Disorders - Substance Use Disorders
Spoth, R., Trudeau, L., Redmond, C., Shin, C.
OBJECTIVE: This brief report summarizes a replication and extension of a developmental outcome modeling study, by examining whether delayed substance initiation during adolescence, resulting from universal middle school preventive interventions, reduces problematic use in young adults Ages 25 and 27, up to 14.5 years after baseline.
METHOD: Participants were middle school students from 36 Iowa schools randomly assigned to the Strengthening Families Program plus Life Skills Training (SFP 10-14 + LST), LST-only, or a control condition. Self-report questionnaires originally were collected at 11 time points, through Age 22. A subsequent grant allowed for assessments at Ages 25 and 27, including measures of drunkenness, alcohol-related problems, cigarette use, illicit drug use (lifetime and frequency), marijuana use and prescription drug misuse. These outcomes were modeled as variables influenced by growth factors describing substance initiation during adolescence. Models included the effects of baseline risk, intervention condition assignment, and their interaction; risk-related moderation effects were examined and relative reduction rates were calculated for dichotomous variables.
RESULTS: Model fits were good. Analyses showed significant or marginally significant indirect intervention effects on all outcomes, through effects on adolescent substance initiation growth factors. Intervention x Risk interaction effects favored the higher risk subsample, replicating earlier findings. Additional direct effects on young adult use were observed only for cigarette frequency. Relative reduction rates were larger for the higher risk subsamples, ranging from 3.9% to 36.2%.
CONCLUSIONS: Universal preventive interventions implemented during early adolescence have the potential to decrease the rates of substance misuse and associated problems into young adulthood. (PsycINFO Database Record
Journal of Consulting & Clinical Psychology, 84(10) : 913-21
- Year: 2016
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Skills training, Other Psychological Interventions
Van-Ryzin, M. J., Roseth, C. J., Fosco, G. M., Lee, Y. K., Chen, I. C.
Although research has documented the positive effects of family-based prevention programs, the field lacks specific information regarding why these programs are effective. The current study summarized the effects of family-based programs on adolescent substance use using a component-based approach to meta-analysis in which we decomposed programs into a set of key topics or components that were specifically addressed by program curricula (e.g., parental monitoring/behavior management,problem solving, positive family relations, etc.). Components were coded according to the amount of time spent on program services that targeted youth, parents, and the whole family; we also coded effect sizes across studies for each substance-related outcome. Given the nested nature of the data, we used hierarchical linear modeling to link program components (Level 2) with effect sizes (Level 1). The overall effect size across programs was .31, which did not differ by type of substance. Youth-focused components designed to encourage more positive family relationships and a positive orientation toward the future emerged as key factors predicting larger than average effect sizes. Our results suggest that, within the universe of family-based prevention, where components such as parental monitoring/behavior management are almost universal, adding or expanding certain youth-focused components may be able to enhance program efficacy.
Clinical Psychology Review, 45 : 72-80
- Year: 2016
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Family therapy, Other Psychological Interventions
Webb, M. J., Kauer, S. D., Ozer, E. M., Haller, D. M., Sanci, L. A.
BACKGROUND: Adolescence and young adulthood are important developmental periods. Screening for health compromising behaviours and mental health disorders during routine primary care visits has the potential to assist clinicians to identify areas of concern and provide appropriate interventions. The objective of this systematic review is to investigate whether screening and subsequent interventions for multiple health compromising behaviours and mental health disorders in primary care settings improves the health outcomes of young people.
METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, literature searches were conducted in Medline, PsycINFO, Scopus and Cochrane Library databases (Prospero registration number CRD42013005828) using search terms representing four thematic concepts: primary care, young people, screening, and mental health and health compromising behaviour. To be eligible for inclusion, studies had to: include a measure of health outcome; include at least 75 % of participants aged under 25 years; use a screening tool that assessed more than one health domain; and be conducted within a primary care setting. Risk of bias was assessed using the Quality Rating Scale.
