Disorders - substance use disorders
Thomas, Roger E., Lorenzetti, Diane, Spragins, Wendy
Background: Many adolescents receive mentoring. There is no systematic review if mentoring prevents alcohol and drug use.; Objectives: Assess effectiveness of mentoring to prevent adolescent alcohol/drug use.; Search Methods: Cochrane CENTRAL (issue 4), MEDLINE (1950-to July 2011), EMBASE (1980-to July 2011), 5 other electronic and 11 Grey literature electronic databases, 10 websites, reference lists, experts in addictions and mentoring.; Selection Criteria: Randomised controlled trials (RCTs) of mentoring in adolescents to prevent alcohol/drug use.; Data Collection and Analysis: We identified 2,113 abstracts, independently assessed 233 full-text articles, 4 RCTs met inclusion criteria. Two reviewers independently extracted data and assessed risks of bias. We contacted investigators for missing information.; Main Results: We identified 4 RCTs (1,194 adolescents). No RCT reported enough detail to assess whether a strong randomisation method was used or allocation was concealed. Blinding was not possible as the intervention was mentoring. Three RCTs provided complete data. No selective reporting.Three RCTs provided evidence about mentoring and preventing alcohol use. We pooled two RCTs (RR for mentoring compared to no intervention = 0.71 (95% CI = 0.57 to 0.90, P value = 0.005). A third RCT found no significant differences.Three RCTs provided evidence about mentoring and preventing drug use, but could not be pooled. One found significantly less use of "illegal" drugs," one did not, and one assessed only marijuana use and found no significant differences.One RCT measured "substance use" without separating alcohol and drugs, and found no difference for mentoring.; Authors' Conclusions: All four RCTs were in the US, and included "deprived" and mostly minority adolescents. Participants were young (in two studies age 12, and in two others 9-16). All students at baseline were non-users of alcohol and drugs. Two RCTs found mentoring reduced the rate of initiation of alcohol, and one of drug usage. The ability of the interventions to be effective was limited by the low rates of commencing alcohol and drug use during the intervention period in two studies (the use of marijuana in one study increased to 1% in the experimental and to 1.6% in the control group, and in another study drug usage rose to 6% in the experimental and 11% in the control group). However, in a third study there was scope for the intervention to have an effect as alcohol use rose to 19% in the experimental and 27% in the control group. The studies assessed structured programmes and not informal mentors.;
Cochrane Database of Systematic Reviews, (11) : CD007381
- Year: 2011
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Werb, Dan, Mills, Edward J., Debeck, Kora, Kerr, Thomas, Montaner, Julio S. G., Wood, Evan
Background: Anti-illicit-drug public-service announcements (PSAs) have become a cornerstone of drug policy in the USA. However, studies of the effectiveness of these interventions have not been subjected to a systematic evaluation.; Methods: The authors searched 10 electronic databases along with major conference abstract databases (from inception until 15 February 2010) for all articles and abstracts that evaluated the effectiveness of anti-illicit-drug PSAs. The authors evaluated all studies that assessed intention to use illicit drugs and/or levels of illicit-drug use after exposure to PSAs, and conducted meta-analyses of these studies.; Results: The authors identified seven randomised trials (n=5428) and four observational trials (n=17 404). Only one randomised trial showed a statistically significant benefit of PSAs on intention to use illicit drugs, and two found evidence that PSAs significantly increased intention to use drugs. A meta-analysis of eligible randomised trials demonstrated no significant effect. Observational studies showed evidence of both harmful and beneficial effects.; Conclusion: Existing evidence suggests that the dissemination of anti-illicit-drug PSAs may have a limited impact on the intention to use illicit drugs or the patterns of illicit-drug use among target populations.;
Journal of Epidemiology & Community Health, 65(10) : 834-840
- Year: 2011
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Shek, D. T. L., Yu, L.
