Abstract
In order to quantify the effectiveness of family interventions in preventing and reducing adolescent illicit drug use, we conducted a systematic review and meta-analysis of randomized controlled trials. We searched the Cochrane Database of Systematic Reviews, Educational Research Information Centre (ERIC), MEDLINE, Embase, and PsycINFO for studies published between 1995 and 2013. Results were described separately for different outcomes (marijuana vs. other illicit drugs) and intervention types (universal, selective, and indicated prevention). Meta-analyses were performed when data were sufficient (e.g., marijuana and other illicit drug initiation in universal samples), using random effect models. Otherwise, we provided narrative reviews (e.g., regarding selective and indicated prevention). Thirty-nine papers describing 22 RCTs were eligible for inclusion. Universal family interventions targeting parent–child dyads are likely to be effective in preventing (OR 0.72; 95 % CI 0.56, 0.94) and reducing adolescent marijuana use, but not in preventing other illicit drugs (OR 0.90; 95 % CI 0.60, 1.34). Among high-risk groups, there is no clear evidence for the effectiveness of family interventions in preventing and reducing illicit drug use and drug disorders. The three small RCTs among substance-(ab)using adolescents gave some indication that programs might reduce the frequency of illicit drug use. Family interventions targeting parent–child dyads are likely to be effective in preventing and reducing adolescent marijuana use in general populations, but no evidence for other illicit drug use was found. We underline the need to strengthen the evidence base with more trials, especially among at-risk populations.


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Notes
Interventions can be ordered in three types: (1) universal interventions are intended for all members of a general population or a subgroup regardless of whether they have a higher risk; (2) selective interventions are intended for individuals or population subgroups which are at higher risk; and (3) indicated interventions are intended for members of populations that have been individually identified as being at high risk and show early signs of being on the trajectory towards a specific disorder, in this case drug abuse (Mrazek and Haggerty 1994). Using this definition ensures similar handling of all included studies, yet assignments of studies may differ from original authors’ classifications.
References
Bauman, K. E., Foshee, V. A., Ennett, S. T., Pemberton, M., Hicks, K. A., King, T. S., et al. (2001). The influence of a family program on adolescent tobacco and alcohol use. American Journal of Public Health, 91, 604–610.
Calafat, A., Garcia, F., Juan, M., Becoña, E., & Fernández-Hermida, J. R. (2014). Which parenting style is more protective against adolescent substance use? Evidence within the European context. Drug and Alcohol Dependence, 138, 185–192.
Catalano, R. F., Gainey, R. R., Fleming, C. B., Haggerty, K. P., & Johnson, N. O. (1999). An experimental intervention with families of substance abusers: One-year follow-up of the focus on families project. Addiction, 94, 241–254.
Connell, A. M., Dishion, T. J., Yasui, M., & Kavanagh, K. (2007). An adaptive approach to family intervention: Linking engagement in family-centered intervention to reductions in adolescent problem behavior. Journal of Consulting and Clinical Psychology, 75(4), 568–579.
Cuijpers, P. (2003). Three decades of drug prevention research. Drugs: Education Prevention and Policy, 10, 7–20.
De Graaf, R., Radovanovic, M., Van Laar, M., Fairman, B., Degenhardt, L., Aguilar-Gaxiola, S., et al. (2010). Early Cannabis use and estimated risk of later onset of depression spells: Epidemiologic evidence from the population-based World Health Organization World Mental Health Survey initiative. American Journal of Epidemiology, 172(2), 149–159.
DeGarmo, D. S., Eddy, J. M., Reid, J. B., & Fetrow, R. A. (2009). Evaluating mediators of the impact of the Linking the Interests of Families and Teachers (LIFT) multimodal preventive intervention on substance use initiation and growth across adolescence. Prevention Science, 10, 208–220.
Dembo, R., Shemwell, M., Pacheco, K., Seeberger, W., Rollie, M., Schmeidler, J., et al. (2000). A longitudinal study of the impact of a family empowerment intervention on Juvenile offender psychosocial functioning: An expanded assessment. Journal of Child and Adolescent Substance Abuse, 10(2), 1–7.
Egger, M., & Smith, G. D. (1997). Meta-analysis. potentials and promise. BMJ, 315, 1371–1374.
Faggiano, F., Vigna-Taglianti, F. D., Versino, E., Zambon, A., Borraccino, A., & Lemma, P. (2005). School-based prevention for illicit drugs’ use (Review). Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD003020.pub2.
Fang, L., & Schinke, S. P. (2013). Two-year outcomes of a randomized, family-based substance use prevention trial for Asian American adolescent girls. Psychology of Addictive Behaviors, 27(3), 788.
Fang, L., Schinke, S. P., & Cole, K. C. (2010). Preventing substance use among early Asian-American adolescent girls: initial evaluation of a web-based, mother–daughter program. Journal of Adolescent Health, 47(5), 529–532.
Fergusson, D. M., Horwood, L. J., & Ridder, E. M. (2007). Conduct and attentional problems in childhood and adolescence and later substance use, abuse and dependence: Results of a 25-year longitudinal study. Drug and Alcohol Dependence, 88(Suppl 1), S14–S26.
Fosco, G. M., Frank, J. L., Stormshak, E. A., & Dishion, T. J. (2013). Opening the “Black Box”: Family check-up intervention effects on self-regulation that prevents growth in problem behavior and substance use. Journal of School Psychology, 51(4), 455–468.
Foxcroft, D., Ireland, D., Lister-Sharp, D., Lowe, G., & Breen, R. (2003). Longer-term primary prevention for alcohol misuse in young people: A systematic review. Addiction, 98, 397–411.
Furr-Holden, C. D., Ialongo, N. S., Anthony, J. C., Petras, H., & Kellam, S. G. (2004). Developmentally inspired drug prevention: Middle school outcomes in a school-based randomized prevention trial. Drug and Alcohol Dependence, 73(2), 149–158.
Gates, S., McCambridge, J., Smith, L. A., & Foxcroft, D. (2006). Interventions for prevention of drug use by young people delivered in non-school settings (Review). The Cochrane Collaboration. doi:10.1002/14651858.CD005030.pub2.
Gottfredson, D. C., & Wilson, D. B. (2003). Characteristics of effective school-based substance abuse prevention. Prevention Science, 4(1), 27–38.
Grigorenko, E. L., Edwards, L., & Chapman, J. (2014). Cannabis use among juvenile detainees: Typology, frequency and association. Criminal Behaviour and Mental Health, 25(1), 54–65.
Grossbard, J. R., Mastroleo, N. R., Kilmer, J. R., Lee, C. M., Turrisi, R., Larimer, M. E., et al. (2010). Substance use patterns among first-year college students: Secondary effects of a combined alcohol intervention. Journal of Substance Abuse Treatment, 39, 384–390.
Haggerty, K. P., Skinner, M., Fleming, C. B., Gainey, R. R., & Catalano, R. F. (2008). Long-term effects of the Focus on Families project on substance use disorders among children of parents in methadone treatment. Addiction, 103, 2008–2016.
Haggerty, K., Skinner, M. L., MacKenzie, E. P., & Catalano, R. F. (2007). A randomized trial of parents who care: Effects on key outcomes at 24-month follow-up. Prevention Science, 8, 249–260.
Henquet, C., Krabbendam, L., Spauwen, J., Kaplan, C., Lieb, R., Wittchen, H. U., et al. (2005). Prospective cohort study of cannabis use, predisposition for psychosis, and psychotic symptoms in young people. BMJ, 330(7481), 11.
Hibell, B., Guttormsson, U., Ahlström, S., Balakireva, O., Bjarnason, T., Kokkevi, A., et al. (2012). The 2011 ESPAD report. Substance use among students in 36 European countries. Stockholm: The Swedish Council for Information on Alcohol and Other Drugs.
Higgins, J. P., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003). Measuring inconsistency in meta-analyses. BMJ, 327, 557–560.
