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‘Inconclusive’ was the verdict of a review which aimed to assess the effectiveness of brief alcohol interventions among patients aged 11 to 21 attending for emergency care in the USA. Most promising targets seem to have been the more heavy or irresponsibly drinking among patients who were young adults rather than adolescents.
Though some studies may have been persuasive, this review of recent attempts to find which therapeutic approaches work best for young risky drinkers was unable to reach firm conclusions due to variability in the studies and methodological inadequacies. Still, the tentative conclusions accord with those in UK guidance.
Despite the challenges, review confirms that hepatitis C infection can be prevented among injectors, but it takes multi-component strategies with elements such as substitute prescribing to reduce or eliminate drug injection, treatment of infection, and enabling safe injection practices by providing sterile injecting equipment and behaviour-change counselling.
Binge drinkers among young Swiss men being conscripted in to the army responded to around 16 minutes of alcohol advice by on average cutting their intake 20% more than recruits whose drinking was simply assessed, a rare demonstration of the impact of a brief intervention in an unselected population.
REVIEW 2011 HTM file
A meta-analysis of interventions to reduce adolescent cannabis use
The first synthesis of research on therapeutic interventions for adolescent cannabis users highlighted the relative success of family and multi-component approaches, but the evidence base was too narrow to securely determine what works best.
STUDY 2011 HTM file
Shared decision-making: increases autonomy in substance-dependent patients
An innovative Dutch study tested a way of involving substance users as equals in decisions over issues addressed in their treatment. The effect was to give these typically submissive personalities a greater sense of control over their lives. Just as influential was the lead offered by the clinician's personality.
Compared to basic drug education, it should at least have moderated current use, but this attempt to deploy motivational interviewing as an across-the-board prevention strategy among college students in London neither did that, nor did it prevent non-users starting to use, negative findings which raise interesting questions.
Addressing the substance use promoting tendencies of the personality traits of London secondary school pupils at particular risk of substance misuse led to less intensive drinking six months later, and there was some support for the psychological mechanisms thought to underpin the intervention.
Offering valuable clues to how best to do motivational interviewing, this London study of cannabis-using students found they were most likely to stop using after brief interventions which embodied the spirit of the approach and featured responses from the counsellor reflecting back and elaborating on the student's comments.
In one English district, most of the problem-drinking offenders who agreed to be ordered in to alcohol treatment by the courts stopped drinking or successfully cut back.
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