Disorders - Substance Use Disorders
Roberts, Clare, Williams, Rachael, Kane, Robert, Pintabona, Yolanda, Cross, Donna, Zubrick, Stephen, Silburn,
Sven
This cluster randomized controlled trial evaluated the impact of a universal mental health
promotion program, the Aussie Optimism Program (AOP), on adolescent tobacco and alcohol use. Students aged 10 - 13 years (N = 3288) from 63
government primary schools were recruited from an urban population area in Western Australian. Schools were randomized to a usual school health
curriculum control group (21 schools), an AOP group with teacher training (20 schools), or AOP with teacher training plus coaching (22 schools). The
intervention was implemented in primary school Grades 6 and 7, with follow-up in secondary school Grade 8. Students completed confidential
questionnaires relating to consumption of cigarettes and alcohol over the past month. The intervention program contained activities relating to
social skills, social problem solving and challenging unhelpful thoughts. The intervention was associated with lower levels of alcohol use at post-
test and lower levels of both alcohol and tobacco use at a 12-month secondary school follow-up, but only when AOP was implemented by teachers who
received training and coaching in the program. Hence, mental health promotion programs that focus on general life skills may also impact upon health
risk behaviors such as alcohol and tobacco use in young adolescents. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal
abstract)
Advances in Mental Health, 10(1) : 72-82
- Year: 2011
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Skills training
Riggs, P. D., Winhusen, T., Davies, R. D., Leimberger, J. D., Mikulich-Gilbertson, S., Klein, C., Macdonald, M., et-al
Objective: To evaluate the efficacy and safety of osmotic-release methylphenidate (OROSMPH) compared with
placebo for attention-deficit/ hyperactivity disorder (ADHD), and the impact on substance treatment outcomes in adolescents concurrently receiving
cognitivebehavioral therapy (CBT) for substance use disorders (SUD). Method: This was a 16-week, randomized, controlled, multi-site trial of OROS-MPH
+ CBT versus placebo + CBT in 303 adolescents (aged 13 through 18 years) meeting DSM-IV diagnostic criteria for ADHD and SUD. Primary outcome
measures included the following: for ADHD, clinician-administered ADHD Rating Scale (ADHD-RS), adolescent informant; for substance use, adolescent-
reported days of use in the past 28 days. Secondary outcome measures included parent ADHD-RS and weekly urine drug screens (UDS). Results: There were
no group differences on reduction in ADHD-RS scores (OROS-MPH: -19.2, 95% confidence interval [CI], -17.1 to -21.2; placebo, -21.2, 95% CI, -19.1 to
-23.2) or reduction in days of substance use (OROS-MPH: -5.7 days, 95% CI, 4.0-7.4; placebo: -5.2 days, 95% CI, 3.5-7.0). Some secondary outcomes
favored OROS-MPH, including lower parent ADHD-RS scores at 8 (mean difference = 4.4, 95% CI, 0.8-7.9) and 16 weeks (mean difference =6.9; 95% CI,
2.9-10.9) and more negative UDS in OROS-MPH (mean = 3.8) compared with placebo (mean = 2.8; p =.04). Conclusions: OROS-MPH did not show greater
efficacy than placebo for ADHD or on reduction in substance use in adolescents concurrently receiving individual CBT for co-occurring SUD. However,
OROS-MPH was relatively well tolerated and was associated with modestly greater clinical improvement on some secondary ADHD and substance outcome
measures. Clinical Trial Registration Information-Attention Deficit Hyperactivity Disorder (ADHD) in Adolescents with Substance Use Disorders (SUD);
http://www.clinicaltrials.gov; NCT00264797. (copyright) 2011 American Academy of Child and Adolescent Psychiatry.
Journal of the American Academy of Child & Adolescent Psychiatry, 50(9) : 903-
914
- Year: 2011
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Medications used to treat substance abuse, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Robbins, M. S., Feaster, D. J., Horigian, V. E., Rohrbaugh, M., Shoham, V., Bachrach, K., Miller, M., et-al
Objective: To determine the
effectiveness of brief strategic family therapy (BSFT; an evidence-based family therapy) compared to treatment as usual (TAU) as provided in
community-based adolescent outpatient drug abuse programs. Method: A randomized effectiveness trial in the National Drug Abuse Treatment Clinical
Trials Network compared BSFT to TAU with a multiethnic sample of adolescents (213 Hispanic, 148 White, and 110 Black) referred for drug abuse
treatment at 8 community treatment agencies nationwide. Randomization encompassed both adolescents' families (n = 480) and the agency therapists (n
= 49) who provided either TAU or BSFT services. The primary outcome was adolescent drug use, assessed monthly via adolescent self-report and
urinalysis for up to 1 year post randomization. Secondary outcomes included treatment engagement ((greater-than or equal to)2 sessions), retention
((greater-than or equal to)8 sessions), and participants' reports of family functioning 4, 8, and 12 months following randomization. Results: No
overall differences between conditions were observed in the trajectories of self-reports of adolescent drug use. However, the median number of days
of self-reported drug use was significantly higher, (chi)2(1) = 5.40, p <.02, in TAU (Mdn = 3.5, interquartile range [IQR] = 11) than BSFT (Mdn = 2,
IQR = 9) at the final observation point. BSFT was significantly more effective than TAU in engaging, (chi)2(1) = 11.33, p <.001, and retaining,
(chi)2(1) = 5.66, p <.02, family members in treatment and in improving parent reports of family functioning, (chi)2(2) = 9.10, p <.011. Conclusions:
We discuss challenges in treatment implementation in community settings and provide recommendations for further research. (copyright) 2011 American
Psychological Association.
Journal of Consulting & Clinical Psychology, 79(6) : 713-727
- Year: 2011
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Family therapy
Shetgiri, R., Kataoka, S., Lin, H., Flores, G.
Purpose: Few studies have rigorously evaluated
school-based interventions to reduce violence and substance use in high school students, especially Latinos. This study assessed the effects of a
school-based program on reducing violence and substance use among primarily Latino high school students. Methods: Ninth-grade students at risk for
violence and substance use were randomized to intervention or control groups. The intervention was based on an existing program developed for white
and African American youth. Data on smoking, alcohol and drug use, fighting, and grades were collected at baseline and 4 and 8 months post
enrollment. Results: There were 55 students in the control and 53 in the intervention group; 74% of controls and 78% of intervention students were
Latino. There were no significant changes in fighting, smoking, or alcohol or drug use, from baseline to 8-month follow-up, between the intervention
and control group. Pre and post grade point average (GPA) decreased from 2.3 at baseline to 1.8 at follow-up (p < .01) in the intervention group,
with no significant between-group changes in GPA from baseline to follow-up. Conclusions: This school-based program showed no reduction in violence
or substance use. The findings suggest that a program targeting non-Latino youth may not be optimal for reducing violence and substance use in
Latinos; greater attention to cultural appropriateness and racial/ethnic differences may be needed. There was a decrease in interventiongroup GPA but
no significant change compared with controls. Further studies of the impact of school-based substance use and violence prevention programs on
academics, and the effectiveness of afterschool or community-based programs compared to school-based programs are needed.
Journal of the National Medical Association, 103(9-10) : 932-940
- Year: 2011
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Skills training
Slater, Michael D., Kelly, Kathleen J., Lawrence, Frank R., Stanley, Linda R., Comello, Maria Leonora G.
Two media-based interventions designed
to reduce adolescent marijuana use ran concurrently from 2005 to 2009. Both interventions used similar message strategies, emphasizing marijuana's
inconsistency with personal aspirations and autonomy. \"Be Under Your Own Influence\" was a randomized community and school trial replicating and
extending a successful earlier intervention of the same name (Slater et al. Health Education Research 21:157 - 167, 2006). \"Above the Influence\" is
a continuing national television, radio, and print campaign sponsored by the Office of National Drug Control Policy (ONDCP). This study assessed the
simultaneous impact of the interventions in the 20 U.S. communities. Results indicate that earlier effects of the \"Be Under Your Own Influence\"
intervention replicated only in part and that the most plausible explanation of the weaker effects is high exposure to the similar but more extensive
ONDCP \"Above the Influence\" national campaign. Self-reported exposure to the ONDCP campaign predicted reduced marijuana use, and analyses partially
support indirect effects of the two campaigns via aspirations and autonomy. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal
abstract)
Prevention Science, 12(1) : 12-22
- Year: 2011
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions
Spoth, R., Redmond, C., Clair, S., Shin, C., Greenberg, M., Feinberg, M.
Background: Substance misuse by adolescents and related health issues constitute a major public health problem. Community-based
partnership models designed for sustained, quality implementation of proven preventive interventions have been recommended to address this problem.
There is very limited longitudinal study of such models. Purpose: To examine the long-term findings from an RCT of a community-university partnership
model designed to prevent substance misuse and related problems. Design/setting/participants: A cohort sequential design included 28 public school
districts in rural towns and small cities in Iowa and Pennsylvania that were randomly assigned to community-university partnership or usual-
programming conditions. At baseline, 11,960 students participated, across two consecutive cohorts. Data were collected from 2002 to 2008.
