Disorders - substance use disorders
Hennessy,
E. A., Tanner-Smith, E. E., Finch, A. J., Sathe, N., Kugley, S.
Executive Summary/Abstract: BACKGROUND: Substance use disorders (SUDs) among youth are a major public health
problem. In the United States, for example, the incidence of SUDs increases steadily after age 12 and peaks among youth ages 18-23 (White, Evans,
Ali, Achara-Abrahams, & King, 2009). Although not every youth who experiments with alcohol or illicit drugs is diagnosed with an SUD, approximately
7-9% of 12-24 year olds in the United States were admitted for public SUD treatment in 2013 (Substance Abuse and Mental Health Services
Administration [SAMHSA], 2016). Recovery from an SUD involves reduction or complete abstinence of use, defined broadly as \"voluntarily sustained
control over substance use, which maximises health and wellbeing and participation in the rights, roles and responsibilities of society\" (UK Drug
Policy Commission, 2008). However, SUDs are often experienced as chronic conditions; among youth who successfully complete substance use treatment,
approximately 45-70% return to substance use within months of treatment discharge (Anderson, Ramo, Schulte, Cummins, & Brown, 2007; Brown, D'Amico,
McCarthy, & Tapert, 2001; Ramo, Prince, Roesch, & Brown, 2012; White et al., 2004). Thus, multiple treatment episodes and ongoing recovery supports
after treatment are often necessary to assist with the recovery process (Brown et al., 2001; Ramo et al., 2012; White et al., 2004). Success and
engagement at school and in postsecondary education are critical to healthy youth development. For youth in recovery from SUDs, school attendance,
engagement, and achievement build human capital by motivating personal growth, creating new opportunities and social networks, and increasing life
satisfaction and meaning (Keane, 2011; Terrion, 2012; 2014). Upon discharge from formal substance use treatment settings, schools become one of the
most important social environments in the lives of youth with SUDs. Healthy school peer environments can enable youth to replace substance use
behaviors and norms with healthy activities and prosocial, sober peers. Conversely, many school environments may be risky for youth in recovery from
SUDs due to perceived substance use among peers, availability of drugs or alcohol, and substance-approving norms on campus (Centers for Disease
Control [CDC], 2011; Spear & Skala, 1995; Wambeam, Canen, Linkenbach, & Otto, 2014). Given the many social and environmental challenges faced by
youth in recovery from substance use, recovery-specific institutional supports are increasingly being linked to educational settings. The two primary
types of education-based continuing care supports for youth in recovery, defined under the umbrella term of \"recovery schools\" for this review, are
recovery high schools (RHSs) and collegiate recovery communities (CRCs). RHSs are secondary schools that provide standard high school education and
award secondary school diplomas, but also include therapeutic programming aimed at promoting recovery (e.g., group check-ins, community service,
counseling sessions). CRCs also provide recovery oriented support services (e.g., self-help groups, counseling sessions, sober dorms) for students,
but are embedded within larger college or university settings. The primary aims of RHSs and CRCs are to promote abstinence and prevent relapse among
students, and thus ultimately improve students' academic success. OBJECTIVES: This review summarized and synthesized the available research
evidence on the effects of recovery schools for improving academic success and behavioural outcomes among high school and college students who are in
recovery from substance use. The specific research questions that guided the review are as follows: 1. What effect does recovery school attendance
(versus attending a non-recovery or traditional school setting) have on academic outcomes for students in recovery from substance use? Specifically
(by program type): a. For recovery high schools: what are the effects on measures of academic achievement, high school completion, and college
enrolment?b. For c
Campbell Systematic Reviews, 14(1) : 1-86
- Year: 2018
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder), Relapse prevention
-
Treatment and intervention: Service Delivery & Improvement, Other service delivery and improvement
interventions
Bonell, C., Allen, E., Warren, E., McGowan, J., Bevilacqua, L., LeGood,
R., Wiggins, M., Mathiot, A., Fletcher, A., Scott, S., Elbourne, D., Christie, D., Viner, R.
Purpose: Antisocial behaviours among youth are a public health pri-ority because of their high prevalence
and harmful effects. Bullying and anti-social behaviour are associated with worse physical and mental health and poorer educational attainment.
