Disorders - Substance Use Disorders
Simonton, A. J., Young, C. C., Johnson, K. E.
BACKGROUND:
Adolescent substance use, a major problem in the United States, has a significant negative effect on both short- and long-term mental and physical
health. Physical activity (PA) may offer potentially effective strategies to combat substance use in youth. Like substance use, PA behaviors
developed during adolescence persist into adulthood, so adolescence may be an ideal period in which to implement PA interventions to prevent
substance abuse. However, there are no known systematic literature reviews of PA-based interventions that target substance use in adolescence.
OBJECTIVE(S): To review PA interventions for adolescents, including research designs, intervention characteristics, and measures of substance use.
METHOD(S): Five databases were searched for articles published in English peer-reviewed journals. Search terms were related to the adolescent
population, substance use, and PA interventions. RESULT(S): 17 articles fit inclusion criteria. The results suggest that PA interventions may
decrease substance use in teens. A majority of the interventions were delivered in high schools. Substance use measures/outcomes included intention
or willingness to use, cessation, and actual use. Alcohol use was measured most, followed by marijuana and tobacco use. Although most of the studies
utilized group sessions to deliver interventions, decreased substance use was also associated with one-time, multi-health consultations.
Conclusions/Importance: School-based interventions targeting multiple health behaviors may offer a particularly effective and efficient way to
decrease substance use in adolescents.
Substance use & misuse, 53(12) : 2052-2068
- Year: 2018
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Physical activity, exercise
Garner, B. R., Lwin, A. K., Strickler, G. K., Hunter, B. D., Shepard, D. S.
BACKGROUND: Pay-for-performance (P4P) has been recommended as a promising strategy to improve
implementation of high-quality care. This study examined the incremental cost-effectiveness of a P4P strategy found to be highly effective in
improving the implementation and effectiveness of the Adolescent Community Reinforcement Approach (A-CRA), an evidence-based treatment (EBT) for
adolescent substance use disorders (SUDs).\rMETHODS: Building on a $30 million national initiative to implement A-CRA in SUD treatment settings, urn
randomization was used to assign 29 organizations and their 105 therapists and 1173 patients to one of two conditions (implementation-as-usual (IAU)
control condition or IAU+P4P experimental condition). It was not possible to blind organizations, therapists, or all research staff to condition
assignment. All treatment organizations and their therapists received a multifaceted implementation strategy. In addition to those IAU strategies,
therapists in the IAU+P4P condition received US $50 for each month that they demonstrated competence in treatment delivery (A-CRA competence) and US
$200 for each patient who received a specified number of treatment procedures and sessions found to be associated with significantly improved patient
outcomes (target A-CRA). Incremental cost-effectiveness ratios (ICERs), which represent the difference between the two conditions in average cost per
treatment organization divided by the corresponding average difference in effectiveness per organization, and quality-adjusted life years (QALYs)
were the primary outcomes.\rRESULTS: At trial completion, 15 organizations were randomized to the IAU condition and 14 organizations were randomized
to the IAU+P4P condition. Data from all 29 organizations were analyzed. Cluster-level analyses suggested the P4P strategy led to significantly higher
average total costs compared to the IAU control condition, yet this average increase of 5% resulted in a 116% increase in the average number of
months therapists demonstrated competence in treatment delivery (ICER = $333), a 325% increase in the average number of patients who received the
targeted dosage of treatment (ICER = $453), and a 325% increase in the number of days of abstinence per patient in treatment (ICER = $8.134). Further
supporting P4P as a cost-effective implementation strategy, the cost per QALY was only $8681 (95% confidence interval $1191-$16,171).\rCONCLUSION:
This study provides experimental evidence supporting P4P as a cost-effective implementation strategy.\rTrial registration: nct01016704 .
Implementation
Science, 13(1) : 92
- Year: 2018
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Other service delivery and improvement
interventions
Burrow-Sanchez, J. J., Hops,
H.
