Disorders - Substance Use Disorders
Slesnick, N., Guo, X., Brakenhoff, B., Bantchevska, D.
While research on homeless adolescents and young adults evidencing substance use disorder is increasing, there is a dearth of information regarding effective interventions, and more research is needed to guide those who serve this population. The current study builds upon prior research showing promising findings of the community reinforcement approach (CRA) (Slesnick, Prestopnik, Meyers, & Glassman, 2007). Homeless adolescents and young adults between the ages of 14 to 20. years were randomized to one of three theoretically distinct interventions: (1) CRA (. n=. 93), (2) motivational enhancement therapy (MET, n=. 86), or (3) case management (CM, n=. 91). The relative effectiveness of these interventions was evaluated at 3, 6, and 12. months post-baseline. Findings indicated that substance use and associated problems were significantly reduced in all three interventions across time. Several moderating effects were found, especially for sex and history of childhood abuse. Findings show little evidence of superiority or inferiority of the three interventions and suggest that drop-in centers have choices for addressing the range of problems that these adolescents and young adults face.
Journal of Substance Abuse Treatment, 54 : 1-13
- Year: 2015
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
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Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, Skills training, Other Psychological Interventions, Other service delivery and improvement interventions
Smith, D. C., Ureche, D. J., Davis, J. P., Walters, S. T.
Background: Many adolescents in need of substance use disorder treatments never engage in treatment. Further, the most promising interventions that could be adapted to target treatment engagement often use normative feedback (NF) despite concerns about its appropriateness for adolescents. This preliminary study will inform a larger trial designed to isolate whether NF is an inert, helpful, or harmful active ingredient within pretreatment motivational interviewing (MI) interventions designed to increase treatment engagement. Methods: Adolescents (N = 48) presenting for treatment intake assessments were randomized to receive MI (n = 22) or MI+NF (n = 26) immediately following their assessments. Three-month outcomes included the percentage of youth engaged in treatment, the percentage of youth reporting past-month binge drinking, and the percentage of days of abstinence. Results: Treatments were delivered with high fidelity, and a high proportion of eligible participants were recruited and retained in this study. Participants significantly increased their percentage of days of abstinence by approximately 10% at follow-up (d = .32, P =.03), with no significant differences between groups. Fifty-five percent of youth in MI and 41.7% of youth in MI+NF engaged in treatment (odds ratio [OR] = .60, nonsignificant; 95% confidence interval, CI [0.136-2.68]). Conclusions: Larger trials should test whether NF is an active ingredient in adolescent MI interventions, and should also determine the mechanisms through which MI+NF may produce effects. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Substance Abuse, 36(3) : 350-358
- Year: 2015
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
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Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, Personalised feedback, normative feedback
, Other service delivery and improvement interventions
Spirito, A., Hernandez, L., Cancilliere, M.K., Graves, H., Barnett, N.
This study examined the feasibility and preliminary efficacy of a brief parent-based prevention intervention to delay or prevent the initiation of alcohol and drug use in young adolescents with emotional/behavioral disorders. Findings from a small randomized clinical trial comparing the individualized family substance use preventive intervention based on the Family Check-Up model (FCU condition) to a Psychoeducation (PE) session revealed that parents in both conditions reported an increase in alcohol-related communication at three and six months as well as an increase in general family communication. Parents in the FCU condition reported an increase on overall substance-related communication, and reported experiencing less problematic family communication compared to those in PE. Parents in the PE condition reported greater increases in parental monitoring than parents in the FCU condition. Study findings suggest a larger trial is indicated to test individual and family factors that lead to differential efficacy of these preventive interventions. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Journal of Child & Adolescent Substance Abuse, 24(5) : 308-322
- Year: 2015
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
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Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, Psychoeducation, Other Psychological Interventions
Santisteban, D. A., Mena, M. P., Muir, J., McCabe, B. E., Abalo, C., Cummings, A. M.
OBJECTIVE: The purpose of this randomized trial was to investigate the efficacy of 2 behavioral treatments focusing on different change mechanisms in ameliorating a borderline personality disorder constellation of behaviors and substance use in adolescents referred by juvenile diversion programs.
METHODS: Forty adolescents 14-17 years of age and meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for borderline personality disorder and substance use disorders were randomized to integrative borderline personality disorder-oriented adolescent family therapy (I-BAFT) or individual drug counseling. This design allowed a comparison of 2 manualized interventions, 1 family based and 1 individually oriented. Profiles of clinical change were used to detect impact and estimate treatment effect sizes.
RESULTS: Primary analyses showed that both interventions had a clinically significant impact on borderline personality disorder behaviors 12 months after baseline but with no differential treatment effects. The impact on substance use was more complex. Subgroup analyses revealed that adolescents with depression had significantly more severe profiles of borderline personality disorder and substance use. These youths were the only group to show reductions in substance use, but they only did so if they received the I-BAFT intervention. Study data also documented the high dosage of intensive residential treatment needed by this population.
CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Results highlight the intensive treatment needs of juvenile justice-involved youths with co-occurring substance use and borderline personality disorder including depression, the hybrid outpatient and residential treatment often required by this population, and the promise of a family-oriented approach, particularly for youths with severe symptoms and co-occurring depression. (PsycINFO Database Record
Psychiatric Rehabilitation Journal, 38(1) : 55-64
- Year: 2015
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
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Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Psychological Interventions (any)
, Dialectical behavioural therapy (DBT)
, Family therapy, Other Psychological Interventions
Schwinn, T. M., Thom, B., Schinke, S. P., Hopkins, J.
Purpose Rates of drug use among sexual-minority youths are disproportionately high. Yet, expressly designed prevention programs targeting this population are absent. This study developed and tested a web-based drug abuse prevention program for sexual-minority youths. Methods A sample (N = 236) of sexual-minority youths was recruited via Facebook. Online, all youths completed pretests; youths randomly assigned to the intervention received a 3-session prevention program; and all youths completed posttest and 3-month follow-up measurements. Results At 3-month follow-up and compared to youths in the control arm, intervention-arm youths reported less stress, reduced peer drug use, lower rates of past 30-day other drug use, and higher coping, problem solving, and drug-use refusal skills. Conclusions Outcome data suggest the potential of tailored intervention content to address sexual-minority youths' drug use rates and related risk factors. Moreover, study procedures lend support to the feasibility of using the Internet to recruit sexual-minority youths, collect data, and deliver intervention.
Journal of Adolescent Health, 56(5) : 571-573
- Year: 2015
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
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Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Skills training, Technology, interventions delivered using technology (e.g. online, SMS)
Tanner-Smith, E. E., Steinka-Fry, K. T., Hennessy, E. A., Lipsey, M. W., Winters, K.C.
Brief interventions aimed at reducing alcohol use among youth may interrupt a possible developmental progression to more serious substance use if they can also affect the use of other illicit drugs. This meta-analysis examined the findings of recent research on the effects of brief alcohol interventions for adolescents and young adults on both alcohol and illicit drug use. Eligible studies were those using randomized or controlled quasi-experimental designs to examine the effects of brief alcohol interventions on illicit drug use outcomes among youth. A comprehensive literature search identified 30 eligible study samples that, on average, included participants age 17, with 57 % male participants and 56 % White youth. Three-level random-effects meta-analyses were used to estimate mean effect sizes and explore variability in effects. Overall, brief interventions targeting both alcohol and other drugs were effective in reducing both of these substances. However, the brief interventions that targeted only alcohol had no significant secondary effects on untargeted illicit drug use. The evidence from current research, therefore, shows modest beneficial effects on outcomes that are targeted by brief interventions for youth, but does not show that those effects generalize to untargeted illicit drug use outcomes.;
Journal of Youth & Adolescence, 44(5) : 1011-1023
- Year: 2015
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
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Stage: Universal prevention
, At risk (indicated or selected prevention)
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Treatment and intervention: Psychological Interventions (any)
Noel, V., Stanger, C., Budney, A. J.
Aims: While contingency management (CM) interventions are effective in decreasing youth substance use, this effect is shortterm. Poor parent monitoring and tobacco use predict youth substance use but their role and the role of parent impulsive decision making in substance use relapse is unknown. This study examined the influence of parent impulsive decision making and tobacco use on parent monitoring and the treatment related changes in parent monitoring on post treatment youth substance use. Methods: Participants included 230 youths aged 12-18 years who abused either alcohol, marijuana or both, and their parent(s). Families participated in a 14-week randomized trial examining the efficacy of the addition of CM to MET/CBT intervention. Frequency of youth substance use was assessed using the Timeline Follow Back method. Parents self-reported their tobacco use and monitoring of youth behaviors. To measure impulsive decision making, parents completed a delay discounting task (degree of preference for smaller immediate over larger delayed rewards). Results: A latent growth model for youth substance use frequency at discharge, 3, 6, and 9months was fit. Five predictors were then added: parent monitoring at intake/discharge, treatment condition, parent delay discounting, and parent tobacco smoking status (smoker/non-smoker). The final model fit well (X2(18, N= 230) = 17.55, p = .49, RMSEA= .00). Poor parent monitoring at intake (B = .68) and higher parent delay discounting (B = .14) was associated with poor parent monitoring at discharge. Although treatment condition did not predict youth substance use post treatment, poor parent monitoring at discharge (B = .39) and parent tobacco use (B = .37) predicted the youth substance use intercept (more days of substance use during treatment) accounting for 31% of the variance. No variable predicted rate of change in substance use post treatment. Conclusions: Addressing parent substance use and impulsive decision making and targeting parent monitoring may be beneficial in improving the maintenance of parent monitoring and reducing youth substance use long-term.
Drug & Alcohol Dependence, 146 : e53
- Year: 2015
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
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Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Motivational interviewing, includes Motivational Enhancing Therapy, Contingency management
, Other service delivery and improvement interventions
Oesterle, S., Hawkins, J., Kuklinski, M. R., Fagan, A. A., Fleming, C., Rhew, I. C., Brown, E. C., Abbott, R. D., Catalano, R. F.
This study tested sustained effects of the Communities That Care (CTC) prevention system on health-risking behaviors 9 years after baseline in a community-randomized trial involving 24 towns in seven states. Earlier analyses found sustained effects on abstinence from drug use and delinquency through Grade 12 in a panel of fifth graders. At age 19, 91 % (n = 3986) of the living panel completed the survey. Data were analyzed using generalized linear mixed models. The prevalence of lifetime and current substance use and delinquency were the primary outcomes. Secondary outcomes included substance use disorders, major depression, suicidality, educational attainment, and sexual risk behaviors. CTC had a significant overall effect across lifetime measures of the primary outcomes for males, but not for females or the full sample, although lifetime abstinence from delinquency in the full sample was significantly higher in CTC communities (ARR = 1.16). Males in CTC communities also continued to show greater lifetime abstinence from cigarette smoking (ARR = 1.22). CTC did not have a sustained effect on current substance use and delinquency nor did it improve the secondary outcomes at age 19 for either gender. Communities using CTC may need to extend their prevention planning to include the high school years to sustain effects on drug use and delinquency beyond high school for both genders. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (journal abstract).
American Journal of Community Psychology, 56(3-4) : 217-228
- Year: 2015
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
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Stage: Universal prevention
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Treatment and intervention: Service Delivery & Improvement, Other service delivery and improvement interventions
Mason, M., Ola, B., Zaharakis, N., Zhang, J.
Tobacco and alcohol use continues to be associated with negative health outcomes among adolescents and young adults. New technologies such as text messaging can increase access to substance use interventions and have now been established as an evidence-based, recommended approach towards substance use prevention. This review presents results from a meta-analysis examining the effectiveness of text message interventions for tobacco and alcohol cessation within adolescent and young adult populations. Results from 14 studies with effect sizes are ranging from -0.25 to 0.54. Combining the effect sizes across studies yielded a summary effect size of 0.25, indicating that in general, text interventions have a positive effect on reducing substance use behaviors. Results are discussed in the context of prevention opportunities and recommendations for future text messaging intervention research. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Prevention Science, 16(2) : 181-188
- Year: 2015
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
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Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Kouyoumdjian, F. G., McIsaac, K. E., Liauw, J., Green, S., Karachiwalla, F., Siu, W., Burkholder, K., Binswanger, I., Kiefer, L., Kinner, S. A., Korchinski, M., Matheson, F. I., Young, P., Hwang, S. W.
We systematically reviewed randomized controlled trials of interventions to improve the health of people during imprisonment or in the year after release. We searched 14 biomedical and social science databases in 2014, and identified 95 studies. Most studies involved only men or a majority of men (70/83 studies in which gender was specified); only 16 studies focused on adolescents. Most studies were conducted in the United States (n = 57). The risk of bias for outcomes in almost all studies was unclear or high (n = 91). In 59 studies, interventions led to improved mental health, substance use, infectious diseases, or health service utilization outcomes; in 42 of these studies, outcomes were measured in the community after release. Improving the health of people who experience imprisonment requires knowledge generation and knowledge translation, including implementation of effective interventions.
American Journal of Public Health, 105(4) : e13-e33
- Year: 2015
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
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Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
Kirby, K. C., Meyers, K., Carpenedo, C. M., Bresani, E., Dugosh, K. L., Zentgraf, K., Zaslav, D.
Aims: Little research has examined methods for helping parents with treatment-resistant adolescents (12-17 yrs) and young adults (18-25 yrs).Weadapted the Community Reinforcement and Family Training (CRAFT) program for treatment-resistant adults for use by parents dealing with treatment resistant youth (12-25 yrs) and evaluated the revised program on efficacy in facilitating treatment entry, reducing drug use, and reducing behavior problems. Methods: Parents (N= 56) were randomly assigned to receive 12 individual sessions of either CRAFT (n = 32) or Alanon/NarAnon Facilitation Training (AFT; n = 24) delivered at our Family Training Program (FTP). Youth treatment entry was monitored weekly and at 3- and 6-month follow-up assessments. Substance use and behavior problems were monitored through parent report at 3- and 6-month follow-up assessments. Results: Large differences were seen in the number of youth receiving a treatment referral with 75% of the CRAFT parents getting their child to FTP for a referral compared to 33% in the ANF group (2 = 9.722, p = .002). Rates of transfer for youth from FTP to specialty treatment in the community were lower: 41% vs 29% in CRAFT and ANF, respectively. Although not statistically significant, there were small to moderate effect sizes for a group by time interaction for drug use (d = .38) and for problem reduction (d = .36 for adolescents; d = .62 for young adults) favoring greater reductions in CRAFT. Conclusions: Preliminary results suggest that the modified CRAFT program is more efficacious than ANF in getting youth into treatment. Effects on drug use and problem behavior are not yet clear.
Drug & Alcohol Dependence, 156 : e112
- Year: 2015
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
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Stage: Treatment resistant/treatment refractory
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Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Marsiglia, F. F., Kulis, S. S., Booth, J. M., Nuno-Gutierrez, B. L., Robbins, D. E.
In the face of rising rates of substance use among Mexican youth and rapidly narrowing gender differences in use, substance use prevention is an increasingly urgent priority for Mexico. Prevention interventions have been implemented in Mexico but few have been rigorously evaluated for effectiveness. This article presents the long term effects of a Mexico-based pilot study to test the feasibility of a linguistically specific (Mexican Spanish) adapted version of keepin'it REAL, a school-based substance abuse prevention model program. University affiliated researchers from Mexico and the US collaborated on the study design, program implementation, data collection, and analysis. Students and their teachers from two middle schools (secundarias) in Guadalajara participated in this field trial of Mantente REAL (translated to Spanish). The schools were randomly assigned to treatment and control conditions. The sample of 431 students reported last 30 day substance use at three times (one pretest and two posttests). Changes in substance use behaviors over time were examined using growth curve models. Long term desired intervention effects were found for alcohol and marijuana use but not for cigarettes. The intervention effects were greater for girls than for boys in slowing the typical developmental increase over time in alcohol use. Marijuana effects were based on small numbers of users and indicate a need for larger scale studies. These findings suggest that keepin' it REAL is a promising foundation for cultural program adaptation efforts to create efficacious school-based universal prevention interventions for middle school students in Mexico. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Journal of Primary Prevention, 36(2) : 93-104
- Year: 2015
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
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Stage: Universal prevention
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Treatment and intervention: Psychological Interventions (any)
, Skills training