Hopson, L. M., & Steiker, L. K. H. (2010). The effectiveness of adapted versions of an evidence-based prevention program in reducing alcohol use among alternative school students. Children and Schools, 32(2), 81–92.
Hyshka, E. (2013). Applying a social determinants of health perspective to early adolescent cannabis use—An overview. Drugs: Education, Prevention and Policy, 20(2), 110–119.
Imbens, G., & Rubin, D. (1997). Estimating outcome distributions for compliers in instrumental variables models. Review of Economic Studies, 64, 555–574.
Jackson, C. A., Henderson, M., Frank, J. W., & Haw, S. J. (2012). An overview of prevention of multiple risk behaviour in adolescence and young adulthood. Journal of Public Health, 34(suppl 1), i31–i40.
Kepper, A. S., Monshouwer, K., van Dorsselaer, S., & Vollebergh, W. (2011). Substance use by adolescents in special education and residential youth care institutions. European Child and Adolescent Psychiatry, 20(6), 311–319.
Koning, I. M., Vollebergh, W. A. M., Smit, F., Verdurmen, J. E. E., Van den Eijnden, R. J. J. M., Ter Bogt, T. F., et al. (2009). Preventing heavy alcohol use in adolescents (PAS): Cluster randomized trial of a parent and student intervention offered separately and simultaneously. Addiction, 104, 1669–1678.
Kosterman, R., Hawkins, J. D., Haggerty, K. P., Spoth, R., & Redmond, C. (2001). ‘Preparing for the Drug Free Years’: Session-specific effects of a universal parent-training intervention with rural families. Journal of Drug Education, 31(1), 47–68.
Kulis, S., Nieri, T., Yabiku, S., Stromwall, L., & Marsiglia, F. (2007). Promoting reduced and discontinued substance use among adolescent substance users: Effectiveness of a universal prevention program. Prevention Science, 8, 35–49.
Kumpfer, K. L., Alvarado, R., & Whiteside, H. O. (2003). Family-based interventions for substance use and misuse prevention. Substance Use and Misuse, 38, 1759–1787.
Kumpfer, K. L., Molgaard, V., & Spoth, R. (1996). Family interventions for the prevention of delinquency and drug use in special populations. In R. Peters & R. McMahon (Eds.), Preventing childhood disorders, substance abuse, and delinquency (pp. 241–267). Thousand Oaks: Sage.
Lemstra, M., Bennett, N., Nannapaneni, U., Neudorf, C., Warren, L., Kershaw, T., & Scott, C. (2010). A systematic review of school-based marijuana and alcohol prevention programs targeting adolescents aged 10-15. Addiction Research and Theory, 18(1), 84–96.
Lochman, J. E., & van den Steenhoven, A. (2002). Family-based approaches to substance abuse prevention. Journal of Primary Prevention, 23, 49–114.
Lochman, J. E., & Wells, K. C. (2002). The coping power program at the middle school transition: Universal and indicated prevention effects. Psychology of Addictive Behaviors, 16, S40–S54.
Mason, W., Kosterman, R., Hawkins, D., Haggerty, K., Spoth, R., & Redmond, C. (2007). Influence of a family-focused substance use preventive intervention on growth in adolescent depressive symptoms. Journal of Research on Adolescence, 17, 541–564.
McGillicuddy, N. B., Rychtarik, R. G., Duquette, J. A., & Morsheimer, E. T. (2001). Development of a skill training program for parents of substance-abusing adolescents. Journal of Substance Abuse Treatment, 20, 59–68.
Milburn, N. G., Iribarren, F. J., Rice, E., Lightfoot, M., Solorio, R., Rotheram-Borus, M. J., et al. (2012). A family intervention to reduce sexual risk behavior, substance use, and delinquency among newly homeless youth. Journal of Adolescent Health, 50(4), 358–364.
Moss, H. B., Chen, C. M., & Yi, H. Y. (2014). Early adolescent patterns of alcohol, cigarettes, and marijuana polysubstance use and young adult substance use outcomes in a nationally representative sample. Drug and Alcohol Dependence, 136, 51–62.
Mrazek, P. J., & Haggerty, R. J. (1994). Reducing risks for mental disorders: Frontiers for preventive intervention research. Washington, DC: National Academy Press.
Perry, C. L., Lee, S., Stigler, M. H., Farbakhsh, K., Komro, K. A., Gewirtz, A. H., et al. (2007). The impact of Project Northland on selected MMPI—A problem behavior scales. Journal of Primary Prevention, 28, 449–465.
Petrie, J., Bunn, F., & Byrne, G. (2007). Parenting programmes for preventing tobacco, alcohol and drug misuse in children <18 years: A systematic review. Health Education Research, 22, 177–191.
Piquero, A. R., Farrington, D. P., Welsh, B. C., Tremblay, R., & Jennings, W. G. (2009). Effects of early family/parent training programs on antisocial behavior and delinquency. Journal of Experimental Criminology, 5(2), 83–120.
Porath-Waller, A. J., Beasley, E., & Beirness, D. J. (2010). A meta-analytic review of school-based prevention for cannabis use. Health Education and Behavior, 37(5), 709–723.
Prado, G., Cordova, D., Huang, S., Estrada, Y., Rosen, A., Bacio, G. A., et al. (2012). The efficacy of Familias Unidas on drug and alcohol outcomes for Hispanic delinquent youth: Main effects and interaction effects by parental stress and social support. Drug and Alcohol Dependence, 125, S18–S25.
Prado, G., Pantin, H., Briones, E., Schwartz, S. J., Feaster, D., Huang, S., et al. (2007). A randomized controlled trial of a parent-centered intervention in preventing substance use and HIV risk behaviors in Hispanic adolescents. Journal of Consulting and Clinical Psychology, 75, 914–926.
Riggs, N. R., Chou, C. P., & Pentz, M. A. (2009). Preventing growth in amphetamine use: long-term effects of the Midwestern Prevention Project (MPP) from early adolescence to early adulthood. Addiction, 104(10), 1691–1699.
Rotheram-Borus, M. J., Lee, M., Lin, Y. Y., & Lester, P. (2004). Six-year intervention outcomes for adolescent children of parents with the human immunodeficiency virus. Archives of Pediatrics and Adolescent Medicine, 158, 742–748.
Rotheram-Borus, M. J., Rice, E., Comulada, W. S., Best, K., Elia, C., Peters, K., et al. (2012). Intervention outcomes among HIV-affected families over 18 months. AIDS and Behavior, 16(5), 1265–1275.
Rotheram-Borus, M. J., Stein, J. A., & Lester, P. (2006). Adolescent adjustment over 6 years in HIV-affected families. Journal of Adolescent Health, 39, 174–182.
Rowe, C. L. (2012). Family therapy for drug abuse: Review and updates 2003–2010. Journal of Marital and Family Therapy, 38(1), 59–81.
Schinke, S. P., Fang, L., & Cole, K. C. (2009a). Preventing substance use among adolescent girls: 1-year outcomes of a computerized, mother-daughter program. Addictive Behaviors, 34, 1060–1064.
Schinke, S. P., Fang, L., & Cole, K. C. (2009b). Computer-delivered, parent-involvement intervention to prevent substance use among adolescent girls. Preventive Medicine, 49, 429–435.
Schinke, S. P., Fang, L., Cole, K. C., & Cohen-Cutler, S. (2011). Preventing substance use among black and Hispanic adolescent girls: Results from a computer-delivered, mother–daughter intervention approach. Substance Use and Misuse, 46(1), 35–45.
Schubart, C. D., van Gastel, W. A., Breetvelt, E. J., Beetz, S. L., Ophoff, R. A., Sommer, I. E., et al. (2011). Cannabis use at a young age is associated with psychotic experiences. Psychological Medicine, 41(06), 1301–1310.
Skärstrand, E., Sundell, K., & Andréasson, S. (2013). Evaluation of a Swedish version of the strengthening families programme. The European Journal of Public Health. doi:10.1093/eurpubl/ckt146.