School environment interventions targeting antisocial behaviours may be an efficient way to address multiple health harms in adolescence. The
INCLUSIVE intervention extends previous school environment trials by including a \"restorative practice\" approach, increasingly popular but never
before subject to an RCT in schools. This trial assessed the ef-fectiveness and cost-effectiveness of INCLUSIVE to reduce bullying, aggressive
behaviour and improve health-related behaviours. Methods: INCLUSIVE was a 3-year (2014-2017) cluster randomized controlled trial (RCT) aimed at 11-
16-year-olds in 40 schools (N = 5,960 students) in England. The intervention included: a) involving students in action groups to revise school
policies; b) school-wide restorative practice; and c) a social/emotional learning curriculum. Primary outcomes were bullying (Gatehouse Bullying
Scale: GBS) and school aggressive behaviour (Edinburgh Study of Youth Transitions and Crime ESYTC). Secondary outcomes were: mental health (Strengths
& Difficulties Questionnaire: SDQ), well-being (Short Warwick-Edinburgh Mental Wellbeing Scale: SWEMWBS), quality of life, smoking, alcohol & drug
use, truancy and police contact. Recruited schools were representative of state secondary schools in England. Baseline data were collected prior to
random allocation to intervention or usual practice. Institutional Review Board permissions were obtained. A process evaluation and economic
evaluation were undertaken (not reported here). Statistical analysis used an intention-to-treat approach and multi-level models to account for
school-level clustering. Results: All 40 schools remained in the trial. Student participation rates were >90% for each survey. Schools were
comparable at baseline. At 36 months (primary outcome), intervention schools had significant reductions in bullying (GBS effect estimate-.04
(-.07,-.00)p =.03) but there was no significant difference between arms in aggressive behaviours (ESYTC effect estimate-.25(-.80 to.29)p =.13), both
adjusted for baseline covariates. Secondary outcomes: At 36 months intervention schools showed significant improvements in quality of life (PedsQL:
1.68 (.60,2.75)p =.002) and well-being (SWEMWBS:.44(.07,.81)p =.02) and reductions in psychological distress (SDQ:-.56(-.96,-.17)p =.005), smoking(OR
=.67(.51,.87)p =.003), drunkenness (OR =.62(.48,.80)p <.001), drug use (OR =.73(.56,.95) and police contacts in past year (.78(.64,.97)p =.02). There
were no effects on sexual risk or hospitalisations in past year. Conclusions: The INCLUSIVE intervention was effective at reducing bullying,
improving mental health and well-being, and reducing smoking, risky alcohol use and police contacts in lower secondary-school students in England but
did not reduce aggressive behaviour. Further analyses are planned to identify mechanisms by which components of the intervention had effects and
identify subgroups of schools and students benefiting most. The wide range of positive outcomes suggests the intervention resulted in broad health
promotion which is highly meaningful at a population level. Our findings suggest school environment interventions are an effective way of improving a
wide range of health outcomes in young people. Sources of Support: National Institute of Health Research (NIHR) and Educational Endowment Foundation,
UK.
Journal of
Adolescent Health, 62 (2 Supplement 1) : S9
- Year: 2018
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Chang,
C. C., Liao, J. Y., Huang, C. M., Hsu, H. P., Chen, C. C., Guo, J. L.
BACKGROUND: Studies indicate that adolescent-onset drug users experience a greater likelihood of dependence that continues into
adulthood. The importance of early intervention was evident in treating adolescents before their substance use progressed. We examined the
effectiveness of an intervention program that prevents students who experiment with drugs from reusing them.\rMETHODS: The study was based on 10 out
of 18 invited schools that were randomly assigned to either the intervention group (5 schools, n = 43) or the comparison group (5 schools, n = 41).
The intervention group received an E-course program that comprised a main intervention course (12 sessions) and a booster course (2 sessions). By
reducing the burden of teaching content during the 14 sessions, the in-class counselor had opportunities for face-to-face discussions with students
on their ambivalence toward quitting illegal drugs. The comparison group received the conventional didactic drug prevention course (2 sessions).
Outcomes in terms of stress management, refusal skills, pros of drug use, cons of drug use, and drug use resistance self-efficacy were measured via
structured questionnaires conducted thrice: at baseline, after the main intervention sessions, and after the booster sessions. A linear mixed model
(LMM) was employed to investigate the effects of time and groups on the outcome variables with group, time, and group x time as fixed effects.
