Disorders - Substance Use Disorders
Botvin, G. J., Griffin, K. W., Diaz, T., Scheier, L. M., Williams, C., Epstein, J. A.
National survey data indicate that illicit drug use has steadily increased among American adolescents since 1992.
This upward trend underscores the need for identifying effective prevention approaches capable of reducing the use of both licit and illicit drugs.
The present study examined long-term follow-up data from a large-scale randomized prevention trial to determine the extent to which participation in
a cognitive-behavioral skills-training prevention program led to less illicit drug use than for untreated controls. Data were collected by mail from
447 individuals who were contacted after the end of the 12th grade, 6.5 years after the initial pretest. Results indicated that students who received
the prevention program (Life Skills Training) during junior high school reported less use of illicit drugs than controls. These results also support
the hypothesis that illicit drug use can be prevented by targeting the use of gateway drugs such as tobacco and alcohol.
Addictive Behaviors, 25(5) : 769-74
- Year: 2000
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Skills training
Taylor,
B. J., Graham, J. W., Cumsille, P., Hansen, W. B.
The efficacy of prevention programs is typically
determined through analysis of covariance. To date, a growth curve modeling approach is not used extensively in program evaluation. However, for
longitudinal data there are several advantages to using this approach as compared to methods comparing means at two time points in a piecemeal
fashion. In this study, latent growth curve models were used to evaluate the effect of a program on the average level of drug use, rate of change
(growth) of drug use, and acceleration or deceleration in the rate of change of drug use. The study relied on data from the Adolescent Alcohol
Prevention Trial, a randomized longitudinal drug use prevention program. The program consists of drug use information, resistance skills training,
and normative education components. Data regarding cigarette and alcohol use were collected over a 5-year period, grade 7 to grade 11. Students
receiving the normative education program had significantly lower average levels of reported cigarette and alcohol use, lower rates of growth for
reported cigarette and alcohol use, and less deceleration of reported levels of cigarette and alcohol use as compared with the control group. Growth
curve analysis is a powerful and effective tool with which to model change and program efficacy.
Prevention Science, 1(4) : 183-
97
- Year: 2000
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Skills training
Goldberg, L., MacKinnon, D. P., Elliot, D.
L., Moe, E. L., Clarke, G., Cheong, J. W.
Background: Use of alcohol and other illicit drugs by adolescent male athletes is a significant problem. Participation in sports
may encourage use of drugs that enhance athletic performance, especially anabolic steroids (AS). Because, to our knowledge, no other intervention has
successfully altered substance abuse by athletes, we developed and assessed the efficacy of a team-centered, sex-specific education program designed
to reduce adolescent athletes' intentions to use and use of AS and alcohol and other illicit drugs. Methods: We studied 31 high school football
teams that comprised 3207 athletes in 3 successive annual cohorts (1994-1996). The intervention included interactive classroom and exercise training
sessions given by peer educators and facilitated by coaches and strength trainers. Program content included discussion of sports nutrition, exercise
alternatives to AS and sport supplements, and the effects of substance abuse in sports, drug refusal role-playing, and the creation of health
promotion messages. Questionnaires assessing AS, the use of sport supplements and alcohol and other illicit drugs, and potential risk and protective
factors were administered before and after the intervention (before and after the football season) and up to 1 year after the program. Results: At
season's end, intentions to use (P < .05) and actual AS use (P < .04) were significantly lower among students who participated in the study.
Although AS reduction did not achieve significance at 1 year (P<.08), intentions to use AS remained lower (P = .02). Illicit drug use (marijuana,
amphetamines, and narcotics) was reduced at 1 year, whether alcohol was included (P = .04) or excluded (P = .02) from the index. Other long-term
effects included fewer students reporting drinking and driving (P = .004), less sport supplement use (P = .009), and improved nutrition behaviors (P
< .02). Conclusions: Use of alcohol and other illicit drugs and associated harmful activities can be prevented with a sex-specific, team-centered
education. School athletic teams provide an optimal environment in which to provide drug prevention and health promotion education.
Archives of Pediatrics & Adolescent Medicine, 154(4) : 332-
338
- Year: 2000
- 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
Henggeler, S. W., Pickrel, S. G., Brondino, M. J.
The effectiveness and transportability of multisystemic therapy (MST) were examined in a study that included 118 juvenile
offenders meeting DSM-III-R criteria for substance abuse or dependence and their families. Participants were randomly assigned to receive MST versus
usual community services. Outcome measures assessed drug use, criminal activity, and days in out-of-home placement at posttreatment (T2) and at a 6-
month posttreatment follow-up (T3); also treatment adherence was examined from multiple perspectives (i.e., caregiver, youth, and therapist). MST
reduced alcohol, marijuana, and other drug use at T2 and total days in out-of-home placement by 50% at T3. Reductions in criminal activity, however,
were not as large as have been obtained previously for MST. Examination of treatment adherence measures suggests that the modest results of MST were
due, at least in part, to difficulty in transporting this complex treatment model from the direct control of its developers. Increased emphasis on
quality assurance mechanisms to enhance treatment fidelity may help overcome barriers to transportability.
Mental Health Services Research, 1(3) : 171-
84
- Year: 1999
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Multisystemic
therapy
Kaminer, Y., Burleson, J. A.
In order to test the hypothesis that adolescent substance abusers could be matched to effective treatments
on the basis of their comorbid psychopathology, 32 dually diagnosed adolescents were randomized into two short-term outpatient group psychotherapies:
cognitive-behavioral treatment (CBT), and interactional treatment (IT). Two follow-up assessments were conducted at 3 and 15 months after planned
treatment completion. As reported recently, at the three-month follow-up, no patient-treatment matching effects were identified. However, adolescents
assigned to CBT demonstrated a significant reduction in severity of substance abuse compared to those assigned to IT. At 15-month follow-up, there
were no differential improvements as a function of therapy type. However, subjects in general maintained significant treatment gains on the substance
abuse, family function, and psychiatric status domains of the Teen-Addiction Severity Index (T-ASI), and both CBT and IT were associated with similar
long-term gains. Large scale, randomized, controlled treatment studies are further recommended to examine the findings of this small-scale pilot
study.
American Journal on Addictions, 8(2) : 114-9
- Year: 1999
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions
Polansky, Joan
M., Buki,
Lydia P., Horan, John J., Ceperich, Sherry Dyche, Burows, Deborah Dyer
The effectiveness of 3 substance abuse prevention videotapes derived from
contrasting theoretical frameworks (information-based programming, social skills approaches, and assertiveness training) was experimentally evaluated
on common prevention outcomes and measures of theoretical relevance. 153 7th and 8th graders were stratified on gender and classroom before being
randomly assigned to experimental and control conditions. In a modified replication, 159 9th graders were assessed and treated in a concentrated time
span. A series of 2x2x4 (ReplicationxGenderxTreatment) analysis of covariance (ANCOVA) permitted an inspection of the construct validity of emerging
effects. Although the assertion-training video produced significantly higher levels of assertiveness among 9th graders, the other 2 videos (derived
from information-programming and help-seeking rationales) did not register effects on specific measures of high theoretical relevance. A lack of
posttest differences on the common outcomes may be due to low intended consumption levels displayed by participants and/or floor and ceiling effects
encountered on outcome measures. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Hispanic Journal of Behavioral Sciences, 21(2) : 186-
198
- Year: 1999
- Problem: Substance Use Disorders (any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Skills training
LoSciuto, Leonard, Hilbert, Susan M., Fox, M., Porcellini, Lorraine, Lanphear,
Alden
Examined the efficacy of a school-based initiative in reducing and/or preventing alcohol,
tobacco, and drug (ATD) use in \"at-risk\" youth. This evaluation represents a final report on the Woodrock Youth Development Project (YDP). Data
from two cohorts, representing two academic program years, were combined to yield a final sample of 718 elementary and middle school youth (aged 6-14
yrs). Youth were assigned randomly to either an experimental or control condition. Surveys containing several psychosocial measures were administered
at pretest and posttest. Analyses of covariance (ANCOVA) were used to examine the impact of YDP on ultimate and intermediate outcome variables.
Findings indicated that YDP participation was related to significant reductions in self-reported substance abuse in the last month and in lifetime as
well as improvements in race relations and self-reported school attendance. These findings are discussed in relation to the program and other
prevention efforts. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Journal of Early Adolescence, 19(4) : 488-
507
- Year: 1999
- 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
Bryson, R.
This research explores the potential of making social skills training more accessible to schools by the use of computer-aided
instruction. An easy-to-use software program called Refusal Challenges, which targets important social skills with effective training methods, was
tested. The dependent measure was demonstration of refusal skills strategies. One-hundred-eighty-eight male and female eighth-grade students were
stratified according to pre-treatment refusal skill level, gender, and teacher. They were then randomly assigned from the stratified blocks to either
the computer-based refusal skills training group or a control group. Repeated measures analyses of variance indicated a significant and meaningful
time by treatment interaction for refusal skills scores. The difference between treatment and control groups remained significant and meaningful at
both the post-test and follow-up testing.
Journal of Drug Education, 29(4) : 359-
71
- Year: 1999
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Skills training, Technology, interventions delivered using technology (e.g. online, SMS)
Catalano, R. F., Gainey, R. R., Fleming, C. B., Haggerty, K. P., Johnson, N.
O.
AIMS: Children
whose parents abuse drugs are exposed to numerous factors that increase the likelihood of future drug abuse. Despite this heightened risk, few
experimental tests of prevention programs with this population have been reported. This article examines whether intensive family-focused
interventions with methadone treated parents can reduce parents' drug use and prevent children's initiation of drug use. DESIGN: Parents were
assigned randomly into intervention and control conditions and assessed at baseline, post-test, and 6 and 12 months following the intervention.
Children were assessed at baseline, and 6- and 12-month follow-up points. SETTING: Two methadone clinics in Seattle, Washington. PARTICIPANTS: One
hundred and forty-four methadone-treated parents, and their children (n = 178) ranging in age from 3 to 14 years old. INTERVENTION: The experimental
intervention supplemented methadone treatment with 33 sessions of family training combined with 9 months of home-based case management. Families in
the control condition received no supplemental services. MEASUREMENT: Parent measures included: relapse and problem-solving skills, self-report
measures of family management practices, deviant peer networks, domestic conflict and drug use. Child measures included self-report measures of
rules, family attachment, parental involvement, school attachment and misbehavior, negative peers, substance use and delinquency. FINDINGS: One year
after the family skills training, results indicate significant positive changes among parents, especially in the areas of parent skills, parent drug
use, deviant peers and family management. Few changes were noted in children's behavior or attitudes. CONCLUSIONS: Programs such as this may be an
important adjunct to treatment programs, helping to strengthen family bonding and to reduce parents' drug use.
Addiction, 94(2) : 241-54
- Year: 1999
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions
(any), Medications used to treat substance abuse, Service Delivery & Improvement, Psychological Interventions
(any), Skills training, Case management
Kaminer, Y., Burleson, J. A., Blitz, C., Sussman, J., Rounsaville, B. J.
This study tested the hypothesis that dually diagnosed adolescent substance
abusers could be matched to effective treatments on the basis of their comorbid psychopathology. Specifically, patients with externalizing disorders
would have better outcomes when treated with cognitive-behavioral group treatment (CBT), and subjects with internalizing disorders without comorbid
externalizing disorders would fare better in interactional group treatment (IT). Thirty-two dually diagnosed adolescent substance abusers were
randomized into two 12-week manual guided outpatient group psychotherapies: CBT and IT. At 3-month follow-up, no patient-treatment matching effects
were identified. Adolescents assigned to CBT demonstrated a significant reduction in severity of substance use compared with those assigned to IT.
Improvement in severity of family function showed a trend in favor of CBT. School function, peer-social relationships, legal problems, and
psychiatric severity all showed a consistent nonsignificant direction in favor of CBT over IT. CBT appears to be a promising short-term psychosocial
intervention for adolescents.
Journal of Nervous & Mental
Disease, 186(11) : 684-90
- Year: 1998
- Problem: Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions
Geller, Barbara, Cooper, Thomas B., Sun, Kai, Zimermann, Betsy, Frazier, Jeanne, Williams, Marlene, Heath, Janet
Performed a double-blind, placebo-controlled,
random assignment, parallel group, pharmacokinetically dosed study of lithium for adolescents with bipolar disorders (BDs) and temporally secondary
substance dependency disorders (SDDs). Ss were 12-18 yrs old and were comprehensively assessed during a 6-wk outpatients protocol that included
random weekly urine collection for drug assays and random and weekly serum collection for lithium levels. Using both intent-to-treat (N=25) and
completer (N=21) analyses, there were significant differences on continuous and categorical measures between the active and placebo groups for both
psychopathology measures and weekly random urine drug assays. The mean scheduled weekly serum lithium level of active responders was 0.9 mEq/L.
Addiction to both alcohol and marijuana was the most frequent category of SSD. Lithium treatment of BDs with secondary SDDs in adolescents was an
efficacious treatment for both disorders. (PsycINFO Database Record (c) 2007 APA, all rights reserved).
Journal of the American Academy of Child & Adolescent Psychiatry, 37(2) : 171-
178
- Year: 1998
- Problem: Bipolar Disorders, Substance Use Disorders (any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Lithium
White, D., Pitts, M.
AIMS: To assess the effectiveness of
interventions directed at the prevention or reduction of use of illicit substances by young people or those directed at reducing harm caused by
continuing use. DESIGN: A systematic review was conducted. Reports were identified through electronic and hand searching and contact with known
workers in the area. Studies were included if they reported evaluations of interventions targeting illicit drug use and provided sufficient detail of
the intervention and design of the evaluation to allow judgements to be made of their methodological soundness. Meta-analyses were conducted
combining the data of the methodologically sound studies. PARTICIPANTS AND SETTINGS TARGETED BY INTERVENTIONS: Evaluations of interventions were
included if their targeted audience included young people aged between 8 and 25 years. Identified evaluations were delivered in a range of settings
including: schools and colleges; community settings; the family; medical/therapeutic settings; mass media. MEASUREMENTS: Data extracted from each
report included details of design, content and theoretical orientation of intervention, setting of the intervention, target audience, methods,
population size, subject refusal rates, rates of attrition, outcome measures, length of follow-up and findings, including statistical power.
FINDINGS: The majority of studies identified were evaluations of interventions introduced in schools and targeting alcohol, tobacco and marijuana
simultaneously. These studies were methodologically stronger than interventions targeting other drugs and implemented outside schools. Meta-analyses
showed that the impact of evaluated interventions was small with dissipation of programme gains over time. Interventions targeting hard to reach
groups have not been evaluated adequately. CONCLUSIONS: Effort needs to be directed towards the development of improved evaluative solutions to the
problems posed by these groups. There is still insufficient evidence to assess the effectiveness of the range of approaches to drugs education; more
methodologically sound evaluations are required. There is also a need to target interventions to reflect the specific needs and experiences of
recipients.
Addiction, 93(10) : 1475-
87
- Year: 1998
- Problem: Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any)