The present study attempts to examine the longitudinal impact of a curriculum-based positive youth development program, entitled the Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programmes), on adolescent problem behavior in Hong Kong. Using a longitudinal randomized group design, six waves of data were collected from 19 experimental schools (n = 3,797 at Wave 1) in which students participated in the Project P.A.T.H.S. and 24 control schools (n = 4,049 at Wave 1). At each wave, students responded to questions asking about their current problem behaviors, including delinquency and use of different types of drugs, and their intentions of engaging in such behaviors in the future. Results based on individual growth curve modeling generally showed that the participants displayed lower levels of substance abuse and delinquent behavior than did the control students. Participants who regarded the program to be helpful also showed lower levels of problem behavior than did the control students. The present findings suggest that the Project P.A.T.H.S. is effective in preventing adolescent problem behavior in the junior secondary school years. (copyright)2011 with author. Published by TheScientificWorld.
The Scientific World Journal, 11 : 546-567
- Year: 2011
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Sevy, S., Robinson, D. G., Sunday, S., Napolitano, B., Miller, R., McCormack, J., Kane, J.
The purpose of this study is to compare the efficacy of olanzapine and risperidone for the acute treatment of first-episode schizophrenia patients with cannabis use disorders. This secondary analysis of a previously published study included 49 first-episode patients with a diagnosis of schizophrenia, schizophreniform disorder, or schizoaffective disorder and a co-occurring lifetime diagnosis of cannabis use disorders randomly assigned to treatment with either olanzapine (n = 28) or risperidone (n = 21) for 16. weeks. The olanzapine group did not differ significantly from the risperidone group for initial response rates of positive symptoms, and rates of cannabis use or alcohol use during the study. Positive symptoms and the Scale for Assessment of Negative Symptoms (SANS) global asociality-anhedonia scores improved over time but did not differ between study medications. In both groups, cannabis use during the study was higher in patients who used cannabis within three months of the admission. Thus, our results suggest that olanzapine and risperidone had a similar initial efficacy on psychotic symptoms and substance use in first-episode patients with co-occurring cannabis use disorders. If clinicians are choosing between olanzapine versus risperidone treatment for this population, their decision should be based upon factors other than symptom response and short-term substance misuse. (copyright) 2011 Elsevier Ltd.
Psychiatry Research, 188(3) : 310-314
- Year: 2011
- Problem: Psychosis Disorders, Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
, First episode (psychosis only)
-
Treatment and intervention: Biological Interventions (any)
, Typical Antipsychotics (first generation)
, Atypical Antipsychotics (second generation)
Santisteban, D. A., Mena, M. P., McCabe, B. E.
A small randomized trial investigated a new family-based intervention for Hispanic adolescents who met DSM-IV criteria for substance abuse disorder. The Culturally Informed and Flexible Family-Based Treatment for Adolescents (CIFFTA) is a tailored/adaptive intervention that includes a flexible treatment manual and multiple treatment components. The study used an " add on" design to isolate the effects on substance abuse, behavior problems, and parenting practices attributable to the newly developed components. Twenty-eight Hispanic adolescents and their families were randomized either to the experimental treatment or to traditional family therapy (TFT) and were assessed at baseline and 8-month follow-up. Despite the small sample, results revealed statistically significant time - treatment effects on both self-reported drug use (marijuana + cocaine), F(1, 22) = 10.59, p < .01, (eta)2 = .33 and adolescent reports of parenting practices, F(1, 22) = 9.01, p < .01, (eta)2 = .29. Both sets of analyses favored CIFFTA participants. There was a significant time - treatment effect, F(1, 22) = 6.72, p = .02, (eta)2 = .23, favoring CIFFTA on parent report of parenting practices using a composite that matched the variables used for adolescents, but only a nonsignificant trend, F(1, 22) = 2.43, p = .13, (eta)2 = .10, with a composite that used all parenting subscales. Parent reports of adolescent behavior problems did not show a significant time or time - treatment effect. These results show the promise of this adaptive treatment for substance abuse in Hispanic adolescents and suggest the need for a larger randomized trial to fully investigate this treatment. (copyright) 2011 American Psychological Association.