Intervention: Partnerships supported community teams that implemented universal, evidence-based interventions selected from a menu. The selected
family-focused intervention was implemented with 6th-grade students and their families; school-based interventions were implemented during the 7th
grade. Observations demonstrated intervention implementation fidelity. Main outcome measures: Outcome measures were lifetime, past-month, and past-
year use of a range of substances, as well as indices of gateway and illicit substance use; they were administered at baseline and follow-ups,
extending to 4.5 years later. Results: Intent-to-treat, multilevel ANCOVAs of point-in-time use at 4.5 years past baseline were conducted, with
supplemental analyses of growth in use. Data were analyzed in 2009. Results showed significantly lower substance use in the intervention group for 12
of 15 point-in-time outcomes, with relative reductions of up to 51.8%. Growth trajectory analyses showed significantly slower growth in the
intervention group for 14 of 15 outcomes. Conclusions: Partnership-based implementation of brief universal interventions has potential for public
health impact by reducing growth in substance use among youth; a multistate network of partnerships is being developed. Notably, the tested model is
suitable for other types of preventive interventions. (copyright) 2011 American Journal of Preventive Medicine.
American Journal of Preventive Medicine, 40(4) : 440-
447
- Year: 2011
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Skills training, Other Psychological Interventions
Zywiak, W.
H., Graney, D. D., Wood, M. D., Stout, R. L.
College Facilitation for Alcohol Problems has been developed from Extended Case
Monitoring (Stout et al. 1999) to address heavy drinking among college students with an intervention that capitalizes on students being available for
a number of semesters, at a time when drinking patterns are being developed. Three hundred seventy-four First Offenders of a university's substance
use policy were randomized to college facilitation or college as usual. College facilitation consisted of telephone calls about once a month spread
across four academic semesters. The phone calls emphasized rapport, academic progress, and used academic progress has a hook to reduce drinking
intensity among college students. In addition, any topics or issues that the student wanted to bring up were discussed. The sample consisted of 160
(43%) women, 354 (95%) Caucasian students, and 274 (73%) freshmen. All students were scheduled to complete 6, 12, 18, and 24 month research follow-
ups and retention rates were 97, 94, 91, and 88%, respectively. Sixty-four percent or 11.5 of the 18 planned college facilitation (CF) telephone
contacts were completed. Since academic progress was a large component of the telephone calls, and academic drinking is known to vary according to
the day of the week, we examined drinking on each day of the last full week of classes, for each of the four semesters following randomization.
Contrary to predictions, during the first end of the semester following randomization, there was a statistical trend for more drinking by CF students
than control students on that Friday [t(330.6) = 1.84, p = 0.07, CF 4.40 (5.39) SDUs, control 3.41 (4.62) SDUs]. However, when this data was
transformed (the fourth root) the statistical trend was no longer evident (p = 0.27). In contrast, in the hypothesized direction, we did find a
difference for drinking on Sunday during the last week of the second semester following randomization [t(316.6) = 1.76, p = 0.08, CF 0.07 (0.77)
SDUs, control 0.26 (1.20) SDUs, i.e., the controls were drinking four times as much as the CF students on this day]. When this variable was
transformed, the group difference was significant [t(273.5=2.47, p = 0.01. d = 0.26]. For g.p.a., there was an increase from baseline to the second
semester for CF students relative to controls [t(196) = 2.31, p = 0.02, d = 0.33; CF + 0.07(0.70), control )0.15(0.64)]. This intervention effect on
g.p.a. is particularly noteworthy since the g.p.a. data are not susceptible to response bias.
Alcoholism: Clinical & Experimental Research, 35 : 212A
- Year: 2011
- Problem: Substance Use Disorders (any), Alcohol
Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Schwinn, Traci M., Schinke, Steven P., Di-Noia, Jennifer
This study developed and
tested an Internet-based gender-specific drug abuse prevention program for adolescent girls. A sample of seventh, eighth, and ninth grade girls (N =
236) from 42 states and 4 Canadian provinces were randomly assigned to an intervention or control group. All girls completed an online pretest
battery. Following pretest, intervention girls interacted with a 12-session, Internet-based gender-specific drug prevention program. Girls in both
groups completed the measurement battery at posttest and 6-month follow-up. Analysis of posttest scores revealed no differences between groups for
30-day reports of alcohol, marijuana, poly drug use, or total substance use (alcohol and drugs). At 6-month follow-up, between-group effects were
found on measures of 30-day alcohol use, marijuana use, poly drug use, and total substance use. Relative to girls in the control group, girls exposed
to the Internet-based intervention reported lower rates of use for these substances. Moreover, girls receiving the intervention achieved gains over
girls in the control group on normative beliefs and self-efficacy at posttest and 6-month follow-up, respectively.
Prevention Science, 11(1) : 24-32
- Year: 2010
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Psychoeducation, Skills training, Technology, interventions delivered using technology (e.g. online, SMS)
Ringwalt, Chris L., Clark, Heddy Kovach, Hanley, Sean, Shamblen, Stephen R., Flewelling, Robert L.
School-based drug prevention curricula constitute the nation’s most prevalent strategy
to prevent adolescent drug use. We evaluated the effects of one such curriculum, Project ALERT, on adolescent substance use. In particular, we sought
to determine if a single effect on 30-day alcohol use, noted shortly following the completion of the 2-year program, could be detected 1 year later.
We also looked for delayed effects on other outcomes of interest, namely lifetime alcohol use, and 30-day and lifetime use of cigarettes, marijuana,
and inhalants. We employed a randomized controlled trial that used school as the unit of assignment. Thirty-four schools with grades 6–8 from 11
states completed the study. Seventy-one Project ALERT instructors taught 11 core lessons to sixth graders and 3 booster lessons to seventh graders.
Students were assessed prior to the onset of the intervention, as sixth graders, after the completion of the 2-year curriculum, as seventh graders,
and again 1 year later as eighth graders. This paper examines data from the pretest and final posttest. Using hierarchical nonlinear modeling, we
found that our earlier effect on 30-day alcohol use did not persist. Further, we continued to find no effects for lifetime alcohol use and both the
lifetime and 30-day use of cigarettes, marijuana, and inhalants. Our findings do not support the long-term effectiveness of Project ALERT, when
delivered to sixth graders. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (journal abstract)
Prevention
Science, 11(2) : 172-184
- Year: 2010
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Skills training
Roberts-Lewis, Amelia C., Welch-Brewer, Chiquitia
L., Jackson, Mary S., Kirk, Raymond, Pharr, O. Martin
The objective
of this preliminary study was to determine the effectiveness of a female gender-specific substance abuse treatment intervention (Holistic Enrichment
for At-Risk Teens, or HEART) in improving problems related to personal and social functioning. A quasi-experimental, 2-group pretest and posttest
repeated measures design was used to evaluate the effectiveness of a treatment intervention with 101 incarcerated girls who met DSM-IV criteria for
substance dependence. A repeated measures MANCOVA revealed that the HEART program appeared to be more effective in reducing problems related to
social functioning than the standard treatment substance abuse intervention. At posttest, significant differences were found between the treatment
and comparison groups on three of the four measures of social functioning: problems with family, problems with friends, and problems with school. No
significant differences were found between the 2 groups on 3 posttest measures of personal functioning. A critical need exists for gender-sensitive
substance abuse interventions in female juvenile correctional facilities. Implications for policy, practice, and research are discussed. (PsycINFO
Database Record (c) 2010 APA, all rights reserved) (journal abstract)
Journal of Offender Rehabilitation, 49(7) : 479-
494
- Year: 2010
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Rohrbach, Louise A., Sun, Ping, Sussman,
Steve
Objective: Method: Results: Conclusion: The aims of this trial, conducted 2004-2008, were to examine (1) the
effectiveness of Project Towards No Drug Abuse (TND) at the one-year follow-up when implemented on a large scale; and (2) the relative effectiveness
of two training approaches for program implementers.A total of 65 high schools from 14 school districts across the United States were randomized to
one of three conditions: regular workshop training, comprehensive implementation support, or standard care control. Physical education and health
teachers delivered the program to students (n=2538). Program effectiveness was assessed with dichotomous measures of 30-day substance use at baseline
and one-year follow-up.When the program conditions were considered in aggregate and compared to controls, the program showed a marginally significant
effect in lowering marijuana use from baseline to the one-year follow-up. Significant program effects on hard drug use were achieved for baseline
non-users only. There were no differences in the effects of the two program conditions.Positive outcomes may be achieved by trained teachers when
they implement Project TND in real-world high school environments; however, program effects are likely to be weaker than those achieved in efficacy
trials. Training workshops may be adequate to build capacity for successful program implementation.\rCopyright © 2010 Elsevier Inc. All rights
reserved.
Preventive Medicine, 51(3-4) : 313-
319
- Year: 2010
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Sussman, Steve
The investigation of the applicability of Alcoholics Anonymous/Narcotics Anonymous (AA/NA) for teens has only been a subject
of empirical research investigation since the early 1990s. In the present review, the author describes teen involvement in AA/NA programming,
provides an exhaustive review of the outcomes of 19 studies that used an AA/NA model as part of their formal teen substance abuse treatment programs,
and provides data on the effects of AA/NA attendance on abstinence at follow-up, on which youth tend to become involved in AA/NA, and on mediation of
the benefits of AA/NA participation. In addition, the author suggests the reasons for somewhat limited participation by teens in more informal,
community-based 12-step meetings, and makes suggestions for maximizing participation at meetings in the community. The author concludes that AA/ NA
participation is a valuable modality of substance abuse treatment for teens and that much can be done to increase teen participation, though more
research is needed.
Evaluation & the Health
Professions, 33(1) : 26-55
- Year: 2010
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions