duration was significantly greater in the disulfiram group than in the placebo group [68.5 (SD 37.5) vs. 29.7 (19.0) days; p=0.012]. Apart from occasional diarrhoea, there was no difference in side effects between groups. In some cases, disulfiram may be an effective and well-tolerated pharmacological adjunct to psychosocial and behavioural treatment programmes for treatment of adolescent alcohol-dependent patients.
Drug & Alcohol Review, 22(3) : 295-7
- Year: 2003
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Medications used to treat substance abuse
Werch, C., Owen, D., Carlson, J., DiClemente, C., Edgemon, P., Moore, M.
Examined the 1-yr follow-up effects of the STARS (Start Taking Alcohol Risks Seriously) for Families program, a 2-yr preventive intervention based on a stage of acquisition model, consisting of nurse consultations and parent materials. A randomized controlled trial was conducted, with participants receiving either the intervention or a minimal intervention control. Participants included a cohort of 650 6th-grade students from two urban middle schools--one magnet (bused) and one neighborhood. Trained project staff administered questionnaires to students following a standardized protocol in the schools. For the magnet school sample, significantly fewer intervention students (5%) were planning to drink in the next 6 mo than control students (18%). Magnet school intervention students also had less intentions to drink in the future, greater motivation to avoid drinking and less total alcohol risk than control students. For the neighborhood school, intervention students had less total alcohol risk than controls. This brief, stage and risk/protective factor tailored program holds promise for reducing risk for alcohol use among urban school youth 1 yr after intervention, and has the unique advantage of greater 'transportability' over classroom-based prevention programs. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Health Education Research, 18(1) : 74-87
- Year: 2003
- Problem: Alcohol Use
- Type: Randomised controlled trials
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Stage: Universal prevention
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Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Cruz, Iris Y., Dunn, Michael E.
Altering alcohol expectancies has reduced alcohol use among young adults and may lead to successful prevention of early alcohol use. The authors randomly assigned 216 4th-grade children to an expectancy challenge or control condition and used individual-differences scaling to map expectancies into memory network format, with preference mapping to model likely paths of association. After expectancy intervention, children exhibited a greater likelihood to associate alcohol use with negative and sedating consequences and a decreased likelihood to associate alcohol with positive and arousing consequences. Children and adults who emphasize negative and sedating effects have been found to be less likely touse alcohol. Therefore, expectancy challenge interventions that have been successful at modifying expectancies and subsequently decreasing alcohol consumption of adults may be useful in reducing the likelihood of early alcohol use among children.
Journal of Consulting & Clinical Psychology, 71(3) : 493-503
- Year: 2003
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Foxcroft, D., Ireland, D., Lister-Sharp, D., Lowe, G., Breen, R.
Reviewed and summarized rigorous evaluations of psychosocial and educational interventions aimed at the primary prevention of alcohol misuse by young people aged up to 25 yrs, especially over the longer term (3 yrs or more). A comprehensive search was conducted of 22 databases and recursive checking was done of bibliographies for randomized and non-randomized controlled trials and interrupted time-series studies. 20 of the 56 studies selected for inclusion showed evidence of ineffectiveness. No firm conclusions about the effectiveness of prevention interventions in the short- and medium term were possible. Over the longer term, the Strengthening Families Programme (SFP) showed promise as an effective prevention intervention. The Number Needed to Treat (NNT) for the SFP over 4 yrs for three alcohol initiation behaviors (alcohol use, alcohol use without permission and first drunkenness) was 9 (for all 3 behaviors). One study also highlighted the potential value of culturally focused skills training over the longer-term. Conclusions include the ideas that (1) research into important outcome variables needs to be undertaken; (2) the methodology of evaluations needs to be improved; and (3) the SFP needs to be evaluated on a larger scale and in different settings. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Addiction, 98(4) : 397-411
- Year: 2003
- Problem: Alcohol Use
- Type: Systematic reviews
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Stage: Universal prevention
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Treatment and intervention: Psychological Interventions (any)
Gottfredson, Denise C., Wilson, David B.
This study summarizes, using meta-analytic techniques, results from 94 studies of school-based prevention activities that examined alcohol or other drug use outcomes. It set out to determine what features of school-based substance abuse prevention programs are related to variability in the size of program effects, It asked (1) Which populations (e.g., high risk vs. general population) should be targeted for prevention services? (2) What is the best age or developmental stage for prevention programming? (3) Does program duration matter? and (4) Does the role of the person delivering the service (e.g., teacher, law enforcement officer, peer) matter? The results suggest that targeting middle school aged children and designing programs that can be delivered primarily by peer leaders will increase the effectiveness of school-based substance use prevention programs. The results also imply that such programs need not be lengthy. The evidence related to the targeting issue is sparse, but suggests that, at least for programs teaching social competency skills, targeting higher risk youths may yield stronger effects than targeting the general population. Suggestions for future research are offered.