Journal of Family Psychology, 25(4) : 610-614
- Year: 2011
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Family therapy, Other Psychological Interventions, Other service delivery and improvement interventions
Roberts, Clare, Williams, Rachael, Kane, Robert, Pintabona, Yolanda, Cross, Donna, Zubrick, Stephen, Silburn, Sven
This cluster randomized controlled trial evaluated the impact of a universal mental health promotion program, the Aussie Optimism Program (AOP), on adolescent tobacco and alcohol use. Students aged 10 - 13 years (N = 3288) from 63 government primary schools were recruited from an urban population area in Western Australian. Schools were randomized to a usual school health curriculum control group (21 schools), an AOP group with teacher training (20 schools), or AOP with teacher training plus coaching (22 schools). The intervention was implemented in primary school Grades 6 and 7, with follow-up in secondary school Grade 8. Students completed confidential questionnaires relating to consumption of cigarettes and alcohol over the past month. The intervention program contained activities relating to social skills, social problem solving and challenging unhelpful thoughts. The intervention was associated with lower levels of alcohol use at post-test and lower levels of both alcohol and tobacco use at a 12-month secondary school follow-up, but only when AOP was implemented by teachers who received training and coaching in the program. Hence, mental health promotion programs that focus on general life skills may also impact upon health risk behaviors such as alcohol and tobacco use in young adolescents. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Advances in Mental Health, 10(1) : 72-82
- Year: 2011
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Skills training
Riggs, P. D., Winhusen, T., Davies, R. D., Leimberger, J. D., Mikulich-Gilbertson, S., Klein, C., Macdonald, M., et-al
Objective: To evaluate the efficacy and safety of osmotic-release methylphenidate (OROSMPH) compared with placebo for attention-deficit/ hyperactivity disorder (ADHD), and the impact on substance treatment outcomes in adolescents concurrently receiving cognitivebehavioral therapy (CBT) for substance use disorders (SUD). Method: This was a 16-week, randomized, controlled, multi-site trial of OROS-MPH + CBT versus placebo + CBT in 303 adolescents (aged 13 through 18 years) meeting DSM-IV diagnostic criteria for ADHD and SUD. Primary outcome measures included the following: for ADHD, clinician-administered ADHD Rating Scale (ADHD-RS), adolescent informant; for substance use, adolescent-reported days of use in the past 28 days. Secondary outcome measures included parent ADHD-RS and weekly urine drug screens (UDS). Results: There were no group differences on reduction in ADHD-RS scores (OROS-MPH: -19.2, 95% confidence interval [CI], -17.1 to -21.2; placebo, -21.2, 95% CI, -19.1 to -23.2) or reduction in days of substance use (OROS-MPH: -5.7 days, 95% CI, 4.0-7.4; placebo: -5.2 days, 95% CI, 3.5-7.0). Some secondary outcomes favored OROS-MPH, including lower parent ADHD-RS scores at 8 (mean difference = 4.4, 95% CI, 0.8-7.9) and 16 weeks (mean difference =6.9; 95% CI, 2.9-10.9) and more negative UDS in OROS-MPH (mean = 3.8) compared with placebo (mean = 2.8; p =.04). Conclusions: OROS-MPH did not show greater efficacy than placebo for ADHD or on reduction in substance use in adolescents concurrently receiving individual CBT for co-occurring SUD. However, OROS-MPH was relatively well tolerated and was associated with modestly greater clinical improvement on some secondary ADHD and substance outcome measures. Clinical Trial Registration Information-Attention Deficit Hyperactivity Disorder (ADHD) in Adolescents with Substance Use Disorders (SUD); http://www.clinicaltrials.gov; NCT00264797. (copyright) 2011 American Academy of Child and Adolescent Psychiatry.
