Disorders - Substance Use Disorders
Sloboda, Zili, Stephens, Richard C., Stephens, Peggy C., Grey, Scott F., Teasdale, Brent, Hawthorne, Richard D., Williams, Joseph, et-al
Objectives: Methods: Results: Conclusions: The purpose of the study was to determine whether a universal school-based substance abuse
prevention program, Take Charge of Your Life (TCYL), prevents or reduces the use of tobacco, alcohol, or marijuana.Eighty-three school clusters
(representing school districts) from six metropolitan areas were randomized to treatment (41) or control (42) conditions. Using active consenting
procedures, 19,529 seventh graders were enrolled in the 5-year study. Self-administered surveys were completed by the students annually. Trained Drug
Abuse Resistance Education (D.A.R.E.) police officers presented TCYL in seventh and ninth grades in treatment schools. Analyses were conducted with
data from 17,320 students who completed a baseline survey. Intervention outcomes were measured using self-reported past-month and past-year use of
tobacco, alcohol, and marijuana when students were in the 11th grade.Main effect analyses show a negative program effect for use of alcohol and
cigarettes and no effect for marijuana use. Subgroup analyses indicated that the negative effect occurred among nonusers at baseline, and mostly
among white students of both genders. A positive program effect was found for students who used marijuana at baseline. Two complementary papers
explore the relationship of the targeted program mediators to the use of alcohol, tobacco, and marijuana and specifically for students who were
substance-free or who used substances at baseline.The negative impact of the program on baseline nonusers of alcohol and tobacco indicate that TCYL
should not be delivered as a universal prevention intervention. The finding of a beneficial effect for baseline marijuana users further supports this
conclusion. The programmatic and methodological challenges faced by the Adolescent Substance Abuse Prevention Study (ASAPS) and lessons learned offer
insights for prevention researchers who will be designing similar randomized field trials in the future.
Drug & Alcohol Dependence, 102(1-3) : 1-10
- Year: 2009
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Skills training
Ringwalt, Christopher L., Clark, Heddy Kovach, Hanley, Sean, Shamblen, Stephen R., Flewelling,
Robert L.
Objective:
Design: Setting: Participants: Main Outcome Measures: Results: Conclusion: To evaluate the effects of Project ALERT on adolescents' lifetime and 30
-day use of cigarettes, alcohol, marijuana, and inhalants.Cluster randomized trial.Schools from 11 states were enrolled in 2 successive cohorts from
2004 to 2008.All public schools in the United States that included grades 6 through 8 and enrolled at least 100 students in sixth grade were
recruited. Of the 40 schools that began the study, 34 (17 per condition) completed it. Data were analyzed from 5883 unique participants. Intervention
Project ALERT, a manualized classroom-based substance use prevention curriculum for the middle grades, was taught to sixth and seventh
graders.Students were surveyed before the onset of the intervention, as sixth graders, and after the completion of the 2-year intervention, as
seventh graders. Outcome measures included lifetime and 30-day use of cigarettes, alcohol, marijuana, and inhalants.At baseline, students in the
intervention condition were slightly to moderately more likely to report use for each of the 8 measures examined than were students in the control
condition. For all measures except lifetime use of cigarettes, these differences were less pronounced at follow-up and therefore were in the
direction of favorable program effects. These changes were statistically significant, however, for only 1 outcome measure, past 30-day use of alcohol
(reduction in the adjusted odds ratio from 2.07 at baseline to 1.32 at follow-up; P = .006).Project ALERT was not effective when delivered to the
sixth grade population we targeted.
Archives of Pediatrics & Adolescent Medicine, 163(7) : 625-
632
- Year: 2009
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Skills training
Waldron, H. B., Turner, C. W.
This review synthesized findings from 17 studies since 1998 regarding evaluation of
outpatient treatments for adolescent substance abuse. These studies represented systematic design advances in adolescent clinical trial science. The
research examined 46 different intervention conditions with a total sample of 2,307 adolescents. The sample included 7 individual cognitive behavior
therapy (CBT) replications (n = 367), 13 group CBT replications (n = 771), 17 family therapy replications (n = 850) and 9 minimal treatment control
conditions (n = 319). The total sample was composed of approximately 75% males, and the ethnic/racial distribution was approximately 45% White, 25%
Hispanic, 25% African American, and 5% other groups. Meta-analysis was used to evaluate within-group effect sizes as well as differences between
active treatment conditions and the minimal treatment control conditions. Methodological rigor of studies was classified using Nathan and Gorman
(2002) criteria, and treatments were classified using criteria for well-established and probably efficacious interventions based on Chambless et al.