RESULTS: From 5051 articles identified, nine studies fulfilled the inclusion criteria and were reviewed: two randomised controlled trials (RCTs), one pilot RCT, two clustered RCTs, one randomised study with multiple intervention groups and no control group, one cluster RCT with two active arms, one longitudinal study and one pre-post study. Seven studies, including two RCTs and one clustered RCT, found positive changes in substance use, diet, sexual health or risky sexual behaviour, alcohol-related risky behaviour, social stress, stress management, helmet use, sleep and exercise. Of only two studies reporting on harms, one reported a negative health outcome of increased alcohol use.
CONCLUSIONS: There is some evidence that the use of screening and intervention with young people for mental health disorder or health compromising behaviours in clinical settings improves health outcomes. Along with other evidence that young people value discussions of health risks with their providers, these discussions should be part of the routine primary care of young people. Further quality studies are needed to strengthen this evidence.
BMC Family Practice, 17 : 104
- Year: 2016
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy
Arnaud, N., Baldus, C., Elgan, T. H. De-Paepe, N., Tonnesen, H., Csemy, L., Thomasius, R.
BACKGROUND: Mid-to-late adolescence is a critical period for initiation of alcohol and drug problems, which can be reduced by targeted brief motivational interventions. Web-based brief interventions have advantages in terms of acceptability and accessibility and have shown significant reductions of substance use among college students. However, the evidence is sparse among adolescents with at-risk use of alcohol and other drugs.
OBJECTIVE: This study evaluated the effectiveness of a targeted and fully automated Web-based brief motivational intervention with no face-to-face components on substance use among adolescents screened for at-risk substance use in four European countries.
METHODS: In an open-access, purely Web-based randomized controlled trial, a convenience sample of adolescents aged 16-18 years from Sweden, Germany, Belgium, and the Czech Republic was recruited using online and offline methods and screened online for at-risk substance use using the CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble) screening instrument. Participants were randomized to a single session brief motivational intervention group or an assessment-only control group but not blinded. Primary outcome was differences in past month drinking measured by a self-reported AUDIT-C-based index score for drinking frequency, quantity, and frequency of binge drinking with measures collected online at baseline and after 3 months. Secondary outcomes were the AUDIT-C-based separate drinking indicators, illegal drug use, and polydrug use. All outcome analyses were conducted with and without Expectation Maximization (EM) imputation of missing follow-up data.
RESULTS: In total, 2673 adolescents were screened and 1449 (54.2%) participants were randomized to the intervention or control group. After 3 months, 211 adolescents (14.5%) provided follow-up data. Compared to the control group, results from linear mixed models revealed significant reductions in self-reported past-month drinking in favor of the intervention group in both the non-imputed (P=.010) and the EM-imputed sample (P=.022). Secondary analyses revealed a significant effect on drinking frequency (P=.037) and frequency of binge drinking (P=.044) in the non-imputation-based analyses and drinking quantity (P=.021) when missing data were imputed. Analyses for illegal drug use and polydrug use revealed no significant differences between the study groups (Ps>.05).
CONCLUSIONS: Although the study is limited by a large drop-out, significant between-group effects for alcohol use indicate that targeted brief motivational intervention in a fully automated Web-based format can be effective to reduce drinking and lessen existing substance use service barriers for at-risk drinking European adolescents.
TRIAL REGISTRATION: International Standard Randomized Controlled Trial Registry: ISRCTN95538913; http://www.isrctn.com/ISRCTN95538913 (Archived by WebCite at http://www.webcitation.org/6XkuUEwBx).
Journal of Medical Internet Research, 18(5) : e103
- Year: 2016
- Problem: Substance Use Disorders (any), Alcohol Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, Technology, interventions delivered using technology (e.g. online, SMS)
Champion, K. E., Newton, N. C., Teesson, M.
PURPOSE OF REVIEW: Alcohol and other drug use are major contributors to the global burden of disease. Prevention is critical and evidence is beginning to support the use of online mediums to prevent alcohol and other drug use and harms among adolescents. This study aims to expand the evidence base by conducting a systematic review of recent universal prevention programs delivered by computers and the Internet.
RECENT FINDINGS: A total of 12 papers reporting outcomes from trials of nine universal online prevention programs were identified. Of the identified interventions, five targeted multiple substances, two focused solely on alcohol, one targeted only cannabis and one primarily addressed smoking. The majority of programs were delivered at school; however one was implemented in a primary care setting. Six programs demonstrated significant, but modest, effects for alcohol and/or other drug use outcomes.
SUMMARY: Evidence to support the efficacy of computer and Internet-based prevention programs for alcohol and other drug use and related harms among adolescents is rapidly emerging, demonstrating that online prevention is an area of increasing promise. Further replication work, longer-term trials and attempts to increase the impact are required.
Current Opinion in Psychiatry, 29(4) : 242-9
- Year: 2016
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Technology, interventions delivered using technology (e.g. online, SMS)
Davis, D. R., Kurti, A. N., Skelly, J. M., Redner, R., White, T. J., Higgins, S. T.
This report describes a systematic literature review of voucher and related monetary-based contingency management (CM) interventions for substance use disorders (SUDs) over 5.2years (November 2009 through December 2014). Reports were identified using the search engine PubMed, expert consultations, and published bibliographies. For inclusion, reports had to (a) involve monetary-based CM; (b) appear in a peer-reviewed journal; (c) include an experimental comparison condition; (d) describe an original study; (e) assess efficacy using inferential statistics; (f) use a research design allowing treatment effects to be attributed to CM. Sixty-nine reports met inclusion criteria and were categorized into 7 research trends: (1) extending CM to special populations, (2) parametric studies, (3) extending CM to community clinics, (4) combining CM with pharmacotherapies, (5) incorporating technology into CM, (6) investigating longer-term outcomes, (7) using CM as a research tool. The vast majority (59/69, 86%) of studies reported significant (p<0.05) during-treatment effects. Twenty-eight (28/59, 47%) of those studies included at least one follow-up visit after CM was discontinued, with eight (8/28, 29%) reporting significant (p<0.05) effects. Average effect size (Cohen's d) during treatment was 0.62 (95% CI: 0.54, 0.70) and post-treatment it was 0.26 (95% CI: 0.11, 0.41). Overall, the literature on voucher-based CM over the past 5years documents sustained growth, high treatment efficacy, moderate to large effect sizes during treatment that weaken but remain evident following treatment termination, and breadth across a diverse set of SUDs, populations, and settings consistent with and extending results from prior reviews.
Preventive Medicine, 92 : 36-46
- Year: 2016
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Case management
Lauricella, M., Valdez, J. K., Okamoto, S. K., Helm, S., Zaremba, C.
Contemporary prevention science has focused on the application of cultural adaptations of evidence-based prevention programs for minority youth populations. Far less is known about culturally grounded methods that are intended to organically develop prevention programs within specific populations and communities. This article systematically reviews recent literature on culturally grounded interventions used to prevent health disparities in ethnic minority youth populations. In this review, we assessed 31 peer-reviewed articles published in 2003 or later that fit inclusionary criteria pertaining to the development and evaluation of culturally grounded prevention programs. The evaluated studies indicated different approaches toward cultural grounding, as well as specific populations, geographic regions, and health issues that have been targeted. Specifically, the findings indicated that most of the studies focused on the development and evaluation of culturally grounded HIV/STI and substance abuse prevention programs for Mexican-American, African American, and American Indian/Alaska Native youth residing in the South or Southwestern US. These studies largely relied on community-based participatory or qualitative research methods to develop programs from the "ground up." This review has implications for the development of future culturally grounded and culturally adapted prevention programs targeting underserved minority youth populations and geographic regions. Specifically, it identifies populations and regions where culturally grounded prevention efforts are underdeveloped or non-existent, providing some scientific direction for the future development of these types of programs. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Journal of Primary Prevention, 37(1) : 11-32
- Year: 2016
- 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
Melendez-Torres, G., Dickson, K., Fletcher, A., Thomas, J., Hinds, K., Campbell, R., Murphy, S., Bonell, C.