Journal of the American Academy of Child & Adolescent Psychiatry, 50(9) : 903-914
- Year: 2011
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Medications used to treat substance abuse, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Robbins, M. S., Feaster, D. J., Horigian, V. E., Rohrbaugh, M., Shoham, V., Bachrach, K., Miller, M., et-al
Objective: To determine the effectiveness of brief strategic family therapy (BSFT; an evidence-based family therapy) compared to treatment as usual (TAU) as provided in community-based adolescent outpatient drug abuse programs. Method: A randomized effectiveness trial in the National Drug Abuse Treatment Clinical Trials Network compared BSFT to TAU with a multiethnic sample of adolescents (213 Hispanic, 148 White, and 110 Black) referred for drug abuse treatment at 8 community treatment agencies nationwide. Randomization encompassed both adolescents' families (n = 480) and the agency therapists (n = 49) who provided either TAU or BSFT services. The primary outcome was adolescent drug use, assessed monthly via adolescent self-report and urinalysis for up to 1 year post randomization. Secondary outcomes included treatment engagement ((greater-than or equal to)2 sessions), retention ((greater-than or equal to)8 sessions), and participants' reports of family functioning 4, 8, and 12 months following randomization. Results: No overall differences between conditions were observed in the trajectories of self-reports of adolescent drug use. However, the median number of days of self-reported drug use was significantly higher, (chi)2(1) = 5.40, p <.02, in TAU (Mdn = 3.5, interquartile range [IQR] = 11) than BSFT (Mdn = 2, IQR = 9) at the final observation point. BSFT was significantly more effective than TAU in engaging, (chi)2(1) = 11.33, p <.001, and retaining, (chi)2(1) = 5.66, p <.02, family members in treatment and in improving parent reports of family functioning, (chi)2(2) = 9.10, p <.011. Conclusions: We discuss challenges in treatment implementation in community settings and provide recommendations for further research. (copyright) 2011 American Psychological Association.
Journal of Consulting & Clinical Psychology, 79(6) : 713-727
- Year: 2011
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Family therapy
Shetgiri, R., Kataoka, S., Lin, H., Flores, G.
Purpose: Few studies have rigorously evaluated school-based interventions to reduce violence and substance use in high school students, especially Latinos. This study assessed the effects of a school-based program on reducing violence and substance use among primarily Latino high school students. Methods: Ninth-grade students at risk for violence and substance use were randomized to intervention or control groups. The intervention was based on an existing program developed for white and African American youth. Data on smoking, alcohol and drug use, fighting, and grades were collected at baseline and 4 and 8 months post enrollment. Results: There were 55 students in the control and 53 in the intervention group; 74% of controls and 78% of intervention students were Latino. There were no significant changes in fighting, smoking, or alcohol or drug use, from baseline to 8-month follow-up, between the intervention and control group. Pre and post grade point average (GPA) decreased from 2.3 at baseline to 1.8 at follow-up (p < .01) in the intervention group, with no significant between-group changes in GPA from baseline to follow-up. Conclusions: This school-based program showed no reduction in violence or substance use. The findings suggest that a program targeting non-Latino youth may not be optimal for reducing violence and substance use in Latinos; greater attention to cultural appropriateness and racial/ethnic differences may be needed. There was a decrease in interventiongroup GPA but no significant change compared with controls. Further studies of the impact of school-based substance use and violence prevention programs on academics, and the effectiveness of afterschool or community-based programs compared to school-based programs are needed.
Journal of the National Medical Association, 103(9-10) : 932-940
- Year: 2011
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Skills training
Slater, Michael D., Kelly, Kathleen J., Lawrence, Frank R., Stanley, Linda R., Comello, Maria Leonora G.
Two media-based interventions designed to reduce adolescent marijuana use ran concurrently from 2005 to 2009. Both interventions used similar message strategies, emphasizing marijuana's inconsistency with personal aspirations and autonomy. "Be Under Your Own Influence" was a randomized community and school trial replicating and extending a successful earlier intervention of the same name (Slater et al. Health Education Research 21:157 - 167, 2006). "Above the Influence" is a continuing national television, radio, and print campaign sponsored by the Office of National Drug Control Policy (ONDCP). This study assessed the simultaneous impact of the interventions in the 20 U.S. communities. Results indicate that earlier effects of the "Be Under Your Own Influence" intervention replicated only in part and that the most plausible explanation of the weaker effects is high exposure to the similar but more extensive ONDCP "Above the Influence" national campaign. Self-reported exposure to the ONDCP campaign predicted reduced marijuana use, and analyses partially support indirect effects of the two campaigns via aspirations and autonomy. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Prevention Science, 12(1) : 12-22
- Year: 2011
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Other Psychological Interventions
Spoth, R., Redmond, C., Clair, S., Shin, C., Greenberg, M., Feinberg, M.