(1996). Three treatment approaches, multidimensional family therapy, functional family therapy, and group CBT emerged as well-established models for
substance abuse treatment. However, a number of other models are probably efficacious, and none of the treatment approaches appeared to be clearly
superior to any others in terms of treatment effectiveness for adolescent substance abuse. [ABSTRACT FROM AUTHOR]\rCopyright of Journal of Clinical
Child & Adolescent Psychology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a
listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This
abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material
for the full abstract. (Copyright applies to all Abstracts.)
Journal of Clinical Child & Adolescent
Psychology, 37(1) : 238-261
- Year: 2008
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
Robbins, Michael S., Szapocznik, Jose, Dillon, Frank R., Turner, Charles W., Mitrani, Victoria B., Feaster, Daniel
J.
Many family therapies for adolescent drug use include ecological interventions. The purpose of
this randomized clinical trial was to establish whether ecological interventions contribute to the impact of family therapy above and beyond the
contributions of family process-only interventions. A family-based ecological approach, structural ecosystems therapy (SET), was compared with family
process-only condition (FAM) and community services control (CS). One hundred ninety substance-abusing or dependent African American and Hispanic
adolescents were randomized to SET, FAM, or CS. Follow-up assessments were conducted at 3, 6, 12, and 18 months postrandomization. SET was
significantly more efficacious than FAM and CS in reducing adolescent drug use. However, these improvements were limited to Hispanic adolescents. The
study demonstrates the importance of investigating changes in adolescent drug use as a result of treatment condition across more than 1 racial/ethnic
group. (PsycINFO Database Record (c) 2008 APA, all rights reserved) (journal abstract).
Journal of Family Psychology, 22(1) : 51-
61
- Year: 2008
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Family therapy
Werch, C.E., Moore, M.J., Bian,
H., DiClemente, C.C., Ames, S.C., Weiler, R.M., Thombs, D., et-al
Background - Epidemiologic data indicate most
adolescents and adults experience multiple,\rsimultaneous risk behaviors.\rPurpose - To examine the efficacy of a brief image-based multiple behavior
intervention (MBI)\rfor college students.\rMethods - A total of 303 college students attending a southeastern university were randomly\rassigned to:
1) a brief one-on-one tailored consultation with goal plan; or 2) standard care print\rmaterial, with three-month post-intervention data collected.
Results - Significant MANOVA omnibus group by time MANOVAs were performed for six\rgroupings of health behavior measures. Significant group by time
interactions were found on\ralcohol consumption, F(4,278)=3.42, p=.01, marijuana use, F(5,277)=2.75, p=.02, and healthrelated\rquality of life, F
(5,277)=2.87, p=.02, in favor of college students receiving the brief\rintervention. ANOVAs were performed for another four single-measure health
behaviors, with\rparticipants in the intervention group getting more sleep, F(1,281)=9.49, p=.00, and driving less\rafter drinking alcohol, F
(1,266)=5.25, p=.02 than those in the control group over time.\rConclusions - A brief image-based multiple behavior intervention may be useful in
influencing\ra number of critical health habits and health-related quality of life indicators of college students.
Annals of Behavioral
Medicine, 36(2) : 149-157
- Year: 2008
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Liddle, Howard A., Dakof, Gayle A., Turner, Ralph M., Henderson, Craig E., Greenbaum, Paul E.
Aim To examine
the efficacy of two adolescent drug abuse treatments: individual cognitive behavioral therapy (CBT) and multidimensional family therapy (MDFT).
Design A 2 (treatment condition) x 4 (time) repeated-measures intent-to-treat randomized design. Data were gathered at baseline, termination, 6 and
12 months post-termination. Analyses used latent growth curve modeling. Setting Community-based drug abuse clinic in the northeastern United States.
Participants A total of 224 youth, primarily male (81%), African American (72%), from low-income single-parent homes (58%) with an average age of 15
years were recruited into the study. All youth were drug users, with 75% meeting DSM-IV criteria for cannabis dependence and 13% meeting criteria for
abuse. Measurements Five outcomes were measured: (i) substance use problem severity; (ii) 30-day frequency of cannabis use; (iii) 30-day frequency of
alcohol use; (iv) 30-day frequency of other drug use; and (v) 30-day abstinence. Findings Both treatments produced significant decreases in cannabis
consumption and slightly significant reductions in alcohol use, but there were no treatment differences in reducing frequency of cannabis and alcohol
use. Significant treatment effects were found favoring MDFT on substance use problem severity, other drug use and minimal use (zero or one occasion
of use) of all substances, and these effects continued to 12 months following treatment termination. Conclusion Both interventions are promising
treatments. Consistent with previous controlled trials, MDFT is distinguished by the sustainability of treatment effects. ABSTRACT FROM AUTHOR
Addiction, 103(10) : 1660-1670
- Year: 2008
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Family therapy
Longshore, Douglas, Ellickson, Phyllis L., McCaffrey, Daniel F.,
In a recent randomized field trial, Ellickson et al. found the Project ALERT drug
prevention curriculum curbed alcohol misuse and tobacco and marijuana use among eighth-grade adolescents. This article reports effects among ninth-
grade at-risk adolescents. Comparisons between at-risk girls in ALERT Plus schools (basic curriculum extended to ninth grade with five booster
lessons) and at-risk girls in control schools showed the program curbed weekly alcohol and marijuana use, at-risk drinking, alcohol use resulting in
negative consequences, and attitudinal and perceptual factors conducive to drug use. Program-induced changes in perceived social influences, one's
ability to resist those influences, and beliefs about the consequences of drug use mediated the ALERT Plus effects on drug use. No significant
effects emerged for at-risk boys or at-risk adolescents in schools where the basic ALERT curriculum (covering seventh and eighth grades only) was
delivered. Possible reasons for gender differences and implications for prevention programming are discussed. (PsycINFO Database Record (c) 2007 APA,
all rights reserved) (journal abstract).
Health Education &
Behavior, 34(4) : 651-668
- Year: 2007
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Skills training
Kulis, Stephen, Nieri, Tanya, Yabiku,
Scott, Stromwall, Layne K., Marsiglia, Flavio Francisco
Efforts to address youth substance use have focused on prevention among non-users and treatment among severe users with
less attention given to youth occupying the middle ground who have used substances but not yet progressed to serious abuse or addiction. Using a
sample from 35 middle schools of 1,364 youth who reported using substances, this study examined the effectiveness of a universal youth substance use
prevention program, the SAMHSA Model Program keepin' it REAL, in promoting reduced or recently discontinued alcohol, cigarette, and marijuana use.
Discrete-time event history methods modeled the rates of reduced and recently discontinued use across four waves of data. Each substance (alcohol,
cigarettes, and marijuana) was modeled separately. Beginning at the second wave, participants who reported use at wave 1 were considered at risk of
reducing or discontinuing use. Since the data sampled students in schools, multi-level models accounted for the nesting of data at the school level.
Results indicated that prevention program participation influenced the rates of reduced and recently discontinued use only for alcohol, controlling
for baseline use severity, age, grades, socioeconomic status, ethnicity and gender. Among youth who reported use of alcohol in wave 1 (N=1,028), the
rate of reducing use for program participants was 72% higher than the rate for control students. The rate of discontinuing use was 66% higher than
the rate for control students. Among youth who reported use of one or more of the three substances in wave 1 (N=1,364), the rate of discontinuing all
use was 61% higher for program participants than for control students. Limitations and implications of these findings and plans for further research
are discussed.
Prevention Science, 8(1) : 35-49
- Year: 2007
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Skills training
Lane, Jodi, Turner, Susan, Fain, Terry, Sehgal, Amber
In the late 1990s Ventura County, California, USA, implemented the South Oxnard Challenge
Project (SOCP), designed to provide intensive, multi-agency services to youth on probation. SOCP built their program guided by Clear's \"corrections
of place\" model, which argued that community corrections could decrease offender risk by focusing on restorative principles rather than on coercion.
SOCP was designed as a randomized experiment, comparing youths in the experimental group with those on routine probation. Researchers interviewed
youths in both the experimental and control groups 1 year after random assignment. This article reports on self-reported crime and drug use, finding
few significant differences across groups. Specifically, we find that SOCP youths were significantly more likely to indicate that they had committed
a violent crime generally, although a majority of both groups indicated they had done so. We found that those in SOCP who robbed people also did so
significantly more often than did the comparison group. In the control group, youths reported committing homicide significantly more often, but this
was a rare event. Among those youths who reported taking part in gang or posse fights, those in the control group did so significantly more often.
Finally, youths in the control group were significantly more likely to have used ecstasy on more days during the previous month than were those in
the SOCP. (PsycINFO Database Record (c) 2008 APA, all rights reserved) (journal abstract).
Journal of Experimental Criminology, 3(3) : 201-
219
- Year: 2007
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Other service delivery and improvement
interventions
Tebes, J. K., Feinn, R., Vanderploeg, J. J., Chinman, M. J., Shepard, J., Brabham, T., Genovese, M., et-al
Purpose: Positive youth development
(PYD) emphasizes a strengths-based approach to the promotion of positive outcomes for adolescents. After-school programs provide a unique opportunity
to implement PYD approaches and to address adolescent risk factors for negative outcomes, such as unsupervised out-of-school time. This study
examines the effectiveness of an after-school program delivered in urban settings on the prevention of adolescent substance use. Methods: A total of
304 adolescents participated in the study: 149 in the intervention group and 155 in a control group. A comprehensive PYD intervention that included
delivery of an 18-session curriculum previously found to be effective in preventing substance use in school settings was adapted for use in urban
after-school settings. The intervention emphasizes adolescents' use of effective decision-making skills to prevent drug use. Assessments of
substance use attitudes and behaviors were conducted at program entry, program completion, and at the 1-year follow-up to program entry. Propensity
scores were computed and entered in the analyses to control for any pretest differences between intervention and control groups. Hierarchical linear
modeling (HLM) analyses were conducted to assess program effectiveness. Results: The results demonstrate that adolescents receiving the intervention
were significantly more likely to view drugs as harmful at program exit, and exhibited significantly lower increases in alcohol, marijuana, other
drug use, and any drug use 1 year after beginning the program. Conclusions: A PYD intervention developed for use in an urban after-school setting is
effective in preventing adolescent substance use. copyright 2007 Society for Adolescent Medicine.
Journal of Adolescent Health, 41(3) : 239-
247
- Year: 2007
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Skills training
Petrie,
Jane, Bunn, Frances, Byrne, Geraldine
We
conducted a systematic review of controlled studies of parenting programmes to prevent tobacco, alcohol or drug abuse in children <18. We searched
Cochrane Central Register of Controlled Trials, specialized Register of Cochrane Drugs and Alcohol Group, Pub Med, psych INFO, CINALH and SIGLE. Two
reviewers independently screened studies, extracted data and assessed study quality. Data were collected on actual or intended use of tobacco,
alcohol or drugs by child, and associated risk or antecedent behaviours. Due to heterogeneity we did not pool studies in a meta-analysis and instead
present a narrative summary of the findings. Twenty studies met our inclusion criteria. Statistically significant self-reported reductions of alcohol
use were found in six of 14 studies, of drugs in five of nine studies and tobacco in nine out of 13 studies. Three interventions reported increases
of tobacco, drug and alcohol use. We concluded that parenting programmes can be effective in reducing or preventing substance use. The most effective
appeared to be those that shared an emphasis on active parental involvement and on developing skills in social competence, self-regulation and
parenting. However, more work is needed to investigate further the change processes involved in such interventions and their long-term effectiveness.
[References: 38]
Health
Education Research, 22(2) : 177-91
- Year: 2007
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Godley, Mark D., Godley, Susan H., Dennis, Michael L., Funk, Rodney R., Passetti, Lora L.
AIMS: This study compared assertive continuing care (ACC) to usual
continuing care (UCC) on linkage, retention and a measure of continuing care adherence. Outcome analyses tested the direct and indirect effects of
both conditions and level of adherence on early (months 1-3) and longer-term (months 4-9) abstinence. DESIGN: Two-group randomized design. SETTING:
Eleven counties surrounding a community-based residential treatment program in the Midwestern section of the United States. PARTICIPANTS: A total of
183 adolescents, ages 12-17 years, with one or more Diagnostic and Statistical Manual version IV (DSM-IV) substance use dependence disorder and met
American Society for Addiction Medicine (ASAM) placement criteria for non-medical residential treatment. INTERVENTION: Prior to discharge from
residential treatment, participants were assigned randomly to receive either UCC, available at outpatient clinics in the 11-county study area, or ACC
via home visits. MEASUREMENTS: Self-reported interview data were collected at intake, 3, 6 and 9 months post-residential discharge. Urine test data
and interviews with a caregiver were conducted at baseline and 3 months. FINDINGS: ACC led to significantly greater continuing care linkage and
retention and longer-term abstinence from marijuana. ACC resulted in significantly better adherence to continuing care criteria which, in turn,
predicted superior early abstinence. Superior early abstinence outcomes for both conditions predicted longer-term abstinence. CONCLUSIONS: ACC
appears to be an effective alternative to UCC for linking, retaining and increasing adherence to continuing care. Replication with larger samples is
needed to investigate further the direct and indirect effects of ACC found in this study
Addiction, 102(1) : 81-93
- Year: 2007
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Relapse prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions