Disorders - Substance Use Disorders
Smith, D. C., Ureche, D. J., Davis, J.
P., Walters, S. T.
Background: Many adolescents in need of substance use disorder treatments never engage in treatment. Further, the most
promising interventions that could be adapted to target treatment engagement often use normative feedback (NF) despite concerns about its
appropriateness for adolescents. This preliminary study will inform a larger trial designed to isolate whether NF is an inert, helpful, or harmful
active ingredient within pretreatment motivational interviewing (MI) interventions designed to increase treatment engagement. Methods: Adolescents (N
= 48) presenting for treatment intake assessments were randomized to receive MI (n = 22) or MI+NF (n = 26) immediately following their assessments.
Three-month outcomes included the percentage of youth engaged in treatment, the percentage of youth reporting past-month binge drinking, and the
percentage of days of abstinence. Results: Treatments were delivered with high fidelity, and a high proportion of eligible participants were
recruited and retained in this study. Participants significantly increased their percentage of days of abstinence by approximately 10% at follow-up
(d = .32, P =.03), with no significant differences between groups. Fifty-five percent of youth in MI and 41.7% of youth in MI+NF engaged in treatment
(odds ratio [OR] = .60, nonsignificant; 95% confidence interval, CI [0.136-2.68]). Conclusions: Larger trials should test whether NF is an active
ingredient in adolescent MI interventions, and should also determine the mechanisms through which MI+NF may produce effects. (PsycINFO Database
Record (c) 2015 APA, all rights reserved) (journal abstract).
Substance Abuse, 36(3) : 350-
358
- Year: 2015
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Motivational interviewing, includes Motivational Enhancing Therapy, Personalised feedback, normative feedback, Other service delivery and improvement
interventions
Spirito, A., Hernandez, L., Cancilliere, M.K., Graves, H., Barnett, N.
This study examined the feasibility and preliminary
efficacy of a brief parent-based prevention intervention to delay or prevent the initiation of alcohol and drug use in young adolescents with
emotional/behavioral disorders. Findings from a small randomized clinical trial comparing the individualized family substance use preventive
intervention based on the Family Check-Up model (FCU condition) to a Psychoeducation (PE) session revealed that parents in both conditions reported
an increase in alcohol-related communication at three and six months as well as an increase in general family communication. Parents in the FCU
condition reported an increase on overall substance-related communication, and reported experiencing less problematic family communication compared
to those in PE. Parents in the PE condition reported greater increases in parental monitoring than parents in the FCU condition. Study findings
suggest a larger trial is indicated to test individual and family factors that lead to differential efficacy of these preventive interventions.
(PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Journal of Child & Adolescent Substance Abuse, 24(5) : 308-
322
- Year: 2015
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Motivational interviewing, includes Motivational Enhancing Therapy, Psychoeducation, Other Psychological Interventions
Skarstrand, E., Sundell, K., Andreasson, S.
Background: Adolescents' alcohol consumption is a public health concern in Sweden as well as in many other countries.
Underage drinking is associated with increased risks of alcohol-related injuries, risky sexual behaviours and dependence later in life. Different
strategies have been used in the effort to prevent this behaviour, and to postpone the onset of alcohol. The Strengthening Families Programme 10-14
(SFP 10-14) from the USA has been highlighted as one of the more effective prevention programmes. The aim of the present article was to evaluate the
effectiveness of a culturally adapted Swedish version of the SFP 10-14. Methods: This was a cluster randomized controlled trial including 587 sixth-
grade students (age 12) and their parents in 19 elementary schools in Stockholm. Schools were randomly assigned to either control (9 schools, 216
students) or to the family skills training intervention (10 schools, 371 students). The SFP Swedish version consisted of two parts with seven and
five sessions, respectively, held separately for youths and parents except two joint family sessions. Measures of students' self-reported episodes
of drunkenness, smoking, illicit drug use and other norm-breaking behaviours were collected at baseline (March 2003) and at three subsequent yearly
surveys. Data were analysed using multilevel models with an intention-to-treat approach. Results: No preventive effects were found for smoking,
alcohol and illicit drug use and other norm-breaking behaviours, nor did moderators affect the outcome. Conclusion: The Swedish version of the SFP
10-14 was not effective in preventing youths' substance use in a Swedish context. (PsycINFO Database Record (c) 2015 APA, all rights reserved)
(journal abstract).
European
Journal of Public Health, 24(4) : 578-584
- Year: 2014
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Skills training, Other Psychological Interventions
Sandler, I., Wolchik, S. A., Cruden, G., Mahrer, N. E., Ahn, S., Brincks, A., Brown, C. H.
This review presents findings from an overview of meta-analyses of the effects of
prevention and promotion programs to prevent mental health, substance use, and conduct problems. The review of 48 meta-analyses found small but
significant changes that reduce depression, anxiety, antisocial behavior, and substance use. Furthermore, the results were sustained over time.
Meta-analyses often found that the effects were heterogeneous. A conceptual model is proposed to guide the study of moderators of program effects in
future meta-analyses, and methodological issues in synthesizing findings across preventive interventions are discussed.;
Annual Review of
Clinical Psychology, 10 : 243-273
- Year: 2014
- Problem: Anxiety Disorders (any), Depressive Disorders, Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any)
Spoth, R., Trudeau, L., Redmond, C., Shin, C.
Objective: For many
substances, more frequent and problematic use occurs in young adulthood; these types of use are predicted by the timing of initiation during
adolescence. We replicated and extended an earlier study examining whether delayed substance initiation during adolescence, resulting from universal
preventive interventions implemented in middle school, reduces problematic use in young adulthood. Method: Participants were middle school students
from 36 Iowa schools randomly assigned to the Strengthening Families Program: For Parents and Youth 10-14 (Molgaard, Spoth, & Redmond, 2000) plus
Life Skills Training (LST; Botvin, 1995, 2000), LST-only, or a control condition. Self-report questionnaires were collected at 11 time points,
including 4 during young adulthood. The intercept (average level) and rate of change (slope) in young adult frequency measures (drunkenness,
alcoholrelated problems, cigarettes, and illicit drugs) across ages 19-22 were modeled as outcomes influenced by growth factors describing substance
initiation during adolescence. Analyses entailed testing a 2-step hierarchical latent growth curve model; models included the effects of baseline
risk, intervention condition assignment, and their interaction. Results: Analyses showed significant indirect intervention effects on the average
levels of all young adult outcomes, through effects on adolescent substance initiation growth factors, along with Intervention × Risk interaction
effects favoring the higher risk subsample. Additional direct effects on young adult use were observed in some cases. Relative reduction rates were
larger for the higher risk subsample at age 22, ranging from 5.8% to 36.4% on outcomes showing significant intervention effects. Conclusions:
Universal preventive interventions implemented during early adolescence have the potential to decrease the rates of substance use and associated
problems into young adulthood.
Journal of Consulting & Clinical Psychology, 82(6) : 949-963
- Year: 2014
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Skills training, Other Psychological Interventions
Schaeffer, C. M., Henggeler, S. W., Ford, J. D., Mann, M., Chang, R., Chapman, J. E.
Juvenile offenders with substance use problems are at high risk for deleterious long-term outcomes. This study evaluated the capacity of a
promising vocational and employment training program in the building sector (i.e., Community Restitution Apprenticeship-Focused Training, CRAFT) to
mitigate such outcomes through enhanced employment and education. Participants were 97 high-risk juvenile offenders (mean age = 15.8. years)
randomized to CRAFT versus education as usual (EAU) intervention conditions. Multi-method procedures measured employment, education, substance use,
mental health, and criminal outcomes through a 30-month post-baseline follow-up. CRAFT was significantly more effective than EAU at increasing rates
of youth employment and GED attendance. Intervention effects were not observed, however, for months employed, hours worked, or hourly wage. Measures
of youth substance use, mental health symptoms, and criminal activity showed no favorable or iatrogenic effects. The potential of CRAFT was modestly
supported, and suggestions were made for future research. © 2013 Elsevier Inc.
Journal of Substance Abuse Treatment, 46(2) : 134-143
- Year: 2014
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Individual placement and support (IPS), vocational
interventions
Rohde, P., Waldron, H. B., Turner, C. W., Brody, J., Jorgensen, J.
Objective: We evaluated 3 methods of integrating
interventions for depression (Adolescent Coping With Depression Course; CWD) and substance use disorders (Functional Family Therapy; FFT), examining
(a) treatment sequence effects on substance use and depression outcomes and (b) whether the presence of major depressive disorder (MDD) moderated
effects. Method: Participants were 170 adolescents (ages 13-18; 22% female; 61% non-Hispanic White) with comorbid depressive disorder (54% MDD, 18%
dysthymia) and substance use disorders who were randomized to (a) FFT followed by CWD (FFT/CWD), (b) CWD followed by FFT (CWD/FFT), or (c)
coordinated FFT and CWD (CT). Acute treatment (24 treatment sessions provided over 20 weeks) and 6- and 12-month follow-up effects are presented for
substance use (percentage of days of substance use; Timeline Followback) and depression (Childrenâs Depression Rating Scale-Revised). Results:
FFT/CWD achieved better substance use outcomes than CT at posttreatment, and 6- and 12-month follow-ups; substance use effects for CWD/FFT were
intermediate. For participants with baseline MDD, the CWD/FFT sequence resulted in lower substance use than either FFT/CWD or CT. Depressive symptoms
decreased significantly in all 3 treatment sequences with no evidence of differential effectiveness during or following treatment. Attendance was
lower for the second of both sequenced interventions. A large proportion of the sample received treatment outside the study, which predicted better
outcomes in the follow-up. Conclusions: Depression reductions occurred early in all 3 treatment sequences. Of the examined treatment sequences,
FFT/CWD appeared most efficacious for substance use reductions but addressing depression early in treatment may improve substance use outcomes in the
presence of MDD. (PsycINFO Database Record (c) 2014 APA, all rights reserved). © 2014 American Psychological Association.
Journal of
Consulting & Clinical Psychology, 82(2) : 342-348
- Year: 2014
- Problem: Depressive Disorders, Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Family therapy, Other service delivery and improvement
interventions
Schuler, M. S., Griffin, B-A., Ramchand, R., Almirall, D., McCaffrey, D. F.
Objective: The
purpose of this study was to compare the relative effectiveness of three treatment modalities for adolescent substance use: biological drug screening
(BDS), Motivational Enhancement Therapy-Cognitive Behavioral Therapy (MET/CBT5), and BDS combined with MET/CBT5, relative to no treatment.; Method:
This study comprised 5,186 adolescents (70% male) enrolled in substance use treatment and tracked through the Substance Abuse and Mental Health
Services Administration's Center for Substance Abuse Treatment's database (BDS = 1,110; MET/CBT5 = 784; BDS combined with MET/CBT5 = 2,539; no
treatment = 753). Outcomes of interest were substance use frequency and severity of substance use problems at 3, 6, and 12 months, as measured by the
Global Appraisal of Individual Needs survey. Propensity score weighting was used to adjust for pretreatment covariate imbalances between groups.
Weighted generalized linear models were used to estimate the impact of treatment on outcomes at 3, 6, and 12 months.; Results: BDS, alone or in
combination with MET/CBT5, was associated with improved substance use and substance problems outcomes. Relative to youth reporting no treatment
services, the BDS group reported significantly lower substance use at all visits, with the observed difference increasing over time. BDS alone was
associated with significantly fewer substance problems than bds combined with met/cbt5 at all visits and significantly lower use at 12 months.;
Conclusions: Our results demonstrate significant improvement on substance use outcomes associated with BDS and offer preliminary evidence that BDS,
particularly standalone BDS, may be an effective form of drug treatment for adolescents. Further work, including randomized studies, should explore
the optimal format of administering BDS to adolescents to achieve maximum effectiveness.;
Journal of Studies on Alcohol & Drugs, 75(2) : 358-
370
- Year: 2014
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Motivational interviewing, includes Motivational Enhancing Therapy, Other service delivery and improvement
interventions
Sussman, S., Arriaza, B., Grigsby, T. J.
BACKGROUND: Relative to youth in regular high schools, alternative high school (AHS) youth are at high
risk for alcohol, tobacco, and other drug (ATOD) misuse. Prevention and cessation efforts are needed for this population.\rMETHODS: A systematic,
exhaustive literature search was completed to identify ATOD misuse prevention and cessation research studies with AHS youth.\rRESULTS: For the AHS
population, 23 ATOD misuse prevention or cessation program evaluations were located. This review indicated that successful efforts have focused on
instruction in motivation enhancement, life coping skills, and decision making.\rCONCLUSIONS: Alcohol, tobacco, and other drug misuse prevention and
cessation programming for AHSs is effective, delivered in the classroom or as a school-based clinic. There is little evidence, though, that this
programming is effective when delivered through other modalities such as via computer or bridging beyond the school setting. More research and
application of evidence-based programming are recommended for youth in AHS settings.
Journal of School Health, 84(11) : 748-758
- Year: 2014
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any)
Walton, M. A., Resko, S., Barry, K. L., Chermack, S. T., Zucker, R.
A., Zimmerman, M. A., Booth, B. M., Blow, F.
C.
Abstract Aims To examine the efficacy of a brief intervention delivered by a therapist (TBI) or a computer (CBI) in preventing cannabis use
among adolescents in urban primary care clinics. Design A randomized controlled trial comparing: CBI and TBI versus control. Setting Urban primary
care clinics in the United States. Participants Research staff recruited 714 adolescents (aged 12-18 years) who reported no life-time cannabis use on
a screening survey for this study, which included a baseline survey, randomization (stratified by gender and grade) to conditions (control; CBI; TBI)
and 3-, 6- and 12-month assessments. Measurements Using an intent-to-treat approach, primary outcomes were cannabis use (any, frequency); secondary
outcomes included frequency of other drug use, severity of alcohol use and frequency of delinquency (among 85% completing follow-ups). Findings
Compared with controls, CBI participants had significantly lower rates of any cannabis use over 12 months (24.16%, 16.82%, respectively, P < 0.05),
frequency of cannabis use at 3 and 6 months (P < 0.05) and other drug use at 3 months (P < 0.01). Compared with controls, TBI participants did not
differ in cannabis use or frequency, but had significantly less other drug use at 3 months (P < 0.05), alcohol use at 6 months (P < 0.01) and
delinquency at 3 months (P < 0.01). Conclusions Among adolescents in urban primary care in the United States, a computer brief intervention appeared
to prevent and reduce cannabis use. Both computer and therapist delivered brief interventions appeared to have small effects in reducing other risk
behaviors, but these dissipated over time. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract).
Addiction, 109(5) : 786-797
- Year: 2014
- Problem: Substance Use Disorders (any), Alcohol
Use, Cannabis Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Motivational interviewing, includes Motivational Enhancing Therapy, Personalised feedback, normative feedback, Technology, comparing delivery mode (e.g. online vs. face-to-face)
Winters, K. C., Lee, S., Botzet, A., Fahnhorst, T., Nicholson, A.
Two manually guided brief interventions were evaluated with a randomized, controlled trial.
Adolescents (aged 13-17 years) suspected of abusing alcohol and other drugs and their parent were randomly assigned to receive either a 2-session
adolescent only (BI-A), 2-session adolescent and additional parent session (BI-AP), or assessment only control condition (CON). Adolescents were
identified in a school setting, and the intervention was delivered by trained counselors. Outcome analyses (N = 284; 90% of those enrolled) of
relative change (from intake to 12 months) and absolute status (at 12 months) revealed a general pattern of reductions in drug use behaviors,
particularly with the cannabis outcome measures, in both active conditions (BI-A and BI-AP). Students in the control condition showed worse outcome
compared with the BI-A and BI-AP groups. Among the 4 mediating variables measured at 6 months, use of additional services, motivation to change, and
parenting practices had significant influences on 12-month outcome; problem-solving skills approached significance as a mediator. The potential value
of a brief intervention for drug abusing adolescents is discussed. © 2014 American Psychological Association.
Psychology of Addictive Behaviors, 28(2) : 464-
474
- Year: 2014
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Motivational interviewing, includes Motivational Enhancing Therapy
Wong, M. D., Coller, K. M., Dudovitz, R. N., Kennedy, D. P., Buddin, R., Shapiro, M. F., Kataoka, S. H., Brown, A. F., Tseng, C-H., Bergman, P., Chung, P. J.
Objectives: We examined whether exposure to high-performing schools reduces the rates of risky
health behaviors among low-income minority adolescents and whether this is due to better academic performance, peer influence, or other factors.;
Methods: By using a natural experimental study design, we used the random admissions lottery into high-performing public charter high schools in
low-income Los Angeles neighborhoods to determine whether exposure to successful school environments leads to fewer risky (eg, alcohol, tobacco, drug
use, unprotected sex) and very risky health behaviors (e.g., binge drinking, substance use at school, risky sex, gang participation). We surveyed 521
ninth- through twelfth-grade students who were offered admission through a random lottery (intervention group) and 409 students who were not offered
admission (control group) about their health behaviors and obtained their state-standardized test scores.; Results: The intervention and control
groups had similar demographic characteristics and eighth-grade test scores. Being offered admission to a high-performing school (intervention
effect) led to improved math (P < .001) and English (P = .04) standard test scores, greater school retention (91% vs. 76%; P < .001), and lower rates
of engaging in =1 very risky behaviors (odds ratio = 0.73, P < .05) but no difference in risky behaviors, such as any recent use of alcohol, tobacco,
or drugs. School retention and test scores explained 58.0% and 16.2% of the intervention effect on engagement in very risky behaviors, respectively.;
Conclusions: Increasing performance of public schools in low-income communities may be a powerful mechanism to decrease very risky health behaviors
among low-income adolescents and to decrease health disparities across the life span.; Copyright © 2014 by the American Academy of Pediatrics.
Pediatrics, 134(2) : e389-e396
- Year: 2014
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Other service delivery and improvement
interventions