Outpatient psychosocial substance use treatments for young people

An overview of reviews

Nicole Snowdon, Julaine Allan, Anthony Shakeshaft, Debra Rickwood, Emily Stockings, Veronica C. Boland, Ryan J. Courtney

Research output: Contribution to journalArticle

Abstract

Background: Systematic reviews and meta-analyses (reviews) conflict regarding the efficacy and feasibility of substance disorder treatments for young people (YP). This overview of reviews, synthesizes, and methodologically assesses reviews examining substance disorder interventions for YP in outpatient settings. Methods: Reviews published between 1990 and March 2018 were searched using EBM Reviews, PsycINFO, Embase, Ovid Medline, and Campbell Collaboration. Reviews investigating efficacy and/or feasibility of YP substance disorder treatments in outpatient settings were included. Forty-three reviews met all inclusion criteria: To appraise methodological biases, 40 reviews were assessed using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR2) and 3 were narratively assessed. One reviewer (NS) extracted study data and evaluated all 43 reviews. For inter-rater reliability, 13 (30%) reviews were extracted and appraised in duplicate by a second reviewer (JA, RC or ES). Agreement on AMSTAR2 ratings reached 100%. Agreement was moderate; κ = .52 (p < .05), 95% CI (.20, .84). Results: All high quality methodological reviews (n = 6) focused on intervention efficacy and none on treatment feasibility. One (n = 1) high quality review reported evidence for an intervention. Multidimensional Family Therapy (MDFT) has possible efficacy in reducing YP substance use when compared to treatment as usual, Cognitive Behavior Therapy, Adolescent Community Reinforcement Approach and Multifamily Educational Therapy. Conclusions: Methodological and reporting quality of reviews require improvement. High quality reviews focused on intervention efficacy but treatments commonly lacked evidence. One high quality review found MDFT demonstrated promising outcomes. Reviews examining feasibility of interventions were of low methodological quality.

Original languageEnglish
Article number107582
Pages (from-to)1-13
Number of pages13
JournalDrug and Alcohol Dependence
Volume205
DOIs
Publication statusPublished - 1 Dec 2019

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Snowdon, N., Allan, J., Shakeshaft, A., Rickwood, D., Stockings, E., Boland, V. C., & Courtney, R. J. (2019). Outpatient psychosocial substance use treatments for young people: An overview of reviews. Drug and Alcohol Dependence, 205, 1-13. [107582]. https://doi.org/10.1016/j.drugalcdep.2019.107582