Prevention Science, 4(1) : 27-38
- Year: 2003
- Problem: Substance Use Disorders (any), Alcohol Use
- Type: Systematic reviews
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Stage: Universal prevention
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Treatment and intervention: Psychological Interventions (any)
Botvin, Gilbert J., Griffin, Kenneth W., Paul, Elizabeth, Macaulay, Araxi P.
The present study examined the effectiveness of a substance abuse prevention program in preventing tobacco and alcohol use among elementary school students in grades 3 through 6. The prevention program teaches social resistance skills and general personal and social competence skills. Rates of substance use behavior, attitudes, knowledge, normative expectations, and related variables were examined among students (N=1090) from 20 schools that were randomly assigned to either receive the prevention program or serve as a control group. Data were analyzed at both the individual-level and school-level. Individual-level analyses controlling for gender, race, and family structure showed that intervention students reported less smoking in the past year, higher anti-drinking attitudes, increased substance use knowledge and skills-related knowledge, lower creased normative expectations for smoking and alcohol use, and higher self-esteem at the posttest assessment, relative to control students. Findings indicate that a school-based substance abuse prevention approach previously found to be effective among middle school students is also effective for elementary school students. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Journal of Child & Adolescent Substance Abuse, 12(4) : 1-17
- Year: 2003
- Problem: Alcohol Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
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Treatment and intervention: Psychological Interventions (any)
, Skills training
Cuijpers, P., Jonkers, R., De-Weerdt, I., De Jong, A.
Aims: To examine the effects of the 'Healthy School and Drugs' project, a Dutch school-based drug prevention project that was developed in the late 1980s and disseminated during the 1990s. This programme is currently being used by 64-73% of Dutch secondary schools and it is estimated that at least 350 000 high school students receive this intervention each year. Design, setting and participants: A quasi-experimental study in which students of nine experimental (N = 1156) schools were compared with students of three control schools (N = 774). The groups were compared before the intervention, 1 year later, 2 years later and 3 years later. Measurements: Self-report measures of tobacco, alcohol and marijuana use. attitudes towards substance use, knowledge about substances and self-efficacy. Findings: Some effects on the use of tobacco, alcohol and cannabis were found. Two years after the intervention, significant effects could still be shown on alcohol use. Effects of the intervention were also found on knowledge, but there was no clear evidence for any effects on attitude towards substance use and on self-efficacy. Conclusions: This study shows the Healthy School and Drugs project as implemented in Holland may have some effect on drug use in the children exposed to it.
Addiction, 97(1) : 67-73
- Year: 2002
- Problem: Alcohol Use, Cannabis Use
- Type: Controlled clinical trials
-
Stage: Universal prevention
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Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Skills training
Foxcroft, D. R., Ireland, D., Lister-Sharp, D. J., Lowe, G., Breen, R.
BACKGROUND: Alcohol misuse is a cause of concern for health services, policy makers, prevention workers, the criminal justice system, youth workers, teachers and parents. OBJECTIVES: 1. To identify and summarize rigorous evaluations of psychosocial and educational interventions aimed at the primary prevention of alcohol misuse by young people. 2. To assess the effectiveness of primary prevention interventions over the longer-term (> 3 years). SEARCH STRATEGY: Databases searched (no time limits): Project CORK, BIDS, PSYCLIT, ERIC, ASSIA, MEDLINE, FAMILY-RESOURCES-DATABASE, HEALTH-PERIODICALS-DATABASE, EMBASE, BIDS, Dissertation-Abstracts, SIGLE, DRUG-INFO, SOMED, Social-Work-Abstracts, National-Clearinghouse-on-Alcohol-and-Drug-Information, Mental-Health-Abstracts, DRUG-database, ETOH (all searched Feb-June 2002). SELECTION CRITERIA: 1. randomised controlled and non-randomised controlled and interrupted time series designs. 2. educational and psychosocial primary prevention interventions for young people up to 25 years old. 3. alcohol-specific or generic (drugs; lifestyle) interventions providing alcohol outcomes reported. 4. alcohol outcomes: alcohol use, age of alcohol initiation, drinking 5+ drinks on any one occasion, drunkeness, alcohol related violence, alcohol related crime, alcohol related risky behaviour. DATA COLLECTION AND ANALYSIS: Stage 1: All papers screened by one reviewer against inclusion criteria. Stage 2: For those papers that passed Stage 1, key information was extracted from each paper by 2-3 reviewers. MAIN RESULTS: 20 of the 56 studies included showed evidence of ineffectiveness. No firm conclusions about the effectiveness of prevention interventions in the short- and medium-term were possible. Over the longer-term, the Strengthening Families Program (SFP) showed promise as an effective prevention intervention. The Number Needed to Treat (NNT) for the SFP over 4 years for three alcohol initiation behaviours (alcohol use, alcohol use without permission and first drunkeness) was 9 (for all three behaviours). One study also highlighted the potential value of culturally focused skills training over the longer-term (NNT=17 over three-and-a-half years for 4+ drinks in the last week). REVIEWER'S CONCLUSIONS: 1. Research into important outcome variables needs to be undertaken. 2. Methodology of evaluations needs to be improved. 3. The Strengthening Families Programme needs to be evaluated on a larger scale and in different settings. 4. Culturally-focused interventions require further development and rigorous evaluation. 5. An international register of alcohol and drug misuse prevention interventions should be established and criteria agreed for rating prevention intervention in terms of safety, efficacy and effectiveness. [References: 129]