Smit, F., Bolier, L., & Cuijpers, P. (2004). Cannabis use and the risk of later schizophrenia: A review. Addiction, 99(4), 425–430.
Smit, E., Verdurmen, J., Monshouwer, K., & Smit, F. (2008). Family interventions and their effect on adolescent alcohol use in general populations: A meta-analysis of randomized controlled trials. Drug and Alcohol Dependence, 97(3), 195–206.
Soper, A. C., Wolchik, S. A., Tein, J. Y., & Sandler, I. N. (2010). Mediation of a preventive intervention’s 6-year effects on health risk behaviors. Psychology of Addictive Behaviors, 24, 300–310.
Spoth, R., Guyll, M., & Shin, C. (2009a). Universal intervention as a protective shield against exposure to substance use: Long-term outcomes and public health significance. American Journal of Public Health, 99, 2026–2033.
Spoth, R., Lopez, R. M., Redmond, C., & Shin, C. (1999). Assessing a public health approach to delay onset and progression of adolescent substance use: Latent transition and log-linear analyses of longitudinal family preventive intervention outcomes. Journal of Consulting and Clinical Psychology, 67, 619–630.
Spoth, R. L., Randall, G. K., Trudeau, L., Shin, C., & Redmond, C. (2008). Substance use outcomes 51/2 years past baseline for partnership-based, family-school preventive interventions. Drug and Alcohol Dependence, 96, 57–68.
Spoth, R. L., Redmond, C., & Shin, C. (2001). Randomized trial of brief family interventions for general populations: adolescent substance use outcomes 4 years following baseline. Journal of Consulting and Clinical Psychology, 69, 627–642.
Spoth, R., Redmond, C., Shin, C., & Azevedo, K. (2004). Brief family intervention effects on adolescent substance initiation: School-level growth curve analyses 6 years following baseline. Journal of Consulting and Clinical Psychology, 72, 535–542.
Spoth, R. L., Redmond, C., Trudeau, L., & Shin, C. (2002). Longitudinal substance initiation outcomes for a universal preventive intervention combining family and school programs. Psychology of Addictive Behaviors, 16, 129–134.
Spoth, R., Shin, C., Guyll, M., Redmond, C., & Azevedo, K. (2006). Universality of effects: an examination of the comparability of long-term family intervention effects on substance use across risk-related subgroups. Prevention Science, 7, 209–224.
Spoth, R. L., Trudeau, L. S., Guyll, M., & Shin, C. (2012). Benefits of universal intervention effects on a youth protective shield 10 years after baseline. Journal of Adolescent Health, 50(4), 414–417.
Spoth, R., Trudeau, L., Guyll, M., Shin, C., & Redmond, C. (2009b). Universal intervention effects on substance use among young adults mediated by delayed adolescent substance initiation. Journal of Consulting and Clinical Psychology, 77, 620–632.
St. Pierre, T. L., Mark, M. M., Kaltreider, D. L., & Aikin, K. J. (1997). Involving parents of high-risk youth in drug prevention. Journal of Early Adolescence, 17(1), 21–50.
Stanton, B., Cole, M., Galbraith, J., et al. (2004). Randomized trial of a parent intervention: Parents can make a difference in long-term adolescent risk behaviors, perceptions, and knowledge. Archives of Pediatrics and Adolescent Medicine, 158, 947–955.
Stanton, B., Li, X., Galbraith, J., Cornick, G., Feigelman, S., Kaljee, L., et al. (2000). Parental underestimates of adolescent risk behavior: A randomized, controlled trial of a parental monitoring intervention. Journal of Adolescent Health, 26, 18–26.
Stormshak, E. A., Connell, A. M., Véronneau, M. H., Myers, M. W., Dishion, T. J., Kavanagh, K., et al. (2011). An ecological approach to promoting early adolescent mental health and social adaptation: Family-centered intervention in public middle schools. Child Development, 82(1), 209–225.
Stormshak, E. A., & Dishion, T. J. (2009). A school-based, family-centered intervention to prevent substance use: The family check-up. The American Journal of Drug and Alcohol Abuse, 35, 227–232.
Swendsen, J., Burstein, M., Case, B., Conway, K. P., Kierker, L., He, J., & Merikangas, K. R. (2012). Use and abuse of alcohol and illicit drugs in US adolescents. Archives of General Psychiatry, 69, 390–398.
Tait, R. J., Spijkerman, R., & Riper, H. (2013). Internet and computer based interventions for cannabis use: A meta-analysis. Drug and Alcohol Dependence, 133(2), 295–304.
Tremblay, R. E., Masse, L., Pagani, L., & Vitaro, F. (1996). From childhood physical aggression to adolescent maladjustment: The Montreal prevention experiment. In R. DeV. Peters, & R. J. McMahon (Eds.). Preventing childhood disorders substance abuse and delinquency (pp. 268–298). Thousand Oaks, CA: Sage.
Van Laar, M. W., Cruts, A. A. N., Van Ooyen-Houben, M. M. J., Meijer, R. F., & Brunt, T. (Eds.). (2010). Netherlands national drug monitor (NDM), annual report 2009. Utrecht: WODC, Trimbos-Institute.
Van Os, J., Bak, M., Hanssen, M., Bijl, R. V., de Graaf, R., & Verdoux, H. (2002). Cannabis use and psychosis: A longitudinal population-based study. American Journal of Epidemiology, 156(4), 319–327.
Vermeulen-Smit, E., Verdurmen, J. E. E., Engels, R. C. M. E., & Vollebergh, W. A. M. (2015). The role of general parenting and cannabis-specific parenting practices in adolescent cannabis and other illicit drug use. Drug and Alcohol Dependence, 147, 222–228. doi:10.1016/j.drugalcdep.2014.11.014.
Winters, K. C., Fahnhorst, T., Botzet, A., Lee, S., & Lalone, B. (2012). Brief intervention for drug-abusing adolescents in a school setting: Outcomes and mediating factors. Journal of Substance Abuse Treatment, 42(3), 279–288.
Winters, K. C., & Leitten, W. (2007). Brief intervention for drug-abusing adolescents in a school setting. Psychology of Addictive Behaviors, 21, 249–254.
Wolchik, S. A., Sandler, I. N., Millsap, R. E., Plummer, B. A., Greene, S. M., Anderson, E. R., et al. (2002). Six-year follow-up of preventive interventions for children of divorce: A randomized controlled trial. JAMA, 288, 1874–1881.
Wolchik, S. A., Sandler, I. N., Tein, J. Y., Mahrer, N. E., Millsap, R. E., Winslow, E., et al. (2013). Fifteen-year follow-up of a randomized trial of a preventive intervention for divorced families: Effects on mental health and substance use outcomes in young adulthood. Journal of Consulting and Clinical Psychology, 81(4), 660.
Wu, Y., Stanton, B. F., Galbraith, J., Kaljee, L., Cottrell, L., Li, X., et al. (2003). Sustaining and broadening intervention impact: A longitudinal randomized trial of three adolescent risk reduction approaches. Pediatrics, 111, e32–e38.
Young, M., Kersten, C., & Werch, C. (1996). Evaluation of a parent child drug education program. Journal of Drug Education, 26, 57–68.
Zonnevylle-Bender, M. J., Matthys, W., van de Wiel, N. M., & Lochman, J. E. (2007). Preventive effects of treatment of disruptive behavior disorder in middle childhood on substance use and delinquent behavior. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 33–39.
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This work was granted by the Dutch Organization for Health Research and Development (ZonMW: 50-51300-98-007).
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Vermeulen-Smit, E., Verdurmen, J.E.E. & Engels, R.C.M.E. The Effectiveness of Family Interventions in Preventing Adolescent Illicit Drug Use: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Clin Child Fam Psychol Rev 18, 218–239 (2015). https://doi.org/10.1007/s10567-015-0185-7
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DOI: https://doi.org/10.1007/s10567-015-0185-7