Smeerdijk, M., Keet, R., van-Raaij, B., Koeter, M., Linszen, D., de-Haan, L., Schippers, G.

Motivational interviewing and interaction skills training for parents of young adults with recent-onset schizophrenia and co-occurring cannabis use: 15-month follow-up

Background: There is a clear need for effective interventions to reduce cannabis use in patients with first-episode psychosis. This follow-up of a randomized trial examined whether an intervention for parents, based on motivational interviewing and interaction skills (Family Motivational Intervention, FMI), was more effective than routine family support (RFS) in reducing cannabis use in patients with recent-onset schizophrenia.; Method: In a single-blind trial with 75 patients in treatment for recent-onset schizophrenia, 97 parents were randomly assigned to either FMI or RFS. Assessments were conducted at baseline and at 3 and 15 months after the interventions had been ended. Analyses were performed on an intention-to-treat basis using mixed-effect regression models.; Results: From baseline to the 15-month follow-up, there was a significantly greater reduction in FMI compared to RFS in patients' quantity (p = 0.01) and frequency (p < 0.01) of cannabis use. Patients' craving for cannabis use was also significantly lower in FMI at 15 months follow-up (p < 0.01). Both groups improved in parental distress and sense of burden; however, only FMI parents' appraisal of patients' symptoms showed further improvement at the 15-month follow-up (p < 0.05).; Conclusions: The results support the sustained effectiveness of FMI in reducing cannabis use in patients with recent-onset schizophrenia at 15 months follow-up. Findings were not consistent with regard to the long-term superiority of FMI over RFS in reducing parents' distress and sense of burden.;

Psychological Medicine, 45(13) : 2839-2848

Miovsky, M., Vonkova, H., Gabrhelik, R., Stastna, L.

Universality properties of school-based preventive intervention targeted at cannabis use

This study aims to examine the effect of school-based preventive intervention on cannabis use in Czech adolescents with different levels of risk factors and provide evidence of its universality. A randomized controlled prevention trial with six waves was conducted over a period of 33 months. We used a two-level logistic random-intercept model for panel data; we first looked at the statistical significance of the effect of the intervention on cannabis use, controlling for the characteristics of the children and time dummies. Then we analyzed the effects of the interactions between the intervention and the characteristics of the children on cannabis use and related it to the definition of universal preventive interventions. The setting for the study was in basic schools in the Czech Republic in the years 2007-2010. A total of 1,874 sixth-graders (mean age 11.82 years) who completed the baseline testing. According to our results, the prevention intervention was effective. We found all the selected characteristics of the children to be relevant in relation to cannabis use, except their relationships with their friends. We showed empirically that the intervention is universal in two dimensions for the selected characteristics of the children. First, all adolescents who undergo the intervention are expected to benefit. Second, with respect to the effect of the intervention on cannabis use, the total level of individual risk of cannabis use is superior to the composition of the risk factors in the individual risk profile. We present indicative evidence that the drug prevention intervention may be considered a true universal preventive intervention. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).

Prevention Science, 16(2) : 189-199

Piehler, T. F., Winters, K. C.

Parental involvement in brief interventions for adolescent marijuana use

Adolescents (aged 12-18 years) identified in a school setting as abusing marijuana and other drugs were randomly assigned to complete 1 of 2 brief interventions (BIs). Adolescents and their parent (N = 259) were randomly assigned to receive either a 2-session adolescent only (BI-A) or a 2-session adolescent and additional parent session (BI-AP). Interventions were manualized and delivered in a school setting by trained counselors. Adolescents were assessed at intake and at 6 months following the completion of the intervention. Using a latent construct representing 6-month marijuana use outcomes, current findings supported previous research that BI-AP resulted in superior outcomes when compared to BI-A. The presence of a marijuana dependence diagnosis at baseline predicted poorer outcomes when compared to youth without a diagnosis. Both baseline diagnostic status and co-occurring conduct problems interacted with intervention condition in predicting marijuana use outcomes. A marijuana dependence diagnosis resulted in poorer marijuana use outcomes within the BI-A condition when compared to BI-AP. Co-occurring conduct problems were associated with poorer marijuana use outcomes within the BI-AP intervention when compared to BI-A. Implications for implementing BIs given diagnostic status, parent involvement, and co-occurring conduct problems are discussed.; (c) 2015 APA, all rights reserved).

Psychology of Addictive Behaviors, 29(3) : 512- 521

Stewart, D.G., Felleman, B. I., Arger, C. A.

Effectiveness of motivational incentives for adolescent marijuana users in a school-based intervention

Journal of Substance Abuse Treatment, 58 : 43- 50

Stanger, C., Ryan, S. R., Scherer, E. A., Norton, G. E., Budney, A. J.

Clinic- and home-based contingency management plus parent training for adolescent cannabis use disorders

Objective The aim of this study was to conduct a randomized test comparing 2 multicomponent, contingency management interventions, 1 with and 1 without a full parent training curriculum, and an individual treatment for adolescent cannabis use disorders. Method A total of 153 adolescents who met DSM-IV criteria for cannabis abuse or dependence were randomized to motivational enhancement therapy/cognitive-behavioral therapy (MET/CBT), MET/CBT+abstinence-based contingency management (CM), or MET/CBT+CM+Parent Training (PT). Results Overall, during treatment, abstinence was greater for youth receiving clinic- and home-based CM without PT compared to those who received individual MET/CBT. There was no additional benefit of the full PT curriculum on marijuana use, youth externalizing problems, or parenting. Conclusion These results suggest that clinic- plus home-based CM for cannabis use disorders can increase rates of abstinence during treatment over and above an evidence-based treatment (individual MET/CBT), but in this study the addition of a comprehensive parenting training curriculum did not further enhance efficacy. Clinical trial registration information Treatment for Adolescent Marijuana Abuse; http://clinicaltrials.gov; NCT00580671.

Journal of the American Academy of Child & Adolescent Psychiatry, 54(6) : 445-453.e2

Malmberg, M., Kleinjan, M., Overbeek, G., Vermulst, A., Lammers, J., Monshouwer, K., Vollebergh, W.A., Engels, R.C.

Substance use outcomes in the Healthy School and Drugs program: Results from a latent growth curve approach

Aim: To assess the effectiveness of the Healthy School and Drugs (HSD) program for secondary schools on the development of substance use among Dutch early adolescents and to explore whether boys, adolescents of lower educational backgrounds, or adolescents high on personality risk traits, would benefit more from the HSD program than others. Design: Randomized clustered trial with two intervention conditions (i.e., lessons and integral) among a general population of adolescents in the Netherlands. Participants: A total of 3784 students of 23 Dutch secondary schools. Measurements: Structured digital questionnaires were administered pre-intervention and at 8, 20, and 32months follow-ups. The outcome measure was the rate of change in substance use across follow-ups. Differential effectiveness of the HSD program was examined for sex, educational level, and personality traits. Findings: Our results show no HSD intervention effects on the development of substance use. Sex, education level, and personality characteristics of the participants did not moderate the intervention effects. Conclusion: The absence of effects of the Healthy School and Drugs program on the development of substance use indicates that the program should be renewed and redeveloped. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).

Addictive Behaviors, 42 : 194- 202

Mason, M., Light, J., Campbell, L., Keyser-Marcus, L., Crewe, S., Way, T., Saunders, H., King, L., Zaharakis, N. M., McHenry, C.

