Parental substance and alcohol abuse: publications guide

Annotated bibliography

Below are some citations and abstracts from publications from the library’s database:

Arria, A. M., Mericle, A. A., Meyers, K., & Winters, K. C. (2012). Parental substance use impairment, parenting and substance use disorder risk. Journal of Substance Abuse Treatment, 43(1), 114-122.

Using data from a nationally representative sample, this study investigated substance use disorder (SUD) among respondents with ages 15–54 years as a function of their parents’ substance-related impairment and parents’ treatment history. In addition, associations among maternal and paternal substance-related impairment, specific parenting behaviors, and risk for SUD in the proband were examined. As expected, parental substance-related impairment was associated with SUD. Paternal treatment history was associated with a decreased risk for SUD in the proband but did not appear to be associated with positive parenting practices. Results of post hoc analyses suggested that parenting behaviors might operate differently to influence SUD risk in children where parents are affected by substance use problems compared with unaffected families. Future research is warranted to better understand the complex relationships among parental substance use, treatment, parenting behaviors, and SUD risk in offspring. Opportunities might exist within treatment settings to improve parenting skills.

Berg, L., Bäck, K., Vinnerljung, B., & Hjern, A. (2016). Parental alcohol‐related disorders and school performance in 16‐year‐olds—a Swedish national cohort study. Addiction, 111(10), 1795-1803.:

To study the links between parental alcoholrelated disorders and offspring school performance and, specifically, whether associations vary by gender of parent or child and whether associations are mediated by other adverse psychosocial circumstances commonly appearing together with parental alcohol problems, such as parental mental health problems or criminal behaviour. Register study in a national cohort. Sweden. A total of 740 618 individuals born in Sweden in 1990–96. Parental hospital admissions for alcoholrelated disorders and school performance in their offspring, in the final year of compulsory school at age 15–16 years was analysed in relation to sociodemographic confounders and psychosocial covariates, using linear and logistic regressions. Both mothers’ and fathers’ alcoholrelated hospital admissions were associated with lower Zscores of grades and national mathematics tests scores. After adjustment for parental education and sociodemographic confounders, betacoefficients of Zscores of grades were –0.42 [95% confidence interval (CI) = –0.45, –0.39] and –0.42 (95% CI =  –0.43, –0.40), and betacoefficients of mathematics tests scores were –0.36 (95% CI = –0.39, –0.33) and –0.31 (95% CI = –0.33, –0.29), for mothers’ and fathers’ alcoholrelated disorders, respectively. Adjusted odds ratios (ORs) for not being eligible for secondary school were 1.99 (95% CI = 1.84–2.15) and 2.04 (95% CI = 1.95–2.15) for mothers’ and fathers’ alcoholrelated disorders, respectively. Adjusting the analyses for psychosocial factors in the family almost eradicated the statistical effects of parental alcoholrelated disorders on offspring school performance to betacoefficients of 0.03 to –0.10 and ORs of 0.89–1.15. The effect of a mother’s alcoholrelated hospital admission on school performance was stronger in girls than in boys, whereas no gender differences were seen for a father’s alcoholrelated hospital admission. In Sweden, alcoholrelated disorders in both mothers and fathers are associated with lower school performance in their children at age 15–16 years, with most of the statistical effects being attributed to psychosocial circumstances of the family, such as parental psychiatric disorders, drug use and criminality and receipt of social or child welfare interventions.

Capaldi, D. M., Tiberio, S. S., Kerr, D. C., & Pears, K. C. (2016). The relationships of parental alcohol versus tobacco and marijuana use with early adolescent onset of alcohol use. Journal of Studies on Alcohol and Drugs, 77(1), 95-103.

Objective:This study examined whether the use of tobacco and marijuana by fathers or mothers predicted onset of alcohol use in their offspring over and above effects of parental alcohol use.Method:The present study included 146 children of 93 parents (90 fathers and 85 mothers). The fathers were originally recruited as boys to the Oregon Youth Study, a study of community, familial, and individual risk factors for delinquency.Results:Only mothers’ but not fathers’ alcohol use was associated with children’s age at onset. Children’s age at onset was predicted by mothers’ tobacco use and by the interaction of fathers’ marijuana use and alcohol use. These effects were observed when controlling for parental education, child’s gender, and also child’s antisocial behavior—a general developmental risk factor for substance use onset in adolescence.Conclusions:Mothers’ substance use played a major role in childhood onset of alcohol use, yet the role of maternal substance use as a risk factor for their children has previously received less attention than the role of paternal substance use. Also, findings imply that it may be important to identify children of polysubstance-using parents for targeted prevention programs.

