Evidence-Based Interventions for Preventing Substance Use Disorders in Adolescents
The majority of the adult population with substance use disorder began using substances in their youth. Research shows that alcohol, tobacco, and other substance use often starts in early to late adolescence. It usually peaks in early adulthood and then tends to decrease as people age. Evidence shows that the younger a person starts using substances, the more likely they are to abuse them later. Starting substances early is linked to worse health outcomes. These include poor physical and mental health, violent behavior, and issues at work and home.
Prevention efforts often target middle and junior high school kids. This age is when many start to experiment with substances. There is a wide body of literature investigating the effectiveness of prevention programs for this age group. Research shows that the best initiatives focus on risk and protective factors. These factors should be addressed at every level: individual adolescents, their families, schools, and communities.
Griffin et al. (2010) reviewed 7 evidence-based prevention programs that are also accredited by SAMHSA National Registry of Evidence-Based Programs and Polices. A brief summary and key findings have been summarized below:
Life Skills Training (LST)
This program aims to mitigate social and psychological factors that increase the risk for substance use. These include drug-resistant skills, personal self-management skills, and general social skills. LST offers modules for elementary, middle, junior high, and high school-aged students. The middle school curriculum has been studied the most and is intended for ages 11 to 14. The program is typically delivered in fifteen 40-minute class periods.
Random control trials have found:
- Six years after LST, participants smoked less and drank less alcohol. They also used tobacco, alcohol, and marijuana less than the control group.
- Students exposed to at least 60% of LST content had significantly lower rates of alcohol, marijuana, and multiple drug use.
- LST students cited less inhalant use, smoking, and alcohol use at the one-year follow-up.
- At one and two-year follow-ups, LST participants cited a 50% decrease in binge drinking when compared to the control group.
Research shows that LST leads to less violence and delinquency. It also lowers beliefs about substance use and helps build social skills needed to refuse substances.
Project Towards No Drug Abuse (TND)
This is a high school program aimed at helping high-risk individuals. It teaches skills to resist substance use. This is achieved through motivational activities and by enhancing social and decision-making skills.
Five peer-reviewed studies found:
- TND students showed a 25% decrease in hard drug use compared to a control group.
- A 7 to 12% reduction in alcohol use in students who drank alcohol prior to receiving TND.
- After one year, students who took TND showed a 27% drop in cigarette use.
- By the two-year mark, they had a 50% decrease in cigarettes and a 22% drop in marijuana use.
Research also found that students receiving TND were less likely to use hard drugs. TND was also found to be a protective factor against victimization and reduced the occurrence of weapon-carrying.
Brief Alcohol Screening and Intervention for College Students (BASICS)
This program is aimed at college students who drink heavily but are not alcohol dependent. It's also designed for at-risk students. This includes those with poor attendance, violent behavior, sexual misconduct, missing assignments, or those who have had an accident. BASICS is delivered in two interviews, each lasting 1 hour, with a survey between them.
Four peer-reviewed articles found:
- BASICS students drank less often and consumed smaller amounts per session than the control group.
- At the two-year follow-up, BASICS participants still drank less often with fewer drinks than the control group
Other findings showed that BASICS students had lower blood alcohol levels at the one-year follow-up compared to the control group. Also, BASICS acted as a protective factor against the negative effects of alcohol consumption.
Family Matters
Family Matters is a family-based prevention model that aims to prevent tobacco and alcohol use in adolescents aged 12 to 14 years old. This program consists of 4 booklets mailed to the family home, supplemented by telephone calls from trained educators. Family Matters is designed for 79 days.
The literature has found:
- Family Matters participants showed decreases in smoking and alcohol use at the 3-month and 1-year follow-up
- Compared with the control groups, participants in Family Matters showed a 16% lower rate of smoking at the one-year follow-up.
Creating Lasting Family Connections (CLFC)
CLFC’s mission is to prevent violence and substance abuse for youth and families who live in high-risk areas. This is done by bolstering family bonding, communication skills, and promoting ideas and beliefs that do not align with substance use. CLFC has been successful in schools, churches, community centers, and many other environments. CLFC is 20 weeks long, with weekly training sessions for parents and their children.
CLFC has found:
- To increase resiliency skills
- Reduce alcohol and drug use as compared to a control group
- Increase community service
Brief Strategic Family Therapy (BSFT)
BSFT aims to lower risk factors for individuals and families. It does this by building skills and strengthening family ties. BSFT is a family-based model for kids aged 6 to 17. It helps those who show delinquent behavior, use substances, or hang out with peers who do. With BSFT, a counselor will meet with families for 8 to 12 weeks, for 60 to 90 minutes, in their home or an office.
Research has found:
- Participants in BSFT showed significant reductions in marijuana use as compared to the control group.
- Girls were found to have significant decreases in substance use at the posttest and at the one-year follow-up.
- Participants in BSFT showed reductions in overall drug use as compared to the control group.
BSFT helps more people join therapy. It cuts down aggression, improves family functioning, and lessens conduct problems.
Community Trials Intervention to Reduce High-Risk Drinking (RHRD)
RHRD is a universal prevention model. It aims to cut down harmful alcohol behaviors in communities. This includes actions like drinking and driving, underage drinking, and binge drinking. RHRD uses several ways to reach this goal. It raises community awareness, limits alcohol access for minors, and boosts policy enforcement.
The studies reviewed by Griffin et al. (2010) found that individuals who lived in RHRD communities showed:
- Decreases in alcohol consumed
- Rates of drinking and driving decreased
Communities in RHRD also cited fewer alcohol caused traffic accidents and a lower number of assaults.
Key Takeaway: Substance use in adulthood often begins in childhood or adolescent years. Research shows that using evidence-based prevention models offers great benefits. These models help future generations build important life skills and create a strong foundation against substance abuse.
Griffin, K. W., & Botvin, G. J. (2010). Evidence-based interventions for preventing substance use disorders in adolescents. Child and adolescent psychiatric clinics of North America, 19(3), 505–526. https://doi.org/10.1016/j.chc.2010.03.005