Peer Network Counseling with Urban Adolescents: A Randomized Controlled Trial with Moderate Substance Users

Close peer networks can affect adolescents' health behaviors by altering their social environments, and thus their risk for and protection against substance use involvement. We tested a 20. minute intervention named Peer Network Counseling that integrates motivational interviewing and peer network strategies with 119 urban adolescents who reported occasional or problem substance use. Adolescents presenting at primary care clinic were randomized to intervention or control conditions and followed for 6. months. Mixed-effect latent growth models were used to evaluate intervention effects on trajectories of alcohol and marijuana use, offers to use substances, and moderation models to test for interactions between intervention condition and peer network characteristics. A significant intervention effect was found for boys for offers to use alcohol from friends (p < .05), along with a trend significant effect for alcohol use (p < .08). Intervention was more effective in reducing marijuana use, vs. control, for participants with more peer social support (p< .001) and with more peer encouragement for prosocial behavior (school, clubs, sports, religious activities); however, intervention did not affect these network characteristics. Results provide support to continue this line of research to test brief interventions that activate protective peer network characteristics among at-risk adolescents, while also raising some interesting gender-based intervention questions for future research.

Journal of Substance Abuse Treatment, 58 : 16-24

McRae-Clark, A. L., Baker, N. L., Gray, K. M., Killeen, T. K., Wagner, A. M., Brady, K. T., DeVane, C. L., Norton, J.

Buspirone treatment of cannabis dependence: A randomized, placebo-controlled trial

Background: The purpose of this study was to evaluate the efficacy of buspirone, a partial 5-HT1A agonist, for treatment of cannabis dependence. Methods: One hundred seventy-five cannabis-dependent adults were randomized to receive either up to 60. mg/day of buspirone ( n= 88) or placebo ( n= 87) for 12 weeks combined with a brief motivational enhancement therapy intervention and contingency management to encourage study retention. Cannabis use outcomes were assessed via weekly urine cannabinoid tests. Results: Participants in both groups reported reduced cannabis craving over the course of the study; however, buspirone provided no advantage over placebo in reducing cannabis use. Significant gender by treatment interactions were observed, with women randomized to buspirone having fewer negative urine cannabinoid tests than women randomized to placebo ( p= 0.007), and men randomized to buspirone having significantly lower creatinine adjusted cannabinoid levels as compared to those randomized to placebo ( p= 0.023). An evaluation of serotonin allelic variations did not find an association with buspirone treatment response. Conclusions: Buspirone was not more efficacious than placebo in reducing cannabis use. Important gender differences were noted, with women having worse cannabis use outcomes with buspirone treatment. Considerations for future medication trials in this challenging population are discussed.

Drug & Alcohol Dependence, 156 : 29- 37

de-Oliveira-Christoff, A, Boerngen-Lacerda, R.

Reducing substance involvement in college students: A three-arm parallel-group randomized controlled trial of a computer-based intervention

The prevalence of alcohol and other drug use is high among college students. Reducing their consumption will likely be beneficial for society as a whole. Computer and web-based interventions are promising for providing behaviorally based information. The present study compared the efficacy of three interventions (computerized screening and motivational intervention [ASSIST/MBIc], non-computerized screening and motivational intervention [ASSIST/MBIi], and screening only [control]) in college students in Curitiba, Brazil. A convenience sample of 458 students scored moderate and high risk on the ASSIST. They were then randomized into the three arms of the randomized controlled trial (ASSIST/MBIc, ASSIST/MBIi [interview], and assessment-only [control]) and assessed at baseline and 3months later. The ASSIST involvement scores decreased at follow-up compared with baseline in the three groups, suggesting that any intervention is better than no intervention. For alcohol, the specific involvement scores decreased to a low level of risk in the three groups and the MBIc group showed a positive outcome compared with control, and the scores for each question were reduced in the two intervention groups compared to baseline. For tobacco, involvement scores decreased in the three groups, but they maintained moderate risk. For marijuana, a small positive effect was observed in the ASSIST/MBIi and control groups. The ASSIST/MBIc may be a good alternative to interview interventions because it is easy to administer, students frequently use such computer-based technologies, and individually tailored content can be delivered in the absence of a counselor. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).

Addictive Behaviors, 45 : 164-171

Yurasek, A. M., Dennhardt, A. A., Murphy, J. G.