Subjects and schools were selected as random effects in order to consider both within-subject and within-school correlations.\rRESULTS: There was a
significant group x time interaction with regard to stress management, refusal skills, pros of drug use, and drug use resistance self-efficacy,
excluding cons of drug use. The intervention group displayed better stress management compared to the comparison group after the booster
intervention. Similar between-group differences were identified in that the intervention group displayed better refusal skills and drug use
resistance self-efficacy compared to that of the comparison group. The intervention group favored using drugs less (a decrease in the pros of drug
use score) compared to the comparison group after the booster intervention.\rCONCLUSIONS: Our program provided an example of the results of early
intervention among students who experiment with illegal drugs.
Substance Abuse Treatment, Prevention, &
Policy, 13(1) : 2
- Year: 2018
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Gaihre, A., Rajesh, S. K.
Background: Chronic vulnerability characterizes substance abuse disorder with consequent relapse. The
process of abstinence depends on cognitive recovery. Hence, behavioral intervention should account for cognitive dimension of substance abusers.
Recent studies highlight yoga-based intervention as a promising add-on therapy for treating and preventing addictive behaviors. Purpose: The study
aimed to evaluate the efficacy of a yoga-based intervention as an add-on in enhancing cognitive functions, compared with physical exercise to newly
admitted substance abusers seeking an inpatient treatment program. Methods: The study was a single-blind, randomized, comparative design that
included 96 male participants, between 18 and 40 years in a residential rehabilitation treatment unit. Partakers in the yoga or physical exercise
group received supervised daily training for 12 weeks, in addition to standard rehabilitation treatment. Raters blind to the study assessed the
patients on digit span task, cancellation test, and Stroop tests at the baseline and following 12 weeks of intervention. Results: A significant
enhancement in digit forward (yoga - p < 0.0005, d = 0.81; exercise - p < 0.0005, d = 0.73), digit backward (yoga - p < 0.0005, d = 0.88; exercise -
p < 0.0005, d = 0.58), and letter cancellation test scores (yoga - p < 0.0005, d = 1.31; exercise - p < 0.0005, d = 1.4) were observed in both the
yoga and the exercise groups. Stroop word and color task scores were seen significantly higher following yoga (p < 0.005, d = 0.74; p < 0.005, d =
1.13) and exercise (p < 0.0005, d = 0.62; p < 0.0005, d = 0.61). Furthermore, Stroop color-word test showed significant enhancement after yoga (p <
0.0005, d = 1.10) and exercise (p < 0.0005, d = 0.42), with degree of variation higher in the yoga group. Conclusion: Our results suggest that the
add-on yoga or exercise-based intervention show enhancement of cognitive functions. These findings provide the utility of yoga and exercise-based
intervention in improving cognitive functions among substance abusers. Furthermore, rigorous trials are needed to explore the potential long-term
effects of these procedures. Copyright © 2017 S. Karger AG, Basel.
Annals of
Neurosciences, 25(1) : 38-45
- Year: 2018
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Mind-body exercises (e.g. yoga, tai chi, qigong), Physical activity, exercise
Huang, S. F., Zheng, W. L., Liao, J. Y., Huang, C. M., Lin, T. Y., Guo, J. L.
Objective: Age of initiation of drug use is closely associated with the risk of developing drug dependence or abuse. Effective programmes
are needed to prevent adolescents from using drugs at an early age. The aim of this intervention programme was to prevent adolescents from using
illegal drugs by using drama in education (DIE) to convey a universal prevention strategy. Method: We recruited 65 children aged 14-15 years from two
junior high schools and assigned them to experimental (n = 34) and comparison (n = 31) groups. The experimental group attended six 45-minute sessions
of a DIE preventive programme. The comparison group received traditional didactic teaching. We used a generalised estimating equation (GEE) to
analyse the data. Results: GEE analysis revealed that the experimental group showed significant improvements in attitude, subjective norms, perceived
behavioural control and drug-free intentions compared with counterparts in the comparison group. Student feedback indicated that DIE method can
contribute to the prevention of illegal drug use. Conclusion: Applying DIE method to a theory-based drug prevention programme offers a promising way
of increasing the intention to not use illegal drugs among students aged 14-15 years. Copyright © 2018, The Author(s).
Health Education
Journal, 77(4) : 470-481
- Year: 2018
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Liddle, H. A., Dakof, G. A., Rowe, C. L., Henderson, C., Greenbaum,
P., Wang, W., Alberga, L.
This randomized clinical trial (RCT) compared Multidimensional Family Therapy (MDFT) with residential treatment
(RT) for adolescents with co-occurring substance use and mental health disorders on substance use, delinquency, and mental health symptoms. Using an
intent-to-treat design, 113 adolescents who had been referred for residential treatment were randomly assigned to either RT or MDFT in the
home/community. The sample was primarily male (75%) and Hispanic (68%) with an average age of 15.4 years. Seventy-one percent of youth had at least
one previous residential treatment placement. Participants were assessed at baseline and at 2, 4, 12 and 18 months post-baseline. During the early
phase of treatment (baseline to 2 months), youth in both treatments showed significant reductions in substance use [substance use problems (d =
1.10), frequency of use (d = 1.36)], delinquent behaviors (d = 0.18) and externalizing symptoms (d = 0.77), and youth receiving MDFT reported
significantly greater reductions in internalizing symptoms than youth receiving RT (d = 0.42). In phase 2, from 2 to 18 months after baseline, youth
in MDFT maintained their early treatment decreases in substance use problems (d = 0.51), frequency of use (d = 0.24), and delinquent behaviors (d =
0.42) more effectively than youth in RT. During this period, there were no significant treatment differences in maintenance of gains for
externalizing and internalizing symptoms. Results suggest that Multidimensional Family Therapy is a promising alternative to residential treatment
for youth with substance use and co-occurring disorders. The results, if supported through replication, are important because they challenge the
prevailing assumption that adolescents who meet criteria for residential treatment cannot be adequately managed in a non-residential setting.
Copyright © 2018 Elsevier Inc.
Journal of Substance Abuse Treatment, 90 : 47-56
- 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), Family therapy
Harris, S. K., Sherritt, L., Grubb, L., Samuels, R., Silva, T., Vernacchio, L., Wornham, W., Erdem, G., Knight, J. R.
Purpose:
Substance use (SU) can harm the developing adolescent brain, making delaying its initiation or decreasing its frequency among youth an important
public health goal. National guidelines recommend primary care providers screen all adolescents for SU and give brief advice, but studies show that
adherence to this recommendation is suboptimal. Often cited barriers to screening include lack of time and training. To ameliorate these barriers, we
developed a computer-facilitated Screening and Brief Advice (cSBA) system consisting of computerized pre-visit screening and psychoeducation for
patients, and point-of-care decision support and advice guidance for providers. We tested the system's effects, compared to treatment as usual
(TAU), on adolescent receipt of provider advice to avoid SU, and on SU prevention during a 12-month follow-up, as indicated by time to first
substance use post-visit. Methods: Patients ages 11-20 years with upcoming well-visits at 5 Boston-area pediatric primary care practices (54
participating providers) were consecutively recruited in 2015-2016 through mailed informational letters, or upon arrival for their visit.
Participants (N = 1011) provided informed assent (18 years), with an IRB-approved waiver of parent consent. Before seeing their provider,
participants completed the CRAFFT 2.0 screen on a tablet computer, and then were randomized within site (1:2.5) to receive either TAU (n = 279) or
cSBA (n = 732). The computer program then presented cSBA participants with immediate personalized feedback about their screen results, brief
psychoeducation on substance use risks to health and development, and gave providers the screening results, \"talking points\" (guiding 2-3 minutes
of brief discussion), and recommended follow-up plan. We assessed advice receipt with a patient questionnaire immediately post-visit, and substance
use days at baseline and through the 12 months post-visit using a Timeline Follow-Back calendar completed confidentially online or by phone at 3-
month intervals. We used Cox proportional hazards regression analysis in SPSS to compare days-to-first-use post-visit, controlling for age and
baseline use. Results: The participation rate was 89%; 89% of baseline completers had at least one follow-up assessment, with no significant
difference in retention or baseline substance use rates between groups. Participants had mean age+SD 15.0 + 2.3 years, and were comprised of 51%
girls, 44% White non-Hispanic, 77% from two-parent homes, and 65% had college-graduate parents. Most (85%) saw a pediatrician (vs. NP/PA), and 93%
had >1 prior visit with that provider. Twenty-nine percent reported any baseline past-12-month alcohol or drug use, with alcohol, cannabis, and other
drug use rates 27%, 15%, and 2%, respectively; 9% were CRAFFT+ (score >2). cSBA increased patient-reported receipt of provider advice to avoid use
(90% vs. 71%, chi-square p <.001). Adjusted hazard ratios (AHR) for days-to-first-use of any substance in cSBA compared to TAU was.77 (95%CI.61-.98),
indicating longer time until use post-visit in the intervention group; the AHR for alcohol was.75 (.59-.96), and for cannabis.61 (.44-.86).