Background: Substance use has detrimental short-term and long-term consequences for young people. Positive youth development (PYD) interventions, which favour promotion of positive assets over traditional risk reduction, have received attention recently as a possible intervention to prevent adolescent substance use. We aimed to synthesise the evidence on PYD interventions for reduction in substance use in young people. Methods: We searched 21 databases, including MEDLINE, PsycINFO, CINAHL and CENTRAL, and hand-searched key journals and websites. We included studies with more than half of participants aged 11-18 years where interventions meeting a pre-specified definition of PYD were delivered in community settings outside of normal school hours and did not target parents or young people with pre-defined conditions. Two reviewers screened records, assessed full-text studies for inclusion, and extracted data. A modified Cochrane risk of bias tool was used for quality assessment. Results: Ten studies reported in 13 reports were included in our synthesis. PYD interventions did not have an effect of statistical or public health significance on any substance use, illicit drug use or alcohol outcomes in young people. Conclusions: Interventions were diverse in content and delivery. Our review suggests that existing PYD interventions subject to evaluation do not appear to have produced reductions in substance use of public health significance. However, these interventions may not be the best exemplars of a PYD approach. Therefore, our findings should not be taken as evidence for the ineffectiveness of PYD as a theory of change for reducing substance use among young people. Additional rigorous evaluation of PYD interventions is key before further investment. Evaluations were of highly variable quality. Though searches were extensive, we were unable to test for publication bias. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
International Journal of Drug Policy, 36 : 95-103
- Year: 2016
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Stockings, E., Hall, W. D., Lynskey, M., Morley, K. I., Reavley, N., Strang, J., Patton, G., Degenhardt, L.
We did a systematic review of reviews with evidence on the effectiveness of prevention, early intervention, harm reduction, and treatment of problem use in young people for tobacco, alcohol, and illicit drugs (eg, cannabis, opioids, amphetamines, or cocaine). Taxation, public consumption bans, advertising restrictions, and minimum legal age are effective measures to reduce alcohol and tobacco use, but are not available to target illicit drugs. Interpretation of the available evidence for school-based prevention is affected by methodological issues; interventions that incorporate skills training are more likely to be effective than information provision-which is ineffective. Social norms and brief interventions to reduce substance use in young people do not have strong evidence of effectiveness. Roadside drug testing and interventions to reduce injection-related harms have a moderate-to-large effect, but additional research with young people is needed. Scarce availability of research on interventions for problematic substance use in young people indicates the need to test interventions that are effective with adults in young people. Existing evidence is from high-income countries, with uncertain applicability in other countries and cultures and in subpopulations differing in sex, age, and risk status. Concerted efforts are needed to increase the evidence base on interventions that aim to reduce the high burden of substance use in young people. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Lancet Psychiatry, 3(3) : 280-296
- Year: 2016
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
Tanner-Smith, E. E., Lipsey, M. W., Wilson, D. B.
Objectives: To conduct a meta-analysis of the effects of juvenile drug courts on general recidivism, drug recidivism, and drug use, and to explore variability in effects across characteristics of the drug courts and juvenile participants. Methods: We conducted a comprehensive literature search to identify randomized and controlled quasi-experimental studies that reported the effects of juvenile drug courts in the United States. Random-effects meta-analysis models were used to estimate mean odds ratio effect sizes, and meta-regression models were used to explore variability in effects. Results: The literature search yielded 46 eligible evaluation studies. The meta-analysis found that, overall, juvenile drug courts were no more or less effective than traditional court processing, with mean effects sizes that were not statistically significant for general recidivism, drug recidivism, or drug use. There was statistically significant heterogeneity in those effect sizes, but none of the drug court or participant characteristics coded from the study reports were associated with that variability. However, the juvenile drug court evaluations were generally of poor methodological quality, with very few studies employing random assignment and many instances of substantial baseline differences between drug court and comparison groups. Conclusions: Juvenile drug courts were not found to be categorically more or less effective than traditional court processing for reducing recidivism or drug use. The great variability in effects, nonetheless, suggests that there may be effective drug courts, but no distinctive characteristics of the more effective courts could be identified from the descriptive information provided in the generally low quality research studies currently available. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Journal of Experimental Criminology, 12(4) : 477-513
- Year: 2016
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
, At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement
Champion, K E., Newton, Nicola C., Stapinski, L A., Teesson, M
Aim: To evaluate the effectiveness of an online school-based prevention program for ecstasy (MDMA) and new psychoactive substances (NPS). Design: Cluster randomized controlled trial with two groups (intervention and control). Setting Eleven secondary schools in Australia. Participants: A total of 1126 students (mean age: 14.9 years). Intervention: The internet-based Climate Schools: Ecstasy and Emerging Drugs module uses cartoon storylines to convey information about harmful drug use. It was delivered once weekly, during a 4-week period, during health education classes. Control schools received health education as usual. Measurement: Primary outcomes were self-reported intentions to use ecstasy and NPS at 12 months. Secondary outcomes were ecstasy and NPS knowledge and life-time use of ecstasy and NPS. Surveys were administered at baseline, post-intervention and 6 and 12 month post-baseline. Findings: At 12 months, the proportion of students likely to use NPS was significantly greater in the control group (1.8%) than the intervention group [0.5%; odds ratio (OR) = 10.17, 95% confidence interval (CI) = 1.31-78.91]. However, students' intentions to use ecstasy did not differ significantly between groups (control = 2.1%, intervention = 1.6%; OR = 5.91, 95% CI = 1.01-34.73). There was a significant group difference in the change from baseline to post-test for NPS knowledge (beta = -0.42, 95% CI = -0.62 to -0.21, Cohen's d = 0.77), with controls [mean = 2.78, standard deviation (SD = 1.48] scoring lower than intervention students (mean = 3.85, SD = 1.49). There was also evidence of a significant group difference in ecstasy knowledge at post-test (control: mean = 9.57, SD = 3.31; intervention: mean = 11.57, SD = 3.61; beta = -0.54, 95% CI = -0.97 to -0.12, P = 0.01, d = 0.73). Conclusions: The Climate Schools: Ecstasy and Emerging Drugs module, a universal online school-based prevention program, appeared to reduce students' intentions to use new psychoactive substances and increased knowledge about ecstasy and new psychoactive substances in the short term. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Addiction, 111(8) : 1396-1405
- Year: 2016
- Problem: Substance Use Disorders (any), Stimulant Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Babowitch, J. D., Antshel, K. M.
The quantitative literature on the treatment of comorbid depression and substance misuse among adolescents was reviewed, including: (1) a synthesis of the empirical evidence of the multiple models of integrated treatment for depression and substance use, (2) an examination of proposed mechanisms underlying symptom change in these integrated treatment models targeting depression and substance use, and (3) a methodological critique and suggestions for future research. We reviewed 15 studies reporting on treatment outcomes among adolescents with comorbid depression and non-tobacco related substance use disorders (SUD) and general misuse. Although there is empirical evidence linking Cognitive-Behavioral Therapy (CBT), Motivational Enhancement Therapy (MET), and Family-Focused Therapy (FFT) to depression and SUD symptom reduction in adolescents, few studies have provided data on mechanisms that may account for this effect. Potential mechanisms include improvements in dysfunctional reward processing and self-efficacy. Although this review highlights promising findings for the treatment of comorbid depression and substance misuse in adolescents, further work is warranted; as such results could have important implications for intervention development.
Journal of Affective Disorders, 201 : 25-33
- Year: 2016
- Problem: Depressive Disorders, Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Family therapy, Motivational interviewing, includes Motivational Enhancing Therapy