A randomized controlled trial of a behavioral economic intervention for alcohol and marijuana use

Objective - A recent study demonstrated that a single 50-minute supplemental session that targeted the behavioral economic mechanisms of substance-free reinforcement and delayed reward discounting (Substance Free Activity Session: SFAS) enhanced the efficacy of a standard alcohol brief motivational intervention (BMI) for college drinkers. The purpose of the current study was to conduct a randomized controlled trial intended to replicate and extend the aforementioned study by focusing on both drug and alcohol misuse and reducing session length in order to enhance dissemination potential.\rMethod - Participants were 97 college students (58.8% women; 59.8% white/Caucasian & 30.9% African American; M age = 20.01, SD = 2.23) who reported at least one heavy drinking episode in the past month (M = 4.01 episodes). Most participants (62%) reported recent marijuana use (M = 12.22 days of past-month use). After completing a baseline assessment and an individual 30-minute alcohol-focused BMI, participants were randomized to either the 30-minute SFAS session or an education control session.\rResults - A series of mixed model intent-to-treat analyses revealed that both groups reported drinking reductions and that participants in the BMI+SFAS group reported fewer days using marijuana at the 6-month follow-up.\rConclusions - These results do not support the incremental efficacy of the briefer SFAS for reducing drinking but suggest that it may improve marijuana outcomes. Future research is needed to identify the ideal length and timing of the SFAS supplement to BMIs.

Exp Clin Psychopharmacol., 23(5) : 332-338

deGee, E. A., Verdurmen, J. E., Bransen, E., deJonge, J. M., Schippers, G. M.

A randomized controlled trial of a brief motivational enhancement for non-treatment-seeking adolescent cannabis users

Evidence for negative effects of early-onset cannabis use has led to a need for effective interventions targeting adolescent cannabis users. A randomized controlled trial of an Australian two-session intervention based on motivational interviewing (the ACCU, or Weed-Check in Dutch) was replicated in a larger Dutch sample of 119 non-treatment-seeking adolescent cannabis users. Outcome measures at the 3-month follow-up were quantity and frequency of cannabis use, symptoms of dependence, stage of change, and psychosocial functioning. Changes in all measures were in the expected direction, yet not significant. In moderation analyses, heavier cannabis users at baseline receiving the Weed-Check had greater reductions in cannabis use than those in the control condition. These results suggest that the Weed-Check might be beneficial for heavier cannabis- using adolescents. Further research is needed to confirm these results in a sample of adolescent heavy cannabis users and to examine the relationship between MI skills of prevention workers and outcome. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).

Journal of Substance Abuse Treatment, 47(3) : 181-188

Asevedo, E., Mendes, A. C., Berk, M., Brietzke, E.

Systematic review of N-acetylcysteine in the treatment of addictions

Objective: To conduct the first systematic literature review of clinical trials of N-acetylcysteine (NAC) for the treatment of substance abuse disorders and addictive behaviors.; Methods: A search of the MEDLINE, Embase and PsycINFO databases was conducted. The inclusion criteria for the review were clinical trials that used NAC in the treatment of a disorder related to substance use and/or addictive behaviors, limited to texts in English, Spanish, or French. The selected studies were evaluated with respect to type of trial, sample size, diagnostic input, intervention, length of follow-up, outcome variables, and results.; Results: Nine studies analyzing a total of 165 patients met the eligibility criteria and were included in qualitative analysis. These studies evaluated the role of NAC in cocaine dependence (three studies), cannabis dependence (two studies), nicotine dependence (two studies), methamphetamine addiction (one study), and pathological gambling (one study). Five of these trials were double-blind, randomized, and placebo-controlled.; Conclusions: The studies analyzed suggest a potential role for NAC in the treatment of addiction, especially of cocaine and cannabis dependence. These results are concordant with the hypothesis of the involvement of glutamatergic pathways in the pathophysiology of addiction.;

Revista Brasileira De Psiquiatria, 36(2) : 168- 175