Conclusions: Computer-facilitated adolescent screening and provider brief advice significantly delayed, compared to usual care, time to first
substance use following the pediatric well-visit. Sources of Support: NIAAA grants 1R01AA021904 and 1R34AA023026; HRSA/MCHB Leadership Education in
Adolescent Health T71 MC00009 (SKH).
Journal of Adolescent Health, 62 (2 Supplement
1) : S13
- Year: 2018
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Psychoeducation, Personalised feedback, normative feedback
Schwinn, T. M., Schinke, S. P., Hopkins, J., Keller, B., Liu, X.
Early adolescent girls' rates of drug use have matched, and in
some instances, surpassed boys' rates. Though girls and boys share risk factors for drug use, girls also have gender-specific risks. Tailored
interventions to prevent girls' drug use are warranted. This study developed and tested a web-based, drug abuse prevention program for adolescent
girls. The nationwide sample of 13- and 14-year-old girls (N = 788) was recruited via Facebook ads. Enrolled girls were randomly assigned to the
intervention or control condition. All girls completed pretest measures online. Following pretest, intervention girls interacted with the 9-session,
gender-specific prevention program online. The program aimed to reduce girls' drug use and associated risk factors by improving their cognitive and
behavioral skills around such areas as coping with stress, managing mood, maintaining a healthy body image, and refusing drug use offers. Girls in
both conditions again completed measures at posttest and 1-year follow-up. At posttest, and compared to girls in the control condition, girls who
received the intervention smoked fewer cigarettes and reported higher self-esteem, goal setting, media literacy, and self-efficacy. At 1-year
follow-up, and compared to girls in the control condition, girls who received the intervention reported engaging in less binge drinking and cigarette
smoking; girls assigned to the intervention condition also had higher alcohol, cigarette, and marijuana refusal skills, coping skills, and media
literacy and lower rates of peer drug use. This study's findings support the use of tailored, online drug abuse prevention programming for early
adolescent girls. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Journal of Youth and
Adolescence, 47(3) : 490-500
- Year: 2018
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Shin, Y. J., Miller-Day,
M., Hecht, M. L., Krieger, J. L.
Based on social cognitive theory and narrative engagement theory, the
current study examined hypothesized indirect effects of engagement with keepin'it REAL (kiR) curriculum entertainment-education (E-E) videos on
youth alcohol use via youth drug offer refusal efficacy. Students in 7th grade (N = 1,464) at 25 public schools in two Midwestern states were
randomly assigned to one of the two versions of the kiR curriculum, the kiR urban version and the kiR rural version. Each version had their own set
of five culturally-grounded E-E videos depicting communicative skills to refuse drug offers. Differential effects for engagement components were
expected depending on the degree of cultural matching. Pre/post surveys were administered at the beginning and the end of 7th grade. Structural
equation modeling analysis resulted in partial support for the research hypotheses. Rural youth receiving the urban curriculum who reported higher
interest in the E-E videos were more likely to report having higher refusal efficacy, and in turn, less likely to use alcohol. Rural youth receiving
the rural curriculum who identified with the E-E video main characters were more likely to report having higher refusal efficacy, and in turn, less
likely to use alcohol. Implications for E-E health promotion are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Health Communication, 33(7) : 896-906
- Year: 2018
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Hogue, A., Henderson, C. E., Becker, S.
J., Knight, D. K.
This article
updates the evidence base on outpatient behavioral treatments for adolescent substance use (ASU) since publication of the previous review completed
for this journal by Hogue, Henderson, Ozechowski, and Robbins (2014). It first summarizes the Hogue et al. findings along with those from recent
literature reviews and meta-analytic studies of ASU treatments. It then presents study design and methods criteria used to select 11 comparative
studies subjected to Journal of Clinical Child and Adolescent Psychology level of support evaluation. These 11 studies are detailed in terms of their
sample characteristics, methodological quality, and substance use outcomes. Cumulative level of support designations are then made for each
identified treatment approach. These cumulative designations are virtually identical to those of the previous review: ecological family-based
treatment, individual cognitive-behavioral therapy, and group cognitive-behavioral therapy remain well-established; behavioral family-based treatment
and motivational interviewing remain probably efficacious; drug counseling remains possibly efficacious; and an updated total of 5 multicomponent
treatments combining more than 1 approach (3 of which include contingency management) are deemed well-established or probably efficacious. Treatment
delivery issues associated with evidence-based approaches are then reviewed, focusing on client engagement, fidelity and mediator, and predictor and
moderator effects. Finally, to help accelerate innovation in ASU treatment science and practice, the article outlines promising horizons in improving
youth identification and access, specifying and implementing pragmatic treatment in community settings, and leveraging emerging lessons from
implementation science. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Journal of Clinical Child and Adolescent
Psychology, 47(4) : 499-526
- Year: 2018
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Family therapy, Motivational interviewing, includes Motivational Enhancing Therapy, Other Psychological Interventions, Case management
Melendez-Torres, G., Tancred, T., Fletcher, A., Thomas, J., Campbell, R., Bonell, C.
Background: Prevention of substance (alcohol, tobacco, illegal/legal drug) use in adolescents is a public health priority.
As the scope for school-based health education is constrained in school timetables, interventions integrating academic and health education have
gained traction in the UK and elsewhere, though evidence for their effectiveness remains unclear. We sought to synthesize the effectiveness of
interventions integrating academic and health education for the prevention of substance use. Methods: We searched 19 databases between November and
December 2015, among other methods. We included randomized trials of interventions integrating academic and health education targeting school
students aged 4-18 and reporting substance use outcomes. We excluded interventions for specific health-related subpopulations (e.g., children with
behavioural difficulties). Data were extracted independently in duplicate. Outcomes were synthesized by school key stage (KS) using multilevel meta-
analyses, for substance use, overall and by type. Results: We identified 7 trials reporting substance use. Interventions reduced substance use
generally in years 7-9 (KS3) based on 5 evaluations (d = -0.09, 95% CI [-0.17, -0.01], I2 = 35%), as well as in years 10-11 (KS4) based on 3
evaluations (-0.06, [-0.09, -0.02]; I2 = 0%). Interventions were broadly effective for reducing specific alcohol, tobacco, and drug use in both KS
groups. Conclusions: Evidence quality was highly variable. Findings for years 3-6 and 12-13 could not be meta-analysed, and we could not assess
publication bias. Interventions appear to have a small but significant effect reducing substance use. Specific methods of integrating academic and
health education remain poorly understood. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Child: Care, Health and Development, 44(4) : 516-
530
- Year: 2018
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Other Psychological Interventions
Mewton, L., Visontay, R., Chapman, C., Newton, N., Slade, T., Kay-Lambkin, F., Teesson, M.
ISSUES: This overview of reviews will synthesise information from existing reviews to provide a summary of the evidence for universal
alcohol and illicit drug prevention strategies across different intervention settings.\rAPPROACH: Academic databases, including Medline, EMBASE and
PsycInfo were searched on 1 August 2016. All reviews and meta-analyses of universal alcohol and drug prevention conducted since 2006 were included.
The reviews included in this overview were grouped according to the different settings where prevention strategies have been applied (i.e. family,
school, college, workplace, leisure, healthcare, community, media and policy).\rKEY FINDINGS: Fifty-two reviews met the inclusion criteria and were
included in this report. There is sufficient evidence to support universal preventive interventions for alcohol in family and school settings. In
terms of reducing drug use, there is sufficient evidence to support the use of school- and leisure-based universal primary prevention strategies.
Based on evidence published in the last 10 years, mass media campaigns to do not appear to be effective in reducing drug use. More evidence is needed
to support preventive interventions in college, workplace, healthcare and community settings.\rIMPLICATIONS: Through the identification of settings
where preventive interventions are effective, this overview can be used to guide alcohol and drug policy and the allocation of resources.
\rCONCLUSION: The evidence base for universal prevention in several settings could be strengthened, guiding priorities for future research.
Drug & Alcohol
Review, 37 Suppl 1 : S435-S469
- Year: 2018
- Problem: Substance Use Disorders (any), Alcohol
Use
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Physical activity, exercise, Technology, interventions delivered using technology (e.g. online, SMS)