What's New in Addiction Prevention in Young People: A Literature Review of the Last Years of Research

Preventing new substance use behaviors in youth: evaluation of a two-year comprehensive program

Introduction

The Avenir Santé Association implemented a comprehensive prevention program targeting the consumption of the emerging psychoactive substances ecstasy (MDMA), cannabidiol (CBD), and nitrous oxide (N2O).

Methods

The program was evaluated through four actions: (i) training for association workers (n = 84) (ii) on-site student party interventions (n = 248), (iii) social network-based prevention (n = 186), and (iv) provision of prevention tools for party organizers (n = 148).

Results

Results showed a significant increase in understanding of emerging substances among association workers, with a pre-training score of M = 15.76 (SD = 3.65) and a post-training score of M = 18.29 (SD = 2.50). Increased awareness and reflective attitudes toward substance use were observed among young people participating in field actions, with pre- and post-intervention scores for MDMA use intentions being M = 15.89 (SD = 4.60) and M = 19.17 (SD = 3.33), respectively. Similarly, awareness of CBD effects increased from M = 14.18 (SD = 4.14) to M = 17.60 (SD = 3.31). Exposure to Instagram posts on N2O led to more negative attitudes toward N2O among young people, with a significant change in scores from M = 8.16 (SD = 1.57) to M = 8.42 (SD = 1.26). However, exposure to a website providing information about emerging substances did not produce any significant effect.

Discussion

In conclusion, this initiative underscores the usefulness of facilitator training, field interventions, and certain online information strategies for substance judgment and usage intentions. Future prevention programs can advantageously incorporate these actions.

Neuroscience-informed classification of prevention interventions in substance use disorders: An RDoC-based approach

Neuroscience has contributed to uncover the mechanisms underpinning substance use disorders (SUD). The next frontier is to leverage these mechanisms as active targets to create more effective interventions for SUD treatment and prevention. Recent large-scale cohort studies from early childhood are generating multiple levels of neuroscience-based information with the potential to inform the development and refinement of future preventive strategies. However, there are still no available well-recognized frameworks to guide the integration of these multi-level datasets into prevention interventions. The Research Domain Criteria (RDoC) provides a neuroscience-based multi-system framework that is well suited to facilitate translation of neurobiological mechanisms into behavioral domains amenable to preventative interventions. We propose a novel RDoC-based framework for prevention science and adapted the framework for the existing preventive interventions. From a systematic review of randomized controlled trials using a person-centered drug/alcohol preventive approach for adolescents, we identified 22 unique preventive interventions. By teasing apart these 22 interventions into the RDoC domains, we proposed distinct neurocognitive trajectories which have been recognized as precursors or risk factors for SUDs, to be targeted, engaged and modified for effective addiction prevention.

Adolescent Polysubstance Use and Co-Occurring Weapon Carrying, Bullying Victimization, and Depressive Symptomology: Patterns and Differences in the United States

Adolescent substance use commonly co-occurs with poor mental health, bullying victimization and risky behaviors that may lead to violence. The purpose was to describe the United States (US) national prevalence of polysubstance use and co-occurring characteristics and associated demographic characteristics among youth. Middle and high school students in the 2019 CDC YRBS survey reported their demographics and current ( ≥ 1 days in the last 30 days) substances used (alcohol, cigarette, e-cigarette, cannabis); polysubstance combinations were generated. Cross-sectional weighted logistic regression estimated odds of polysubstance use and frequent use ( ≥ 6 days in the last 30 days) by weapon carrying, depressive symptoms, bullying victimization, and demographics. Mean age of the sample was 16 years, 51% were boys, 51% were non-Hispanic White. While accounting for 21% of the sample, 22-40% of Multiracial youth reported polysubstance use and frequent use. Odds of frequent polysubstance use (all combinations) were highest for weapon carrying youth.

Social features in internet-based programs to prevent alcohol consumption among adolescents: a scoping review

Alcohol consumption among adolescents is a social and public health issue. School-based programs are needed to prevent the onset of alcohol consumption during adolescence. Information and communication technologies offer new promising approaches to deliver preventive programs to these populations. The most traditional, successful programs use group dynamics within the classroom. However, the usefulness of social interaction features (SIF) within internet-based interventions remains unclear. The current scoping review aims to identify and evaluate the effectiveness of online and mobile psychosocial preventive interventions that use SIF, and that target adolescents. Web of Science, Scopus and Google Scholar were electronically searched for all articles published between January 2011 and December 2020. Articles reporting on school-based, web-based interventions for adolescents to prevent alcohol consumption and that encouraged any kind of interaction between users ('social interactions') were eligible for inclusion. Fourteen articles were included in the review. These articles assessed eight preventive programs. Six programs showed positive results on outcome variables. In two of them, it was possible to determine that their success was partially due to the SIF. SIF seem to be useful to enhance the receptivity and usefulness of web-based prevention programs, but the current evidence of their effectiveness is scarce. More evidence is required to assess the effectiveness of these features and to improve programs having the objective of preventing the consumption of alcohol among young people.

Adverse and other unintended consequences of setting-based interventions to prevent illicit drug use: A systematic review of reviews

This article explores adverse and unintended consequences (AUCs) of setting-based public health interventions to prevent illicit drug use, including the mechanisms leading to these AUCs. Additionally, the reporting of AUCs in systematic reviews was assessed. Therefore, we conducted a systematic review of reviews and searched four big databases were searched. We included systematic reviews concerned with setting-based interventions to prevent illicit drug use. We used AMSTAR 2 to rate the overall confidence of the results presented in the reviews. Data on study characteristics, types and mechanisms of AUCs were extracted. An a priori categorisation of consequences drew on the WHO-INTEGRATE framework, and the categorisation of mechanisms on the Behaviour Change Wheel. For reviews reporting AUCs, the same information was also retrieved from relevant primary studies. Findings were synthesised narratively and in tables. Finally, we included 72 reviews, of which 18 reported on AUCs. From these, 11 primary studies were identified. Most of the reviews and primary studies were conducted in educational settings. The most prevalent AUCs reported in systematic reviews and primary studies were paradoxical health effects (i.e. increase of drug use). Potential mechanisms discussed primarily focussed on the change though social norms and practices. Changes of knowledge and perception were also mentioned. Concluding, the identified reviews and primary studies paid insufficient attention to AUCs of public health interventions to prevent illicit drug use. Where reported, it was mostly as an afterthought and narrowly framed as health related. No mentions of potential broader social consequences were found.

[Student health representatives at university: Objectives, modalities, and evaluation]

OBJECTIVES

The development of "Student Health Representatives" (ERS), based on the efficiency of prevention strategies among peers, is encouraged by University Health Services (SSU). And yet, the heterogeneity of the local contexts, as well as the lack of a national referential incites reflections as to the stakes, the key factors, and limits of these schemes. In this way, a national training day was organized to respond to the following objectives: What objective and what framework for student health representatives? Which student health representatives and what actions? What type of evaluation for student health representatives?

METHOD

61 university health service professionals (SSU) (32 nurses, 22 doctors, and 7 prevention specialists), representing 29 university health services met and worked on the question of student health representatives.This work on the ERS followed a process of formalized consensus, based on the Glaser technique (Fink 1984). Two workshops with 30 and 31 people were organized, each divided into three groups (six in total). The distribution of each group was decided beforehand, so that there were no more than two members of the same university health service. Each group worked on the following three points: the role of the ERS, student eligibility and definition of their role, and the evaluation of the ERS.A synthesis was drafted after this work of reflection.

RESULTS

An analysis with proposed actions was produced for each of the themes.

CONCLUSION

Even though the ERS must be reassessed and harmonized at the national level, the objectives, the framework, the themes, and the preventive action must respond to local health prerogatives, adapted to each university health policy.

Addictions in Spanish College Students in Confinement Times: Preventive and Social Perspective

Diverse studies have shown that a significant percentage of the Spanish university population suffers from different addictions. They are both a personal and public health problem if there is not a greater awareness of the risks involved and if the appropriate prevention measures are not taken, among them educational ones. In this context, a descriptive and explanatory cross-sectional study was conducted during the first half of June 2020, coinciding with the period of confinement that occurred in Spain during the first wave of the COVID-19 pandemic. Given that this is such an exceptional time, the main objective of this study was to obtain information especially on students’ substance consumption and possible addictions at this time. Knowing the specific situation of this problem in that specific situation may allow for comparative studies in the future. The sample was composed of 310 university students from 14 Spanish universities. The instrument used in the research was the ASSIST questionnaire, developed by the WHO for the detection of alcohol, tobacco, and substance consumption. As result, a moderate and high risk was observed mainly in the following substances: alcohol (36.2%), tobacco (33.2%), cannabis (22.9%), and sedatives (10.3%). Through the logistic regression of the set of drugs, it has been proven that, on the one hand, the addiction to cocaine and sedatives in the family environment and age, on the other hand, are the main predictive variables of drug consumption. The existence of polysubstance abuse was also determined. These data show the need for educational bodies and university institutions to promote awareness, sensitization, and health education programs to deal with this important problem, especially in extraordinary situations, such as the one referred to, which could increase this consumption.

Global Health Determinants Perceived and Expressed by Children and Adolescents Between 6 and 17 Years: A Systematic Review of Qualitative Studies

Aim: To identify the determinants of global health in the literature as perceived and expressed by children and adolescents in order to adapt prevention actions to this young audience. To also question the pertinence of a qualitative approach when interviewing children. Method:Systematic review of the literature from PubMed, Google Scholar, CINAHL, PsycINFO databases. The studies selected used qualitative methods alone for investigating the views of health determinants in children and adolescents. Results:185 articles were read to reach a final selection of 13 articles on global health, excluding studies with children who were ill, studies using quantitative, mixed, or retrospective methodologies, and those dealing exclusively with themes of health. Collecting information from children and adolescents showed the pertinence and effectiveness of qualitative methods. It also appears necessary to explore new paths: improving and adapting the tools and methodological supports used and combining them to enrich repositories. Conclusion:The small amount of qualitative data available with the views of children and adolescents on health determinants requires that new studies with better adapted collection methodologies be set up. To increase pertinence and effectiveness among a young audience, it is necessary, considering the methodologies identified during this literature review, to turn toward a multi-phase method that combines these methods. A methodology in several phases allows each one to use a different approach with young people and to obtain richer and more varied information. A corpus of images appeared as a powerful tool for collection: it facilitates children's capacity for oral expression and places the researcher in a position of listening.

Geographic gender differences in traumatic unintentional injury hospitalization and youth drinking

INTRODUCTION

Few studies have used both spatial and non-spatial techniques to the study of alcohol outcomes. The objectives of this study were to identify clusters of traumatic unintentional injury hospitalizations by gender and blood alcohol concentration (BAC), and to determine trends and correlates by BAC levels.

METHODS

State Trauma Registry data capturing unintentional injuries for those aged 10 to 24 hospitalized with negative and positive BAC levels (n = 6233) were analyzed from 2006 to 2015 for all Chicago block groups. Spatial clustering techniques were applied to detect spatial clusters and Generalized Estimating Equations to determine correlates and trends while controlling for correlation within block groups.

RESULTS

Regardless of BAC level, hospitalization rates decreased for all age groups between 2006 to 2010 and 2011 to 2015 from 94.41 to 67.69 per 100,000 population. The decline for males hospitalized with positive BAC was 1.4 times greater than the decline for their female counterparts. Risk factors included being male, black or of a minority race, having no private insurance and living in a disadvantaged neighborhood. Male hospitalization rates clustered among 33 census block groups located in three Chicago Community Areas. No clustering was detected for female patients. Motor vehicle accidents were the leading cause of hospitalization.

CONCLUSIONS

Hospitalizations are decreasing in Chicago, yet the risk is concentrated, with greater decreasing rates among males than females. Spatial approaches can be valuable tools in analyzing substance abuse outcomes, to identify high-risk areas and shifts in risk within a large geographic area.

[Current State of Family-Based Prevention and Therapy of Substance-Use Disorders in Children and Adolescents: A Review]

Current State of Family-Based Prevention and Therapy of Substance-Use Disorders in Children and Adolescents: A Review Adolescence is a vulnerable period for substance use disorders (SUD) as indicated by epidemiological studies. Research demonstrates the family's role for the etiology of SUD and provides a rationale for interventions based on family-associated risk and resilience factors. In this article, we summarize published results for family-based interventions from 2008-2018. Taken together, prevention programs can be effective when they focus on the promotion of broader developmental competencies and familial resources, rather than narrowly addressing substance use. Moreover, programs could benefit from targeting youth and parents as done in the "Strengthening Families Program 10-14"; most existing programs however target parents and do not include the adolescents. Family-based treatment programs with an evidence base are Multisystemic Therapy, Functional Family Therapy, Multidimensional Family Therapy and Brief Strategic Family Therapy. Overall, the effects of family-based interventions are small-to-middle sized but vary significantly across populations. Across the field of family-based interventions, there is a need for more knowledge on effective components and differential effects. The results could be improved by translational research such as on the emerging concept of mindfulness. Moreover, there is a need for implementation research and the effectiveness of service delivery programs on the community level in Germany.

Reichweite von Suchtprävention aus der Perspektive jugendlicher Endadressaten

Zusammenfassung. Ziele: In dieser Studie wird ermittelt, welcher Anteil von Neuntklässler_innen in ihrem bisherigen Leben durch Suchtpräventionsmaßnahmen zu spezifischen Konsumrisiken (Alkohol, Rauchen, Cannabis, Ecstasy/LSD, Glücksspiel, Computerspiel) erreicht wurde (Reichweite von Suchtprävention). Methodik: Datengrundlage bildet eine niedersachenweite repräsentative Befragung von Schüler_innen der neunten Jahrgangsstufe (n = 10.638). Ergebnisse: 82,7 Prozent der befragten Jugendlichen nimmt bis zur neunten Klasse an Suchtprävention zu mindestens einem Konsumrisiko teil. Die Reichweite von Suchtprävention variiert zwischen den zu adressierenden Konsumrisiken: Rauchen: 66,5 %; Alkohol: 73,3 %; Cannabis: 53,6 %; Ecstasy/LSD: 37,4 %; Glücksspiel: 22,1 %; Computerspiele: 35,7 %. Ebenso variieren die eingesetzten Vermittlungsmethoden: Unterricht durch Lehrkraft: 55,5 %; Workshop: 26,6 %; Projektwoche: 24,4 %; Wettbewerb: 8,5 %; Mitmach-Station: 11,5 %; Infomaterialien: 26,8 %; Online-Informationen: 28,1 %. Während dem Urbanisierungsgrad der Wohnregion kaum eine Bedeutung für die Reichweite von Suchtprävention zukommt, haben Hauptschüler_innen gegenüber Gymnasiast_innen in geringerem Maße an extern vermittelten suchtpräventiven Angeboten teilgenommen. Schlussfolgerungen: Die Ergebnisse zeigen, dass Suchtprävention zum Themenfeld illegale Substanzen und insbesondere exzessiv-belohnenden Verhaltensangeboten einen zu geringen Anteil von Jugendlichen erreicht und ausgebaut werden sollte.

Prevention: From the cradle to the grave and beyond

Present cardiac prevention mainly focuses on risk reduction later in life, and focuses also mainly on reducing risk factors for coronary heart disease. However, multiple studies have gathered evidence that the development risk of cardiovascular disease starts early in life and that even preconceptional influences play an important role in lifetime risk. Therefore, the importance of well-timed prevention strategies to reduce cardiovascular disease is well established. In this article, we discuss different risk factors for future cardiac disease, and how we can respond to lesser known cardiac risk factors in the different stages of life.

[Prevention of substance use disorders]

Prevention of substance use disorders Abstract. Introduction: Adolescence is a vulnerable period for the development of Substance Use Disorders and preventive intervention is a public health priority. In this article, we summarize the available evidence for behavioral preventive action for Substance Use Disorders and related dysregulated behaviors during adolescence in various settings. Results: Current meta-analytic evidence is available mainly for the school and family settings and increasingly also for internet-based prevention. The literature is dominated by US-studies that focus on universal school-based approaches for legal substances in middle adolescence. Only few German studies are published. Taken together the results indicate that developmentally sensitive substance use prevention is effective across different settings with consistent small-to-middle sized effects. Differential effectiveness analyses for schoolbased prevention suggest that younger adolescents benefit most from universal prevention, while for older adolescents targeted approaches are more effective. Conclusions: Across the relevant settings, effective preventive measures are available. However, the results could be improved. There is a need for translational research on effective and more individualized approaches to prevention and differential effects of intervention modules. Moreover, there is a need for research on the implementation of evidence-based programs and especially in Germany, coordinated approaches on community levels are lacking.

Almost Everything We Need to Better Serve Children of the Opioid Crisis We Learned in the 80s and 90s

Opioid use disorder impedes dependent parents' abilities to care for their children. In turn, children may languish in unpredictability and persistent chaos. Societal responses to these children are often guided by a belief that unless the drug dependent parent receives treatment, there is little help for the child. While a preponderance of the drug dependence research is adult-centric, a significant body of research demonstrates the importance of not only addressing the immediate well being of the children of drug dependent caregivers but preventing the continuing cycle of drug dependence. The present commentary demonstrates through a brief review of the US history of drug dependence crises and research from the 1980s and 1990s, a range of “tried and true” family, school, and community interventions centered on children. We already know that these children are at high risk of maladjustment and early onset of drug dependence; early intervention is critical; multiple risk factors are likely to occur simultaneously; comprehensive strategies are optimal; and multiple risk-focused strategies are most protective. Where we need now to turn our efforts is on how to effectively implement and disseminate best practices, many of which we learned in the 1980s and 1990s. The greatest opportunity in both changing the nature of the opioid epidemic at scale and influencing rapid translation of existing research findings into policy and practice is not in asking what to do, but in asking how to do the right things well, and quickly.

Problem Gambling and Delinquent Behaviours Among Adolescents: A Scoping Review

Despite many studies indicating an association between problem gambling and delinquent behaviours among adolescents, there has been no effort to systematically analyze the state of the literature on this relationship. To fill this gap, we conducted a scoping review of the literature published between 2000 and 2016 on problem gambling and delinquent behaviours among adolescents. We searched twelve databases and reviewed reference lists to identify eligible studies. Search terms included a combination of medical subject headings and keywords for gambling, youth, and delinquency, which were combined with the Boolean operator "AND". 1795 studies were identified through the literature search. Nine studies were eligible for inclusion. All of the studies were conducted in North America, with primarily male participants, and most of the data were cross-sectional. No qualitative studies met the inclusion criteria. Screening tools used to measure problem gambling were inconsistent, making comparisons across studies difficult. We found a consistent moderate to strong association between problem gambling and delinquent behaviour. Only one study presented associations by socio-economic status and none considered gender, sex or ethnic differences. Studies in the review showed that problem gambling is associated with both violent and non-violent behaviours among adolescents. These associations may suggest that problem gambling and delinquent behaviours have common risk factors and reflect a syndrome of risky behaviours best targeted through prevention and treatment that is holistic and considers the context in which the youth is situated. Further research is warranted to better understand the relationship between problem gambling and delinquent behaviours.

Exercise Addiction in Practitioners of Endurance Sports: A Literature Review

Practice of endurance sports/activities has gained most devotees over recent decades, thanks to its capacity to maintain and improve health. However, their characteristics and accessibility have facilitated the emergence of addictive behaviors. Excessive practicing can lead to adverse physical and psychological effects seriously prejudicial to health, to the extent that individuals are unable to control this behavior. Recognizing that exercise addiction is still a controversial concept, the aim of the present review is to analyze the state of research into addictive exercise behaviors, specifically centering on running and endurance sports. To this end, a search covering article written in English and dated from 2010 onward was carried out in the Pubmed, Scopus, Web of Science and EBSCOhost databases. Of a total of 2,675 articles in the four databases, 25 were eligible for the final review. The studies reviewed confirmed that excessive practice could encourage the appearance of addictive behaviors and health problems. Most research has reported no age or sex differences in exercise dependence among endurance sport practitioners; however, obsessive passion and dedication to sports activities may be predictors for addiction to exercise. Owing to terminological confusion and the variety of tools used to measure addiction, figures for prevalence differ widely among studies, with values quoted ranging from 3 to 42%. Furthermore, it is clear that there are problems in delimiting, defining and diagnosing this sort of behavior, which has led to addiction to exercise not yet being considered a behavioral disorder.