Objectives: Latina/o adolescents are at
particular risk for substance use disorders (SUDs) and effective treatments are needed. Some critics indicate that standard evidence-based treatments
may not meet the needs of Latina/o adolescents and culturally accommodated treatments are needed; however, few comparative studies have been
conducted to test this assumption. This randomized trial was designed to test a standard group-based version of a cognitive- behavioral treatment
(S-CBT) against its culturally accommodated equivalent (A-CBT) for a sample of Latina/o adolescents with SUDs. Method(s): Seventy Latina/o
adolescents were randomly assigned to 1 of 2 treatment conditions and followed over 4 posttreatment time points with the last at 12-months.
Generalized longitudinal mixed models for count data were conducted to evaluate treatment differences across time for adolescent substance use. The
cultural variables ethnic identity, acculturation, and familism were included in the analysis as potential moderators of treatment outcome. Result
(s): A significant difference was found at the 12-month follow-up in favor of the culturally accommodated treatment (d = .92, 95% confidence
interval, CI [.43, 1.42]) and parental familism moderated treatment outcome (d = .60, 95% CI [.12, 1.08]). Conclusion(s): This is one of the first
studies to demonstrate that a culturally accommodated treatment differentially improved outcomes compared with that of its standard equivalent for a
sample of Latina/o adolescents with SUDs. Copyright © 2018 American Psychological Association.
Cultural Diversity and Ethnic Minority Psychology., 25(3) : 311-
322
- Year: 2018
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Tancred, T., Paparini, S., Melendez-Torres, G. J., Thomas, J., Fletcher, A., Campbell, R., Bonell, C.
BACKGROUND: Schools can play an important role in promoting health. However, many
education policies and institutions are increasingly emphasising academic attainment targets, which appear to be diminishing the time available for
health education lessons. Interventions that integrate both health and academic learning may present an ideal solution, simultaneously addressing
health education and academic development. The theories of change underlying these interventions are therefore of interest, but are poorly studied.
\rMETHODS: A systematic review of evaluations of interventions that integrate academic and health education for reduced substance use and/or violence
was carried out. As part of this, reports describing theory were assessed for quality and data extracted. Theoretical data were synthesised within
and across individual interventions using reciprocal translation and meta-ethnographic line of argument synthesis to produce an overall theory of
change for interventions that integrate health and academic education to prevent substance use and violence.\rRESULTS: Forty-eight reports provided
theoretical descriptions of 18 interventions. An overarching theory that emerged was that eroding 'boundaries' at multiple and mutually reinforcing
levels-by integrating academic and health education, by transforming relationships between teachers and students, by generalising learning from
classrooms to the wider school environment and by ensuring consistent messages from schools and families-is intended to lead to the development of a
community of engaged students oriented towards pro-social behaviour and away from substance use, violence and other risk behaviours.\rCONCLUSIONS:
Eroding 'boundaries' between health and academic education, teachers and students, classrooms and the wider school and schools and families were
seen to be the most critical to establishing new frameworks of family, classroom or school organisation that are conducive to promoting both academic
and social-emotional outcomes. Whether such interventions are feasible to implement and effective in reducing risk behaviours will be examined in
other reports arising from the review.
Systematic
Reviews, 7(1) : 190
- Year: 2018
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Other Psychological Interventions
Zhang, J., Slesnick,
N.
The current study identified subgroups of homeless youth and young adults that exhibited distinct co-occurring patterns of substance
use and social stability (e.g., employment, school attendance, and housing), and evaluated the relative effectiveness of the Community Reinforcement
Approach (CRA), Motivational Enhancement Therapy (MET), and case management (CM) in interrupting substance use and improving social stability. The
differentiating effects of personal characteristics on the co-occurrence of substance use and social stability were also examined.
Psychology of Addictive Behaviors, 32(8) : 873-
884
- Year: 2018
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Motivational interviewing, includes Motivational Enhancing Therapy, Other Psychological Interventions, Case management, Other service delivery and improvement
interventions
Tiburcio, M., Lara, M. A., Martinez, N., Fernandez, M., Aguilar,
A.
BACKGROUND: Web-based cognitive-behavioral interventions to reduce substance use can be a
useful low-cost treatment for a large number of people, and an attractive option in countries where a greater availability of treatment is needed.
OBJECTIVE(S): To evaluate the feasibility and initial effectiveness of a web-based cognitive-behavioral intervention for the reduction of substance
use and depression compared with treatment as usual, with and without a printed self-help manual. METHOD(S): Individuals seeking outpatient treatment
for substance use were randomly assigned to one of the following: (1) the web-based Help Program for Drug Abuse and Depression (n = 23); (2) an in-
person session with an addiction therapist and use of the Alcohol, Smoking, and Substance Involvement Screening Test Self-Help Strategies guide,
followed by treatment as usual (n = 25), or (3) treatment ordinarily offered in the participating treatment centers (n = 26). The study took place in
2013-2014 (trial registration: ISRCTN25429892), and participants completed baseline, posttreatment, and 1-month follow-up evaluation interviews.
RESULT(S): Treatment retention and data availability were comparable in all three conditions. A reduction was observed from baseline to follow-up in
average days of use [F(1,28) = 29.70, p < 0.001], severity of use [F(2,28) = 143.66, p < 0.001], and depressive symptomatology [F = (4)16.40, p <
0.001], independent of the type of treatment provided. CONCLUSION(S): The findings suggest that the web-based intervention to reduce substance abuse
is feasible, although it is not more effective than other intervention modalities; its effectiveness must be evaluated in a larger sample. Attrition
was a main limitation; future studies must improve retention and assess cost-effectiveness.
Substance use &
misuse, 53(13) : 2220-2231
- Year: 2018
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions, Self-help, Technology, interventions delivered using technology (e.g. online, SMS)
Kelley, A., Fatupaito, B., Witzel, M.
American Indian youth substance use is a major public health concern. To date, there has been limited evaluation of American Indian youth
substance use prevention programs. Evaluation of prevention programs is necessary to understand the aspects of programming that are effective or not
effective. This mixed-methods evaluation focuses on select outcomes of a 3-year culturally-based prevention program located in six American Indian
communities in the Rocky Mountain Region. The goals of the prevention program are to reduce binge drinking by 30% and increase community readiness by
1-point over a 5- year period. In the first year of the program, community members worked with program staff to develop an evaluation plan that would
measure the following outcomes: lowering substance use, increasing community readiness, and increasing the reach of prevention messaging through
culturally based prevention. The primary research questions this outcome evaluation sought to answer were as follows: 1) Are there differences in
American Indian youth who participate in culturally-based prevention activities compared with American Indian youth who do not participate in these
activities? 2) Was the prevention program effective in increasing community readiness over a 3-year period? 3) Did community involvement in
prevention activities increase overtime? Results from this evaluation indicate that substance use was similar among intervention (n=200) and non-
intervention youth (n=369). This was somewhat surprising because Intervention youth reported higher levels of social support and community
connections than non-intervention group youth. Community readiness decreased -.81 point from 2015 to 2017. The reach of prevention activities
increased 365% from 2015 to 2017. We provide lessons learned that may help other communities as they document outcomes related to prevention efforts.
Substance use is a multi-faceted problem facing our communities, families, schools, and nation. Innovative, effective, culturally-based prevention
programs like the one highlighted in this paper underscore the need for primary prevention strategies. Copyright © 2018 Elsevier Ltd. All rights
reserved.
Evaluation and Program Planning, 71 : 28-
35
- Year: 2018
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Other service delivery and improvement
interventions
Ismayilova, L., Terlikbayeva, A.
Purpose: The knowledge-based approach to
substance use and HIV prevention, commonly used in Central Asia, does not equip at-risk adolescents with risk reduction skills. This pilot study aims
to adapt and test the feasibility and estimate the effect size parameters of a skill-based and family-focused intervention for at-risk adolescents
from communities affected by heroin trade and use in Kazakhstan, located on the major drug trafficking route from Afghanistan. Method(s): This
National Institute on Drug Abuse-funded pilot trial used a mixed-methods approach and included 181 adolescents (ages 14-17) that reported at least
one risk factor (e.g., substance-using family members or friends and parental criminal history). In addition to the school-based health education
program, intervention-arm adolescent-caregiver dyads received three computerized pilot sessions focusing on risk reduction self-efficacy, resistance
to peer pressure, and strengthening of family relationships. Adolescents completed baseline, 3- and 6-month Audio Computer-Assisted Self-Interview
surveys in Russian and treatment group adolescents (n = 12) also participated in postintervention focus groups. Result(s): Small size effects were
observed for youth-level theoretical mediators associated with lower substance use. Compared to the control group, intervention-arm adolescents
showed improvement in personal and social competencies such as assertiveness (Cohen's d =.21) and self-esteem (d =.22) at 3 months and increased
engagement in prosocial activities at 6 months (d =.41). Adolescents from the intervention group also reported improved self-control skills helping
alleviate emotional distress (an increase in anger and tension management d =.30 at 3 months and a reduction in temper d = -.27 at 6 months) along
with a lower likelihood of binge drinking at 6 months (odds ratio =.18, p =.023). Conclusion(s): In middle-income countries like Kazakhstan, an
intervention that utilizes interactive technologies and combines an empirically tested skills-based approach with family involvement may be an
engaging, acceptable, and culturally appropriate tool for preventing substance use among at-risk youth. Copyright © 2018 Society for Adolescent
Health and Medicine
Journal of Adolescent Health, 63(3) : 301-312
- Year: 2018
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Eddie, D., Conway, F. N., Alayan, N., Buckman, J., Bates, M. E.
Heart rate variability biofeedback (HRV BFB) shows promise as an adjunct intervention for
individuals receiving treatment for substance use disorder (SUD), potentially due to its capacity to reduce craving and negative affect. The present
study sought to examine the utility of integrating HRV biofeedback into a college recovery housing program and gauging its ability to reduce craving
and negative affect in young adults in remission from SUD. Forty-six residents of an SUD recovery house at a public university in the northeastern
United States took part in a non-randomized controlled trial. The active intervention was 12 weeks of HRV BFB performed over a college semester. The
control intervention was a semester-long, waitlist condition. Changes in craving, perceived stress, anxiety, and depressive symptoms were measured
across time during the active HRV BFB intervention and compared to changes that occurred during the waitlist period using piecewise regression
analyses. Significant reductions in craving were noted during HRV BFB, but not during the waitlist control condition; however, the difference in
slopes between conditions was not statistically significant. Levels of self-reported craving, stress, anxiety, and depression varied substantially
between participants and across time. The results suggest that use of HRV BFB in the college recovery setting as a tool to help reduce craving
warrants further examination, particularly among individuals with elevated craving. Added value of HRV BFB comes from the fact that it can be easily
and affordably implemented in everyday life. Copyright © 2018 Elsevier Inc.
Journal of Substance Abuse Treatment, 92 : 70-
76
- Year: 2018
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder), Relapse prevention
-
Treatment and intervention: Psychological Interventions
(any), Biofeedback, neurofeedback, audio/video feedback
MacArthur, G., Caldwell, D. M., Redmore, J., Watkins, S. H., Kipping, R., White, J., Chittleborough, C., Langford, R., Er, V., Lingam, R., Pasch,
K., Gunnell,
D., Hickman, M., Campbell, R.
BACKGROUND: Engagement in multiple risk behaviours can have adverse consequences for health during
childhood, during adolescence, and later in life, yet little is known about the impact of different types of interventions that target multiple risk
behaviours in children and young people, or the differential impact of universal versus targeted approaches. Findings from systematic reviews have
been mixed, and effects of these interventions have not been quantitatively estimated.\rOBJECTIVES: To examine the effects of interventions
implemented up to 18 years of age for the primary or secondary prevention of multiple risk behaviours among young people.\rSEARCH METHODS: We
searched 11 databases (Australian Education Index; British Education Index; Campbell Library; Cumulative Index to Nursing and Allied Health
Literature (CINAHL); Cochrane Central Register of Controlled Trials (CENTRAL), in the Cochrane Library; Embase; Education Resource Information Center
(ERIC); International Bibliography of the Social Sciences; MEDLINE; PsycINFO; and Sociological Abstracts) on three occasions (2012, 2015, and 14
November 2016)). We conducted handsearches of reference lists, contacted experts in the field, conducted citation searches, and searched websites of
relevant organisations.\rSELECTION CRITERIA: We included randomised controlled trials (RCTs), including cluster RCTs, which aimed to address at least
two risk behaviours. Participants were children and young people up to 18 years of age and/or parents, guardians, or carers, as long as the
intervention aimed to address involvement in multiple risk behaviours among children and young people up to 18 years of age. However, studies could
include outcome data on children > 18 years of age at the time of follow-up. Specifically,we included studies with outcomes collected from those
eight to 25 years of age. Further, we included only studies with a combined intervention and follow-up period of six months or longer. We excluded
interventions aimed at individuals with clinically diagnosed disorders along with clinical interventions. We categorised interventions according to
whether they were conducted at the individual level; the family level; or the school level.\rDATA COLLECTION AND ANALYSIS: We identified a total of
34,680 titles, screened 27,691 articles and assessed 424 full-text articles for eligibility. Two or more review authors independently assessed
studies for inclusion in the review, extracted data, and assessed risk of bias.We pooled data in meta-analyses using a random-effects (DerSimonian
and Laird) model in RevMan 5.3. For each outcome, we included subgroups related to study type (individual, family, or school level, and universal or
targeted approach) and examined effectiveness at up to 12 months' follow-up and over the longer term (> 12 months). We assessed the quality and
certainty of evidence using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach.\rMAIN RESULTS: We included in the
review a total of 70 eligible studies, of which a substantial proportion were universal school-based studies (n = 28; 40%). Most studies were
conducted in the USA (n = 55; 79%). On average, studies aimed to prevent four of the primary behaviours. Behaviours that were most frequently
addressed included alcohol use (n = 55), drug use (n = 53), and/or antisocial behaviour (n = 53), followed by tobacco use (n = 42). No studies aimed
to prevent self-harm or gambling alongside other behaviours.Evidence suggests that for multiple risk behaviours, universal school-based interventions
were beneficial in relation to tobacco use (odds ratio (OR) 0.77, 95% confidence interval (CI) 0.60 to 0.97; n = 9 studies; 15,354 participants) and
alcohol use (OR 0.72, 95% CI 0.56 to 0.92; n = 8 studies; 8751 participants; both moderate-quality evidence) compared to a comparator, and that such
interventions may be effective in preventing illicit drug use (OR 0.74, 95% CI 0.55 to 1.00; n = 5 studies; 11,058 participants; low-quality
evidence) and engagement in any antisocial behaviour (OR 0.81, 95% CI 0.66 to 0.98; n = 13 studies; 20,756 participants; very low-quality evidence)
at up to 12 months' follow-up, although there was evidence of moderate to substantial heterogeneity (I2 = 49% to 69%). Moderate-quality evidence
also showed that multiple risk behaviour universal school-based interventions improved the odds of physical activity (OR 1.32, 95% CI 1.16 to 1.50;
I2 = 0%; n = 4 studies; 6441 participants). We considered observed effects to be of public health importance when applied at the population level.
Evidence was less certain for the effects of such multiple risk behaviour interventions for cannabis use (OR 0.79, 95% CI 0.62 to 1.01; P = 0.06; n =
5 studies; 4140 participants; I2 = 0%; moderate-quality evidence), sexual risk behaviours (OR 0.83, 95% CI 0.61 to 1.12; P = 0.22; n = 6 studies;
12,633 participants; I2 = 77%; low-quality evidence), and unhealthy diet (OR 0.82, 95% CI 0.64 to 1.06; P = 0.13; n = 3 studies; 6441 participants;
I2 = 49%; moderate-quality evidence). It is important to note that some evidence supported the positive effects of universal school-level
interventions on three or more risk behaviours.For most outcomes of individual- and family-level targeted and universal interventions, moderate- or
low-quality evidence suggests little or no effect, although caution is warranted in interpretation because few of these studies were available for
comparison (n <= 4 studies for each outcome).Seven studies reported adverse effects, which involved evidence suggestive of increased involvement in a
risk behaviour among participants receiving the intervention compared to participants given control interventions.We judged the quality of evidence
to be moderate or low for most outcomes, primarily owing to concerns around selection, performance, and detection bias and heterogeneity between
studies.\rAUTHORS' CONCLUSIONS: Available evidence is strongest for universal school-based interventions that target multiple- risk behaviours,
demonstrating that they may be effective in preventing engagement in tobacco use, alcohol use, illicit drug use, and antisocial behaviour, and in
improving physical activity among young people, but not in preventing other risk behaviours. Results of this review do not provide strong evidence of
benefit for family- or individual-level interventions across the risk behaviours studied. However, poor reporting and concerns around the quality of
evidence highlight the need for high-quality multiple- risk behaviour intervention studies to further strengthen the evidence base in this field.
Cochrane Database of Systematic
Reviews, 10 : CD009927
- Year: 2018
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any)
Stormshak, E., DeGarmo, D., Chronister, K., Caruthers, A.
Emerging adulthood is characterized by not only opportunity and transition but also a substantial
increase in risk behaviors (Fosco et al. Journal of Family Psychology, 26(4), 565-575, 2012; Johnston et al. 2016). Building on prior research, we
tested a mediational model hypothesizing that Family Check-Up (FCU) intervention effects on young adult risk would be mediated by increases in self-
regulation, and that these changes would continue to affect risk behavior as high school youths transitioned to young adulthood. We also predicted
that the intent-to-treat intervention would be associated with lower levels of risk in young adulthood and that this effect would be accounted for by
intervention-induced improvements in self-regulation during early adolescence, which in turn would prevent young adult risk. Participants were 593
adolescents and their families recruited from three public middle schools and randomized either to the FCU or to a control group. Item response
theory was applied to construct a measure of high-risk behavior at this age, including risk behaviors such as substance abuse, high-risk sexual
behavior, and vocational risk. Results suggested that changes in children's self-regulation that occurred early during the middle school years, and
that were associated with the FCU, led to reductions in risk behaviors during young adulthood. This study builds on our prior research that has
suggested that effects of the FCU during middle school lead to changes in a range of risk behaviors during the transition to high school (Fosco et
al. Journal of School Psychology, 51(4), 455-468, 2013; Stormshak et al. School Mental Health, 2(2), 82-9, 2010).
Prevention science : the official journal of
the Society for Prevention Research, 19(4) : 549-
558
- Year: 2018
- 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
Cather, C., Brunette,
M. F., Mueser, K. T., Babbin, S. F., Rosenheck, R., Correll, C. U., Kalos-Meyer, P.
Lifetime co-occurring substance use
disorders are common at the time of presentation for treatment of a first episode of primary psychosis and persistent substance use disorder (SUD)
leads to poorer outcomes. We assessed whether the NAVIGATE program, a coordinated specialty care service that includes optional substance abuse
content reduced substance use compared to usual care in 404 individuals in the Recovery After Initial Schizophrenia Episode-Early Treatment Program
(RAISE-ETP) study.
Psychiatry
Research, 268 : 303-311
- Year: 2018
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Service Delivery & Improvement, Psychological Interventions
(any), Other service delivery and improvement
interventions