Background: Substance misuse by adolescents and related health issues constitute a major public health problem. Community-based partnership models designed for sustained, quality implementation of proven preventive interventions have been recommended to address this problem. There is very limited longitudinal study of such models. Purpose: To examine the long-term findings from an RCT of a community-university partnership model designed to prevent substance misuse and related problems. Design/setting/participants: A cohort sequential design included 28 public school districts in rural towns and small cities in Iowa and Pennsylvania that were randomly assigned to community-university partnership or usual-programming conditions. At baseline, 11,960 students participated, across two consecutive cohorts. Data were collected from 2002 to 2008. Intervention: Partnerships supported community teams that implemented universal, evidence-based interventions selected from a menu. The selected family-focused intervention was implemented with 6th-grade students and their families; school-based interventions were implemented during the 7th grade. Observations demonstrated intervention implementation fidelity. Main outcome measures: Outcome measures were lifetime, past-month, and past-year use of a range of substances, as well as indices of gateway and illicit substance use; they were administered at baseline and follow-ups, extending to 4.5 years later. Results: Intent-to-treat, multilevel ANCOVAs of point-in-time use at 4.5 years past baseline were conducted, with supplemental analyses of growth in use. Data were analyzed in 2009. Results showed significantly lower substance use in the intervention group for 12 of 15 point-in-time outcomes, with relative reductions of up to 51.8%. Growth trajectory analyses showed significantly slower growth in the intervention group for 14 of 15 outcomes. Conclusions: Partnership-based implementation of brief universal interventions has potential for public health impact by reducing growth in substance use among youth; a multistate network of partnerships is being developed. Notably, the tested model is suitable for other types of preventive interventions. (copyright) 2011 American Journal of Preventive Medicine.
American Journal of Preventive Medicine, 40(4) : 440-447
- Year: 2011
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Skills training, Other Psychological Interventions
Zywiak, W. H., Graney, D. D., Wood, M. D., Stout, R. L.
College Facilitation for Alcohol Problems has been developed from Extended Case Monitoring (Stout et al. 1999) to address heavy drinking among college students with an intervention that capitalizes on students being available for a number of semesters, at a time when drinking patterns are being developed. Three hundred seventy-four First Offenders of a university's substance use policy were randomized to college facilitation or college as usual. College facilitation consisted of telephone calls about once a month spread across four academic semesters. The phone calls emphasized rapport, academic progress, and used academic progress has a hook to reduce drinking intensity among college students. In addition, any topics or issues that the student wanted to bring up were discussed. The sample consisted of 160 (43%) women, 354 (95%) Caucasian students, and 274 (73%) freshmen. All students were scheduled to complete 6, 12, 18, and 24 month research follow-ups and retention rates were 97, 94, 91, and 88%, respectively. Sixty-four percent or 11.5 of the 18 planned college facilitation (CF) telephone contacts were completed. Since academic progress was a large component of the telephone calls, and academic drinking is known to vary according to the day of the week, we examined drinking on each day of the last full week of classes, for each of the four semesters following randomization. Contrary to predictions, during the first end of the semester following randomization, there was a statistical trend for more drinking by CF students than control students on that Friday [t(330.6) = 1.84, p = 0.07, CF 4.40 (5.39) SDUs, control 3.41 (4.62) SDUs]. However, when this data was transformed (the fourth root) the statistical trend was no longer evident (p = 0.27). In contrast, in the hypothesized direction, we did find a difference for drinking on Sunday during the last week of the second semester following randomization [t(316.6) = 1.76, p = 0.08, CF 0.07 (0.77) SDUs, control 0.26 (1.20) SDUs, i.e., the controls were drinking four times as much as the CF students on this day]. When this variable was transformed, the group difference was significant [t(273.5=2.47, p = 0.01. d = 0.26]. For g.p.a., there was an increase from baseline to the second semester for CF students relative to controls [t(196) = 2.31, p = 0.02, d = 0.33; CF + 0.07(0.70), control )0.15(0.64)]. This intervention effect on g.p.a. is particularly noteworthy since the g.p.a. data are not susceptible to response bias.
Alcoholism: Clinical & Experimental Research, 35 : 212A
- Year: 2011
- Problem: Substance Use Disorders (any), Alcohol Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions