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

doi:10.1016/j.drugalcdep.2019.107582

Outpatient psychosocial substance use treatments for young people: An overview of reviews

Drug Alcohol Depend. 2019 Dec 1:205:107582. doi: 10.1016/j.drugalcdep.2019.107582. Epub 2019 Sep 25.

Authors

Nicole Snowdon¹, Julaine Allan², Anthony Shakeshaft³, Debra Rickwood⁴, Emily Stockings⁵, Veronica C Boland⁵, Ryan J Courtney⁵

Affiliations

¹ Lives Lived Well Research Team, Lives Lived Well, P.O. Box 9374, Orange, NSW, 2800, Australia; National Drug and Alcohol Research Centre, 22 - 32 King Street, The University of New South Wales, Randwick, Sydney, NSW, 2031, Australia. Electronic address: nicole.snowdon@liveslivedwell.org.au.
² Lives Lived Well Research Team, Lives Lived Well, P.O. Box 9374, Orange, NSW, 2800, Australia.
³ National Drug and Alcohol Research Centre, 22 - 32 King Street, The University of New South Wales, Randwick, Sydney, NSW, 2031, Australia; Faculty of Health, Allawoona St, University of Canberra, Bruce, Canberra, ACT, 2617, Australia.
⁴ Research and Evaluation, headspace, The National Youth Mental Health Foundation, South Tower, Level 2, 485 La Trobe St, Melbourne VIC 3000, Australia; Faculty of Health, Allawoona St, University of Canberra, Bruce, Canberra, ACT, 2617, Australia.
⁵ National Drug and Alcohol Research Centre, 22 - 32 King Street, The University of New South Wales, Randwick, Sydney, NSW, 2031, Australia.

PMID: 31778903
DOI: 10.1016/j.drugalcdep.2019.107582

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.

Keywords: Adolescence; Overview of reviews; Psychosocial treatment; Substance use.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Ambulatory Care / methods
Ambulatory Care / psychology
Cognitive Behavioral Therapy / methods
Family Therapy / methods
Humans
Outpatients / psychology*
Reproducibility of Results
Review Literature as Topic*
Substance-Related Disorders / psychology*
Substance-Related Disorders / therapy*
Treatment Outcome