Cochrane Database of Systematic Reviews, (3) : CD003024
- Year: 2002
- Problem: Alcohol Use
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
Elder, John P., Litrownik, Alan J., Slymen, Donald J., Campbell, Nadia R., Parra-Medina, Deborah, Choe, Sunny, Lee, Virginia, et-al
Evaluated a community-based tobacco/alcohol use-prevention program that targets high-risk migrant Hispanic adolescents in California. 660 adolescents and 1 adult caregiver for each were recruited from 22 schools through the Migrant Education Program to participate in an 8-wk intervention. Adolescents were randomly assigned to the prevention program or an attention-control (first aid/home safety) group. 70 8-wk groups (37 tobacco/alcohol and 33 control) were conducted. Assessments occurred at baseline, immediate post-intervention, and at 1- and 2-yr follow-ups. Susceptibility to smoking and alcohol and smoking and drinking over the past 30 days were the primary outcomes. Results show that following intervention, no between-group differences in smoking or drinking were significant. 30-day smoking started and remained at very low levels. Those considered susceptible to smoking dropped by nearly 40% in the control group and by 50% in the intervention group. Less-acculturated adolescents were less likely to report drinking in the past 30 days. It is concluded that the current intervention was not effective in preventing cigarette or alcohol consumption, perhaps due to very low baseline levels of smoking and drinking among the migrant youth (PsycINFO Database Record (c) 2007 APA, all rights reserved).
American Journal of Preventive Medicine, 23(4) : 269-275
- Year: 2002
- Problem: Alcohol Use
- Type: Randomised controlled trials
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Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Skills training
Larimer, Mary E., Cronce, Jessica M.
Reviews and assesses the existing body of literature on individually focused prevention and treatment approaches for college student drinking. Studies that evaluate the overall efficacy of an approach by measuring behavioral outcomes such as reductions in alcohol use and associated negative consequences were included. All studies discussed utilized at least one outcome measure focused on behavioral change and included a control or comparison condition; however, not all trials were randomized. Consistent with the results of previous reviews, little evidence exists for the utility of educational or awareness programs. Cognitive-behavioral skills-based interventions and brief motivational feedback (including mailed graphic feedback) have consistently yielded greater support for their efficacy than have informational interventions. There is mixed support for values clarification and normative reeducation approaches. Much of the research suffers from serious methodological limitations. Campuses would best serve the student population by implementing brief, motivational or skills-based interventions, targeting high-risk students identified either through brief screening in health care centers or other campus settings or through membership in an identified risk group. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Journal of Studies on Alcohol, Vol Suppl14 : 148-163
- Year: 2002
- Problem: Alcohol Use
- Type: Systematic reviews
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Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
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Treatment and intervention: Psychological Interventions (any)
Peleg, A., Neumann, L., Friger, M., Peleg, R., Sperber, A. D.
PURPOSE: To implement a brief intervention aimed at reducing abuse of alcohol among adolescents, and to assess its effectiveness. METHODS: One thousand 10th-grade students from seven high schools, chosen by random from the roster of all schools in southern Israel, were assigned to intervention and control groups. The intervention, which was based on Botvin's social skills theory, was conducted over 3 days and included dissemination of information, workshops, lectures by guest experts, and activity areas. It was administered by the staff of the high schools and the Psychological Counseling Service in Israel. A self-administered questionnaire was answered anonymously by students in the 10th grade (pretest) and again in the 11th and 12th grades (posttests). It included questions on sociodemographic data, alcohol-related habits, smoking habits, use of illicit drugs, knowledge, and attitudes. Data were collected between 1994 and 1997 with a 76% follow-up rate at 2 years. RESULTS: At baseline there was no statistical difference in alcohol consumption between the intervention and control groups. At 1- and 2-year follow-up the rates of alcohol consumption did not change in the intervention group (p > .05) but rose significantly in the control group (p < .001). In multiple regression analysis the variables male gender, positive attitudes, cigarette smoking, availability of illegal drugs, and intervention group were significant predictors of alcohol consumption. CONCLUSIONS: The results of this study show the effectiveness of this intervention program, based on reduced alcohol consumption in the intervention group at 1- and 2-year follow-up, compared with the control group. Compared with other programs, the present intervention is brief, intensive, and relatively easy to implement.
Journal of Adolescent Health, 28(4) : 263-9
- Year: 2001
- Problem: Alcohol Use
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation