Disorders - substance use disorders
Salam, R. A., Das, J. K., Lassi, Z. S., Bhutta, Z. A.
Adolescent health care is challenging compared to that of children and adults, due to their rapidly evolving physical, intellectual, and emotional development. This paper is the concluding paper for a series of reviews to evaluate the effectiveness of interventions for improving adolescent health and well-being. In this paper, we summarize the evidence evaluated in the previous papers and suggest areas where there is enough existing evidence to recommend implementation and areas where further research is needed to reach consensus. Potentially effective interventions for adolescent health and well-being include interventions for adolescent sexual and reproductive health, micronutrient supplementation, nutrition interventions for pregnant adolescents, interventions to improve vaccine uptake among adolescents, and interventions for substance abuse. Majority of the evidence for improving immunization coverage, substance abuse, mental health, and accidents and injury prevention comes from high-income countries. Future studies should specifically be targeted toward the low- and middle-income countries with long term follow-up and standardized and validated measurement instruments to maximize comparability of results. Assessment of effects by gender and socioeconomic status is also important as there may be differences in the effectiveness of certain interventions. It is also important to recognize ideal delivery platforms that can augment the coverage of proven adolescent health-specific interventions and provide an opportunity to reach hard-to-reach and disadvantaged population groups. Copyright © 2016 Society for Adolescent Health and Medicine
Journal of Adolescent Health, 59(2 Supplement) : S88-S92
- Year: 2016
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
Rotheram-Borus, M. J., Tomlinson, M., Durkin, A., Baird, K., DeCelles, J., Swendeman, D.
Many young, South African men use alcohol and drugs and have multiple partners, but avoid health care settings-the primary site for delivery of HIV intervention activities. To identify the feasibility of engaging men in HIV testing and reducing substance use with soccer and vocational training programs. In two Cape Town neighborhoods, all unemployed men aged 18-25 years were recruited and randomized by neighborhood to: (1) an immediate intervention condition with access to a soccer program, random rapid diagnostic tests (RDT) for alcohol and drug use, and an opportunity to enter a vocational training program (n = 72); or (2) a delayed control condition (n = 70). Young men were assessed at baseline and 6 months later by an independent team. Almost all young men in the two neighborhoods participated (98 %); 85 % attended at least one practice (M = 42.3, SD = 34.4); 71 % typically attended practice. Access to job training was provided to the 35 young men with the most on-time arrivals at practice, drug-free RDT, and no red cards for violence. The percentage of young men agreeing to complete RDT at soccer increased significantly over time; RDTs with evidence of alcohol and drug use decreased over time. At the pre-post assessments, the frequency of substance use decreased; and employment and income increased in the immediate condition compared to the delayed condition. HIV testing rates, health care contacts, sexual behaviors, HIV knowledge, condom use and attitudes towards women were similar over time. Alternative engagement strategies are critical pathways to prevent HIV among young men. This feasibility study shows that soccer and job training offer such an alternative, and suggest that a more robust evaluation of this intervention strategy be pursued. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
AIDS and Behavior, 20(9) : 1841-1850
- Year: 2016
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Service Delivery & Improvement, Physical activity, exercise, Individual placement and support (IPS), vocational interventions
Wippert, Pia-Maria, Flieser, Michael
Background: Doping presents a potential health risk for young athletes. Prevention programs are intended to prevent doping by educating athletes about banned substances. However, such programs have their limitations in practice. This led Germany to introduce the National Doping Prevention Plan (NDPP), in hopes of ameliorating the situation among young elite athletes. Two studies examined 1) the degree to which the NDPP led to improved prevention efforts in elite sport schools, and 2) the extent to which newly developed prevention activities of the national anti-doping agency (NADA) based on the NDPP have improved knowledge among young athletes within elite sports schools. Methods: The first objective was investigated in a longitudinal study (Study I: t0 = baseline, t1 = follow-up 4 years after NDPP introduction) with N = 22 teachers engaged in doping prevention in elite sports schools. The second objective was evaluated in a cross-sectional comparison study (Study II) in N = 213 elite sports school students (54.5 % male, 45.5 % female, age M = 16.7 +/- 1.3 years (all students had received the improved NDDP measure in school; one student group had received additionally NADA anti-doping activities and a control group did not). Descriptive statistics were calculated, followed by McNemar tests, Wilcoxon tests and Analysis of Covariance (ANCOVA). Results: Results indicate that 4 years after the introduction of the NDPP there have been limited structural changes with regard to the frequency, type, and scope of doping prevention in elite sport schools. On the other hand, in study II, elite sport school students who received further NADA anti-doping activities performed better on an anti-doping knowledge test than students who did not take part (F(1, 207) = 33.99, p < 0.001), although this difference was small. Conclusion: The integration of doping-prevention in elite sport schools as part of the NDPP was only partially successful. The results of the evaluation indicate that the introduction of the NDPP has contributed more to a change in the content of doping prevention activities than to a structural transformation in anti-doping education in elite sport schools. Moreover, while students who did receive additional education in the form of the NDPP"booster sessions" had significantly more knowledge about doping than students who did not receive such education, this difference was only small and may not translate to actual behavior. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Substance Abuse Treatment, Prevention, and Policy Vol 11 2016, ArtID 35, 11 :
- Year: 2016
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Other Psychological Interventions
Tucker, J. S., D'Amico, E. J., Ewing, B. A., Miles, J. N. V., Pedersen, E. R.
Purpose: Homeless young adults between the ages of 18 and 25 exhibit high rates of alcohol use, as well as drug use and sexual risk behaviors. Yet few risk reduction programs exist for this at-risk population, particularly ones that are both effective and can be easily incorporated into settings serving this population (e.g., drop-in centers). This study addresses an important gap in prevention services for homeless emerging adults by conducting a pilot cluster cross-over randomized controlled trial of AWARE, a group-MI (Motivational Interviewing) brief risk reduction intervention focusing on reducing both substance use and sexual risk behavior. Methods: AWARE consists of four 45-min sessions. Rolling admission is used so that youth can join the program at any time, regardless of session. The evaluation took place in two drop-in centers for homeless young adults in the Los Angeles area. Homeless young adults ages 18-25 (mean age = 21.8) received the AWARE program (n = 100) or usual care (n = 100). The sample was 73% male, 79% heterosexual, and 31%non-Hispanic white. Surveys were completed at baseline and 3 months after program completion. The 3-months follow-up rate for the sample was 91%. Results: Satisfaction with the program was high and nearly half (48%) of AWARE participants completed all four sessions. At follow-up, AWARE participants reported a lower frequency of alcohol use over the past 3 months (p = 0.01), were less likely to be classified as a frequent heavy drinker (compared to a non-drinker) in the past 30 days (p = 0.05), and showed a marginally significant positive difference in their confidence that they could reduce/quit their drinking (p = 0.09), compared to control participants. In addition, AWARE participants showed significant increases in both their readiness (p = 0.02) and confidence (p = 0.02) to change their drug use, compared to control participants. In terms of sex-related outcomes, AWARE participants reported greater condom use self-efficacy than the control group at follow-up (p = 0.05), but intervention effects were not found for number of partners or condomuse. Conclusion: Results from this pilot evaluation are promising, suggesting that a brief group-MI intervention can be effective in helping homeless young adults make positive changes in their alcohol use, as well as strengthen their motivation to reduce their drug use and their condom use self-efficacy.
Alcoholism: Clinical and Experimental Research, 40 : 311A
- Year: 2016
- Problem: Substance Use Disorders (any), Alcohol Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy
Veronneau, M.-H., Dishion, T. J., Connell, A.M., Kavanagh, K.
Objective: Substance use in adulthood compromises work, relationships, and health. Prevention strategies in early adolescence are designed to reduce substance use and progressions to problematic use by adulthood. This report examines the long-term effects of offering Family Check-up (FCU) at multiple time points in secondary education on the progression of substance use from age 11 to 23 years. Method: Participants (N = 998; 472 females) were randomly assigned individuals to intervention or control in Grade 6 and offered a multilevel intervention that included a classroom-based intervention (universal), the FCU (selected), and tailored family management treatment (indicated). Among intervention families, 23% engaged in the selected and indicated levels during middle school. Results: Intention to treat analyses revealed that randomization to the FCU was associated with reduced growth in marijuana use (p < .05), but not alcohol and tobacco use. We also examined whether engagement in the voluntary FCU services moderated the effect of the intervention on substance use progressions using complier average causal effect (CACE) modeling, and found that engagement in the FCU services predicted reductions in alcohol, tobacco, and marijuana use by age 23. In comparing engagers with nonengagers: 70% versus 95% showed signs of alcohol abuse or dependence, 28% versus 61% showed signs of tobacco dependence, and 59% versus 84% showed signs of marijuana abuse or dependence. Conclusion: Family interventions that are embedded within public school systems can reach high-risk students and families and prevent progressions from exploration to problematic substance use through early adulthood. (PsycINFO Database Record (c) 2016 APA, all rights reserved) Impact Statement What is the public health significance of this article?-This study suggests that family centered interventions designed to be embedded within the public school service system can have long-term preventive effects on reducing risk for marijuana use especially, but also tobacco and alcohol. By actively and respectfully encouraging at-risk families to participate, those most likely to benefit will engage and have motivation to change; thus, optimizing the use of resources while maintaining the significant impact of the intervention. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Journal of Consulting and Clinical Psychology, 84(6) : 526-543
- Year: 2016
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Voloshyna, D., Walton, M. A., Zucker, R. A., Cunningham, R. M., Polshkova, S.
Despite WHO data showing alarming rates of alcohol consumption and consequences among age 15+ in the Ukraine, evidenced-based, brief alcohol interventions are currently lacking in this country. Of particular concern, are emerging adults, age 18-25, who may be at particularly high risk for alcohol problems, potentially as a result of recent political and economic events. This study examined the feasibility and initial efficacy a brief intervention on reducing risky drinking among emerging adults in the Ukraine. Youth presenting to two settings were screened for risky drinking: (i) Railway Clinical Hospital; and, (ii) Kiev National Medical University. Emerging adults screening positive on the AUDIT-C for risky drinking (>4) were enrolled in the study: 59 participants from the hospital setting (mean age = 22.6 (2.1), 54.2%male) and 61 participants from the university setting (mean age = 20.1(2.3), 55.7%male). In each setting, participants were randomized to receive a brief intervention (consisted of a 45-min session with a clinician) or to a control condition (included an informational brochure), with a follow-up assessment at 3 months. As compared to participants in the hospital setting, participants from the university setting were significantly younger, and single (as opposed to married), with fewer children. Regression analyses were conducted, separately for each setting, predicting alcohol outcomes (consumption and consequences); models controlled for baseline alcohol levels and condition assignment (brief intervention or control). In both settings, the brief intervention group showed significantly less alcohol consumption and consequences at 3-months as compared to the control group (p's < 0.001). However, when examining other drug use (DAST-10 score), the brief intervention groups were not significantly different from the control groups. Findings suggest that brief motivational interventions are promising for reducing risky drinking among emerging adults in the Ukraine in both inpatient hospital and university settings. Additional research is needed to extend these effects to reduce other drug use among Ukrainian youth.
Alcoholism: Clinical and Experimental Research, 40 : 71A
- Year: 2016
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy
Wang, L. J., Lu, S. F., Chong, M. Y., Chou, W. J., Hsieh, Y. L., Tsai, T. N., Chen, C., Lee, Y. H.
Objective: The abuse of illegal substances by youths in Taiwan has become a major public health issue. This study explores the outcomes (relapse rate and academic or social status) of a family-oriented therapy program conducted for substance-using youths who were referred by a judge to participate in it. Methods: The present study includes 121 participants categorized into three groups: 36 youths underwent a weekly ten-session outpatient motivational enhancement psychotherapy (MEP) group program; 41 youths participated in a program that combined the aforementioned MEP program with an additional weekly ten-session parenting skill training (PST) program for their guardians (MEP + PST group); and 44 adolescents who received standard supervision by the court served as the control group. All participants were followed-up for a maximum of 2 years. Results: Of the 121 participants (mean age: 16.1+/-1.1 years), 33.1% relapsed into substance use during the follow-up period. The probability of relapse did not differ significantly between the MEP group (36.1%) and the control group (40.9%), but the youths in the MEP + PST group (22.0%) were at a lower risk of relapse than the control group participants (adjusted hazard ratio =0.48, 95% confidence interval [CI] =0.21-1.09). By the end of the study follow-up period, participants in both the MEP group and the MEP + PST group were more likely to be attending school (MEP group: adjusted odds ratio [aOR] =6.61, 95% CI =1.60-27.35; MEP + PST group: aOR =8.57, 95% CI =1.94-37.82) or employed (MEP group: aOR =7.75, 95% CI =1.95-30.75; MEP + PST group: aOR =7.27, 95% CI =1.76-29.97), when compared to the control group. Conclusion: This study revealed that a family-oriented treatment approach may be a more effective option for preventing youths' relapsing into substance abuse. In comparison to individuals who received standard supervision by the court, those who received MEP experienced a better school attendance or social outcome over the follow-up period. Copyright © 2016 Du et al.
Neuropsychiatric Disease and Treatment, 12 : 699-706
- Year: 2016
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, 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. Copyright © 2016 Elsevier Ltd.
The 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)
Beach, S. R., Barton, A. W., Lei, M. K., Mandara, J., Wells, A. C., Kogan, S. M., Brody, G. H.
African American couples (N = 139; 67.7 % married; with children between the ages of 9 and 14) were randomly assigned to (a) a culturally sensitive, couple- and parenting-focused program designed to prevent stress-spillover (n = 70) or (b) an information-only control condition in which couples received self-help materials (n = 69). Eight months after baseline, youth whose parents participated in the program, compared with control youth, reported increased parental monitoring, positive racial socialization, and positive self-concept, as well as decreased conduct problems and self-reported substance use. Changes in youth-reported parenting behavior partially mediated the effect of the intervention on conduct problems and fully mediated its impact on positive self-concept, but did not mediate effects on lifetime substance use initiation.
Prevention Science, 17(5) : 572-83
- Year: 2016
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Family therapy, Psychoeducation, Other Psychological Interventions
Chilenski, S. M., Welsh, J. A., Perkins, D. F., Feinberg, M. E., Greenberg, M. T.
This study examined how participation in a universal family skills-building program may interact with community risks and resources to produce youth outcomes. Prior research has noted community-level variability in risk and protective factors, but thus far no study has examined the role that participation on a community-wide intervention may play in moderating the effects of community risks or resources. The study included 14 communities (seven in Iowa, seven in Pennsylvania) that implemented a family focused evidence-based program as part of the PROSPER project. Community level variables included both risk factors (percent of low income families, the availability of alcohol and tobacco, norms regarding adolescent substance use, incidence of drug-related crimes) and community resources (proactive school leadership, availability of youth-serving organizations, and student involvement in youth activities). The proximal youth and family outcomes included youth perceptions of their parents' management skills, parent-child activities, and family cohesion. Results indicated that the Strengthening Families Program:10-14 may have moderated the impact of the community risks and resources on community-level youth outcomes; risk levels meaningfully associated with community-level change in program participants, though these results varied somewhat by outcome. Generally, higher levels of resources also meaningfully associated with more positive change after participating in the family-focused intervention. These results suggest that the effect of some evidence-based programs may be even stronger in some communities than others; more research in this area is needed. Copyright © Society for Community Research and Action 2016.
American Journal of Community Psychology, 57(1-2) : 8-19
- Year: 2016
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Sanchez, Z. M., Sanudo, A., Andreoni, S., Schneider, D., Pereira, A. P., Faggiano, F.
BACKGROUND: Most Brazilian schools do not have a continuous program for drug use prevention and do not conduct culturally adapted activities for that purpose. This study evaluated the impact of the Unplugged program on drug use prevention among children and adolescents in public middle schools of Brazil.
METHODS: A non-randomized controlled trial was conducted in 2013 with 2185 students in 16 public schools from 3 Brazilian cities. The intervention group attended 12 weekly classes of the Unplugged program for drug use prevention, and the control group did not attend to any school prevention programs in the same year. Multilevel analyses were used to evaluate temporal and between group changes in the consumption of each drug.
RESULTS: The study suggested that there was no evidence that Unplugged effected 11- to 12-year-old students. However, the program seemed to stimulate a decrease in recent marijuana use (transition from use to non-use in 85.7% of intervention cases and 28.6% of control cases, OR = 17.5, p = 0.039) among 13- to 15-year-old students. In addition, students in this age range who received the Unplugged program had similar drug consumption levels to those observed before the program began. However, students in the control group presented a significant tendency to increase marijuana use and binge drinking.
CONCLUSIONS: This study adds to the evidence of program efficacy among Brazilian middle school students by presenting marginal effects on binge drinking and marijuana use. An 18-month randomized controlled trial is recommended for a future study.
BMC Public Health, 16(1) : 1206
- Year: 2016
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Marsiglia, F. F., Ayers, S. L., Baldwin-White, A., Booth, J.
While parent and youth substance use prevention interventions have shown beneficial effects on preadolescents, many programs have typically targeted US born European American and African American families while overlooking the unique factors that characterize recent immigrant Latino families. This article presents the results on youth substance use when adding a culturally grounded parenting component, Familias Preparando la Nueva Generacion (FPNG), to the existing and already proven efficacious classroom-based drug abuse prevention intervention, keepin'it REAL (kiR). Data come from youth (N=267) participating in the randomized control trial of the interventions who were surveyed at baseline (beginning at 7th grade) and 18 months later (end of 8th grade). Using multivariate linear regression path analyses, results indicate when FPNG and kiR are combined, youth had significantly lowered alcohol and cigarettes use at the end of 8th grade, mediated through anti-drug norms, when compared with youth who only participated in kiR without parental participation in FPNG. These findings indicate that adolescent normative beliefs and related behaviors can be changed through synchronized culturally grounded parent and youth interventions and together can play an important role in reducing adolescent substance use.
Prevention Science, 17(1) : 1-12
- Year: 2016
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions