Using brief interventions to target substance use

Trying substances in adolescence is common, as teenagers push back on parental and societal expectations, to say nothing of believing that nothing can hurt them. However, problematic substance use can have far-reaching negative outcome. A meta-analysis looking at the impact of brief behavioral interventions on problematic substance use was published in Pediatrics.¹

The investigators searched Embase, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Central Register of Controlled Trials, PsycInfo, and Medline. They selected 22 randomized controlled trials, which examined brief intervention, that met the eligibility criteria. They separated the brief interventions into groups including motivational interviewing, psychoeducation, and treatment as usual. The outcomes included substance use for alcohol as well as cannabis and substance-related problem scales.

The researchers conducted pairwise and network meta-analysies with random effects models. When compared to treatment as usual, motivational interviewing was found to reduce heavy alcohol use days by 0.7 days per month (95% credible interval [CrI]: −1.6 to 0.02), alcohol use days by 1.1 days per month (95% CrI −2.2 to −0.3), and overall substance-related problem reduced by a standardized net mean difference of 0.5 (95% CrI –1.0 to 0). Motivational interviewing was not found to reduce cannabis use days, with a net mean difference of −0.05 days per month (95% CrI: −0.26 to 0.14). The researchers did note that the meta-analysis had a lack of consistent reported outcomes as well as limited available comparisons.

The investigators concluded that in comparison to treatment as usual, motivational interview did help reduce both days of alcohol use as well as heavy alcohol use. They believe that these results should to lead to further utilization of motivational interviewing in the primary care setting with teenagers who have problematic alcohol use. However, there was no evidence that the use of motivational interviewing was linked with reduced cannabis use. Due to the large number of teenagers who do use cannabis, the results highlight the need to find effective interventions that target problematic cannabis use.

Reference

1. Steele D, Becker S, Danko K et al. Brief behavioral interventions for substance use in adolescents: a meta-analysis. Pediatrics. September 15, 2020. Epub ahead of print. doi:10.1542/peds.2020-0351