Chuang, E., Wells, R., Bellettiere, J., & Cross, T. P. (2013). Identifying the substance abuse treatment needs of caregivers involved with child welfare. Journal of Substance Abuse Treatment, 45(1), 118-125.

Parental substance use significantly increases risk of child maltreatment, but is often under-identified by child protective services. This study examined how agency use of standardized substance use assessments and child welfare investigative caseworker education, experience, and caseload affected caseworkers’ identification of parental substance abuse treatment needs. Data are from a national probability sample of permanent, primary caregivers involved with child protective services whose children initially remained at home and whose confidential responses on two validated instruments indicated harmful substance use or dependence. Investigative caseworkers reported use of a formal assessment in over two thirds of cases in which substance use was accurately identified. However, weighted logistic regression indicated that agency provision of standardized assessment instruments was not associated with caseworker identification of caregiver needs. Caseworkers were also less likely to identify substance abuse when their caseloads were high and when caregivers were fathers. Implications for agency practice are discussed.

Douglas-Siegel, J. A., & Ryan, J. P. (2013). The effect of recovery coaches for substance-involved mothers in child welfare: Impact on juvenile delinquency. Journal of Substance Abuse Treatment, 45(4), 381-387.

Despite the documented relationship between parental substance abuse and youth delinquency, the effects of parental interventions on delinquency outcomes are unknown. Such interventions are particularly vital for families in the child welfare system who are at heightened risk for both parental substance involvement and youth delinquency. The current study tested the impact of intensive case management in the form of a recovery coach for substance-involved mothers on youth delinquency outcomes among a randomized sample of 453 families involved in a Title IV-E experimental waiver demonstration in Cook County, Illinois. In comparison to control group participants, families enrolled in the Alcohol and Other Drug Abuse (AODA) waiver demonstration experienced a lower rate of juvenile arrest, net of factors such as demographic characteristics, primary drug of choice, and time spent in substitute care. Findings support efforts to curb delinquency among child-welfare involved youth by providing recovery coaches to their substance abusing or dependent parents.

Handley, E. D., & Chassin, L. (2013). Alcohol-specific parenting as a mechanism of parental drinking and alcohol use disorder risk on adolescent alcohol use onset. Journal of Studies on Alcohol and Drugs, 74(5), 684-693.

Objective:The primary aim of the current study was to examine three dimensions of alcohol-specific parenting (anti-alcohol parenting strategies, parental legitimacy in regulating adolescent drinking, and parental disclosure of negative alcohol experiences) as mechanisms in the prospective relations between parental drinking and alcohol use disorder (recovered, current, and never diagnosed) and adolescent alcohol use initiation.Method:Participants were from an ongoing longitudinal study of the intergenerational transmission of alcoholism. Structural equation modeling was used to test a maternal model (n= 268 adolescents and their mothers) and a paternal model (n= 204 adolescents and their fathers) of alcohol-specific parenting.Results:Results indicated that higher levels of drinking among mothers and current alcohol use disorder among fathers were related to more frequent parental disclosure of personal negative experiences with alcohol. Maternal disclosure of negative alcohol experiences mediated the effect of maternal drinking on adolescent onset of alcohol use such that more disclosure predicted a greater likelihood of adolescent drinking initiation at follow-up over and above general parenting. In addition, currently alcoholic mothers were perceived as having less legitimate authority to regulate adolescent drinking, and low levels of legitimacy among fathers was predictive of drinking onset among adolescents.Conclusions:Alcohol-specific parenting is a distinct and influential predictor of adolescent alcohol use initiation that is partially shaped by parents’ own drinking experiences. Moreover, parental conversations about their own personal experiences with alcohol may not represent a form of parent–child communication about drinking that deters adolescent drinking.

Hedges, K. E. (2012). A family affair: contextual accounts from addicted youth growing up in substance using families. Journal of Youth Studies, 15(3), 257-272.

There are currently over 8 million children in the USA living in households where at least one parent is dependent on or abusing substances. Research has shown a link between parental substance use and children initiating substance use. This article uses qualitative data to give a contextual understanding of the experience of growing up in substance using homes. Results found that the habitusof homes was so immersed in substances that children’s initiation into substance use was expected and became a ‘rite of passage’ into full acceptance as an adult member of the family. Furthermore, in many cases youth described a role reversal between child and parent roles or parentification in the family. The conclusion calls for early identification in treatment of youth who use substances with family members to target new norms and behaviors for the entire family posttreatment and to enhance successful recovery when returning to the family.

McCutcheon, V. V., Agrawal, A., Kuo, S. I. C., Su, J., Dick, D. M., Meyers, J. L., … & Schuckit, M. A. (2018). Associations of parental alcohol use disorders and parental separation with offspring initiation of alcohol, cigarette and cannabis use and sexual debut in high‐risk families. Addiction, 113(2), 336-345.

Parental alcohol use disorders (AUDs) and parental separation are associated with increased risk for early use of alcohol in offspring, but whether they increase risks for early use of other substances and for early sexual debut is understudied. We focused on associations of parental AUDs and parental separation with substance initiation and sexual debut to (1) test the strength of the associations of parental AUDs and parental separation with time to initiation (age in years) of alcohol, tobacco and cannabis use and sexual debut and (2) compare the strength of association of parental AUD and parental separation with initiation. Prospective adolescent and young adult cohort of a highrisk family study, the Collaborative Study on the Genetics of Alcoholism (COGA). Six sites in the United States. A total of 3257 offspring (aged 14–33 years) first assessed in 2004 and sought for interview approximately every 2 years thereafter; 1945 (59.7%) offspring had a parent with an AUD. Diagnostic interview data on offspring substance use and sexual debut were based on first report of these experiences. Parental lifetime AUD was based on their own selfreport when parents were interviewed (1991–2005) for most parents, or on offspring and other family member reports for parents who were not interviewed. Parental separation was based on offspring reports of not living with both biological parents most of the time between ages 12 and 17 years. Parental AUDs were associated with increased hazards for all outcomes, with cumulative hazards ranging from 1.19 to 2.71. Parental separation was also an independent and consistent predictor of early substance use and sexual debut, with hazards ranging from 1.19 to 2.34. The strength of association of parental separation with substance initiation was equal to that of having two AUDaffected parents, and its association with sexual debut was stronger than the association of parental AUD in one or both parents. Parental alcohol use disorders (AUDs) and parental separation are independent and consistent predictors of increased risk for early alcohol, tobacco and cannabis use and sexual debut in offspring from families with a high risk of parental AUDs.

Meyers, J. L., Shmulewitz, D., Elliott, J. C., Thompson, R. G., Aharonovich, E., Spivak, B., … & Hasin, D. S. (2014). Parental alcohol history differentially predicts offspring disorders in distinct subgroups in Israel. Journal of Studies on Alcohol and Drugs, 75(5), 859-869.

Objective:The association between alcoholism in parents and related disorders in their offspring is well established in cultures with intermediate/high alcohol consumption, but not in those with low consumption, such as Israel. This study investigated differences in parental transmission of alcohol problems and related psychopathology between immigrants from the former Soviet Union (FSU) to Israel and other Israelis—two Israeli subgroups with differing alcohol consumption behaviors and social norms.Method:A total of 1,347 adults from a household sample were interviewed. Regression analyses were used to examine associations between parental alcohol problems and participant disorders: alcohol, nicotine, and cannabis use disorders (AUD, NUD, CUD); antisocial personality disorder (ASPD); major depressive disorder (MDD); and posttraumatic stress disorder (PTSD). We also examined the associations of parental alcohol problems with participant disorders characterized with two latent factors: externalizing (EXT: AUD, NUD, CUD, ASPD) and internalizing (INT: MDD, PTSD). Differential parental transmission of alcohol problems in FSU (n= 315) and non-FSU (n= 1,032) Israelis was examined with statistical interaction.Results:Among emigrants from the FSU, parental alcohol problems predicted AUD, NUD, CUD, ASPD, PTSD, EXT, and INT (mean ratios = 1.38–4.83). In non-FSU Israelis, parental alcohol problems predicted only ASPD and PTSD (mean ratios = 1.08–4.09). Significant interactions were observed for AUD, CUD, PTSD, and EXT; each relationship was stronger in FSU Israelis and null (AUD, CUD, EXT) or less robust (PTSD) in other Israelis.Conclusions:Parental alcohol problems were related to substance use and psychiatric disorders differently in FSU and other Israelis, two groups with different alcohol consumption levels and drinking norms. We propose that, in social contexts that vary in the degree to which they constrain alcohol behavior, underlying genetic predispositions may manifest as different disorders.

Moreland, A. D., & McRae-Clark, A. (2018). Parenting outcomes of parenting interventions in integrated substance-use treatment programs: A systematic review. Journal of Substance Abuse Treatment, 89, 52-59.:

The high prevalence of women in substance use treatment programs with children, and the co-occurring negative physical and mental health outcomes associated with substance use, led to the development of integrated substance use treatment programs that target a range of women-specific issues. Integrated programs typically offer some type of parenting component, although the level of parenting services varies widely. Existing reviews have found positive child and parent outcomes following integrated treatment programs in general, although studies were not selected on the basis of whether they included parenting interventions. Due to the large percentage of substance using parents and research that parenting interventions contribute to decreased maternal substance use, this critical review examines parental outcomes of published studies on integrated programs that specifically include a parenting intervention component, as well as moderators of parenting and parental substance use/relapse. Across the 15 studies identified, this systematic review primarily focused on 8 parenting outcomes, including program retention, substance use, parenting stress, psychosocial adjustment, depression, child abuse potential, parenting behaviors, and parent-child interaction; as well as 5 additional secondary outcomes. The review discusses results on each of these outcomes, as well as retention rates across the parenting interventions.

Rossow, I., Felix, L., Keating, P., & McCambridge, J. (2016). Parental drinking and adverse outcomes in children: A scoping review of cohort studies. Drug and Alcohol Review, 35(4), 397-405.

There is a growing interest in measuring alcohol’s harms to people other than the drinker themselves. ‘Children of alcoholics’ and foetal alcohol spectrum disorder have received widespread attention. Less is known about how children are affected by postnatal exposure to parental drinking other than alcohol abuse/dependence. In this scoping review, we aim to assemble and map existing evidence from cohort studies on the consequences of parental alcohol use for children, and to identify limitations and gaps in this literature. Systematic review methods were used. Electronic databases were searched (1980 to October 2013) and a total of 3215 abstracts were screened, 326 full text papers examined and 99 eligible for inclusion according to selection criteria including separation of exposure and outcome measurement in time and report of a quantitative effect size. The main finding is the large literature available. Adolescent drinking behaviour was the most common outcome measure and outcomes other than substance use were rarely analysed. In almost two of every three published associations, parental drinking was found to be statistically significantly associated with a child harm outcome measure. Several limitations in the literature are noted regarding its potential to address a possible causal role of parental drinking in children’s adverse outcomes. This study identifies targets for further study and provides a platform for more targeted analytic investigations which ascertain risk of bias, and which are capable of considering the appropriateness of causal inferences for the observed associations.

Thompson Jr, R. G., Alonzo, D., Hu, M. C., & Hasin, D. S. (2017). The influences of parental divorce and maternal‐versus‐paternal alcohol abuse on offspring lifetime suicide attempt. Drug and Alcohol Review, 36(3), 408-414

Research indicates that parental divorce and parental alcohol abuse independently increase likelihood of offspring lifetime suicide attempt. However, when experienced together, only parental alcohol abuse significantly increased odds of suicide attempt. It is unclear to what extent differences in the effect of maternal versus paternal alcohol use exist on adult offspring lifetime suicide attempt risk. This study examined the influences of parental divorce and maternal–paternal histories of alcohol problems on adult offspring lifetime suicide attempt. The sample consisted of participants from the 2001–2002 National Epidemiological Survey on Alcohol and Related Conditions. The simultaneous effect of childhood or adolescent parental divorce and maternal and paternal history of alcohol problems on offspring lifetime suicide attempt was estimated using a logistic regression model with an interaction term for demographics and parental history of other emotional and behavioural problems. Parental divorce and maternal–paternal alcohol problems interacted to differentially influence the likelihood of offspring lifetime suicide attempt. Experiencing parental divorce and either maternal or paternal alcohol problems nearly doubled the likelihood of suicide attempt. Divorce and history of alcohol problems for both parents tripled the likelihood. Individuals who experienced parental divorce as children or adolescents and who have a parent who abuses alcohol are at elevated risk for lifetime suicide attempt. These problem areas should become a routine part of assessment to better identify those at risk for lifetime suicide attempt and to implement early and targeted intervention to decrease such risk. 4.

Waldron, M., Bucholz, K. K., Lynskey, M. T., Madden, P. A., & Heath, A. C. (2013). Alcoholism and timing of separation in parents: Findings in a midwestern birth cohort. Journal of Studies on Alcohol and Drugs, 74(2), 337-348.

Objective:We examined history of alcoholism and occurrence and timing of separation in parents of a female twin cohort.Method:Parental separation (never-together; never-married cohabitants who separated; married who separated) was predicted from maternal and paternal alcoholism in 326 African ancestry (AA) and 1,849 European/other ancestry (EA) families. Broad (single-informant, reported in abstract) and narrow (self-report or two-informant) measures of alcoholism were compared.Results:Parental separation was more common in families with parental alcoholism: By the time twins were 18 years of age, parents had separated in only 24% of EA families in which neither parent was alcoholic, contrasted with 58% of families in which only the father was (father-only), 61% of families in which only the mother was (mother-only), and 75% in which both parents were alcoholic (two-parent); corresponding AA percentages were 59%, 71%, 82%, and 86%, respectively. Maternal alcoholism was more common in EA never-together couples (mother-only: odds ratio [OR] = 5.95; two parent: OR = 3.69). In ever-together couples, alcoholism in either parent predicted elevated risk of separation, with half of EA relationships ending in separation within 12 years of twins’ birth for father-only families, 9 years for mother-only families, and 4 years for both parents alcoholic; corresponding median survival times for AA couples were 9, 4, and 2 years, respectively. EA maternal alcoholism was especially strongly associated with separation in the early postnatal years (mother-only: birth—5 years, hazard ratio [HR] = 4.43; 6 years on, HR = 2.52; two-parent: HRs = 5.76, 3.68, respectively).Conclusions:Parental separation is a childhood environmental exposure that is more common in children of alcoholics, with timing of separation highly dependent on alcoholic parent gender.

 

October PD Blog

Professional development

You can add to the professional development post by commenting below or emailing the library.

Online resources

Webpage

The Healing Foundation has a website linking to resources about intergenerational trauma in Aboriginal and Torres Strait Islanders.

Read – professional reading

Available from the library database

Armstrong, G., Spittal, M. J., & Jorm, A. F. (2018). Are we underestimating the suicide rate of middle and older‐aged Indigenous Australians? An interaction between ‘unknown’Indigenous status and age. Australian and New Zealand Journal of Public Health.

Barnett, A. I., Hall, W., Fry, C. L., Dilkes‐Frayne, E., & Carter, A. (2017). Drug and alcohol treatment providers’ views about the disease model of addiction and its impact on clinical practice: A systematic review. Drug and Alcohol Review.

Hunt, G., Antin, T., Sanders, E., & Sisneros, M. (2018). Queer youth, intoxication and queer drinking spaces. Journal of Youth Studies, 1-21.

Kristjansson, A. L., Kogan, S. M., Mann, M. J., Smith, M. L., Juliano, L. M., Lilly, C. L., & James, J. E. (2018). Does early exposure to caffeine promote smoking and alcohol use behavior? A prospective analysis of middle school students. Addiction.

McCann, T. V., & Lubman, D. I. (2018). Help-seeking barriers and facilitators for affected family members of a relative with alcohol and other drug misuse: A qualitative study. Journal of Substance Abuse Treatment, 93, 7-14.

Wakeford, G., Kannis‐Dymand, L., & Statham, D. (2018). Anger rumination, binge eating, and at‐risk alcohol use in a university sample. Australian Journal of Psychology, 70(3), 269-276.

Open Access Articles

Bryant, L., Garnham, B., Tedmanson, D., & Diamandi, S. (2018). Tele-social work and mental health in rural and remote communities in Australia. International Social Work, 61(1), 143-155.

Lamont-Mills, A., Christensen, S., & Moses, L. (2018). Confidentiality and informed consent in counselling and psychotherapy: a systematic review. Melbourne: PACFA.

Petrakis, M., Robinson, R., Myers, K., Kroes, S., & O’Connor, S. (2018). Dual diagnosis competencies: A systematic review of staff training literature. Addictive Behaviors Reports, 7, 53-57.

Roberts, R. M., Ong, N. W. Y., & Raftery, J. (2018). Factors That Inhibit and Facilitate Wellbeing and Effectiveness in Counsellors Working With Refugees and Asylum Seekers in Australia. Journal of Pacific Rim Psychology, 12.

Tsou, C., Green, C., Gray, G., & Thompson, S. C. (2018). Using the Healthy Community Assessment Tool: Applicability and Adaptation in the Midwest of Western Australia. International Journal of Environmental Research and Public Health, 15(6).

Useful resources

Insight have produced several toolkits of resources for use by workers including:

AOD Literacy Toolkit  

First Nations AOD Toolkit

The 2018 Global Drug Survey has just been released

e-Book of the month

Bukowski, W. M., Laursen, B. P., & Rubin, K. H. (2018). Handbook of Peer Interactions, Relationships, and Groups, Second Edition. New York: The Guilford Press.

The definitive handbook on peer relations has now been significantly revised with 55% new material. Bringing together leading authorities, this volume presents cutting-edge research on the dynamics of peer interactions, their impact on multiple aspects of social development, and the causes and consequences of peer difficulties. From friendships and romance to social withdrawal, aggression, and victimization, all aspects of children’s and adolescents’  relationships are explored. The book examines how individual characteristics interact with family, group, and contextual factors across development to shape social behavior. The importance of peer relationships to emotional competence, psychological well-being, and achievement is analyzed, and peer-based interventions for those who are struggling are reviewed. Each chapter includes an introductory overview and addresses theoretical considerations, measures and methods, research findings and their implications, and future directions (from publisher).

Attend – informal learning sessions, journal club, seminar series

Insight Queensland

Free training sessions at Biala Community Health Centre in Brisbane, unless otherwise specified including:

Online induction modules are a prerequisite to some of the courses. To access and download them visit www.insightqld.org

5 October, 08:30-16:00: Introduction to Motivational Interviewing – Townsville. Prerequisite Module 5

9 October, 09:00-16:30: “AOD Crash Course” – Introduction to Working with People who use Substances – Logan

9 October, 09:00-16:30: “AOD Crash Course” – Introduction to Working with People who use Substances – Brisbane

11 October, 09:00-16:30: Introduction to AOD Clinical Supervision – Brisbane

12 October, 09:00-16:30: Introduction to Motivational Interviewing – Gold Coast. Prerequisite Module 5

16 October, 09:00-16:30: Advanced Harm Reduction – Brisbane. NB: Participants must have completed Insight’s “Understanding Psychoactive Drugs” workshop or be an existing employee of an AOD or Mental Health service to be eligible for this workshop.

18 October, 09:00-16:30: Introduction to Motivational Interviewing – Sunshine Coast. Prerequisite Module 5

18 October, 09:00-16:30: Family Inclusive Practice in AOD Treatment – Brisbane

23 October, 09:00-16:30: Introduction to Withdrawal Management – Logan

23 October, 09:00-16:30: Case Formulation – Brisbane

25 October, 09:00-16:30: Introduction to Motivational Interviewing – Logan. Prerequisite Module 5

25 October, 09:00-16:30: Advanced Harm Reduction – Ipswich. NB: Participants must have completed Insight’s “Understanding Psychoactive Drugs” workshop or be an existing employee of an AOD or Mental Health service to be eligible for this workshop.

25 October, 09:00-16:30: AOD Relapse Prevention and Management – Brisbane. Prerequisite Module 6

30 October, 09:00-16:30: “AOD Crash Course” – Introduction to Working with People who use Substances –  Toowoomba

30 October, 09:00-16:30: Advanced Harm Reduction – Logan. NB: Participants must have completed Insight’s “Understanding Psychoactive Drugs” workshop or be an existing employee of an AOD or Mental Health service to be eligible for this workshop.

Listen – podcasts, webinars

Cracks in the Ice

Supporting frontline workers with information and resources about crystal methamphetamine. 17 October, 11:00-12:00 AEST

Presented by Allan Trifonoff and Roger Nicholas, National Centre for Education and Training on Addiction (NCETA), Flinders University

This webinar will provide attendees with information about
– How ice affects people and communities
– Worker safety and preventing, managing and recovering from ice-related critical incidents
– The impacts of using ice with alcohol and other drugs

Register here

Past Cracks in the Ice webinars are available here

Insight

Free webinars at 10:00-11:00 AEST:

10 October: The Great Vape Debate

17 October: FASD as an Indigenous Rights Issue

24 October: HIV Prevention and U=U

31 October: Becoming a Trauma Informed Clinician- Taming the Inner Chimp by Talking to the Elephant in the Room

Past Insight webinar recordings available now on YouTube

 

Interventions and treatments for adolescent substance abuse: Publications guide

Annotated bibliography

Below are some citations and abstracts from publications about interventions and treatment for adolescent substance abuse.

Allen, M. L., Garcia-Huidobro, D., Porta, C., Curran, D., Patel, R., Miller, J., & Borowsky, I. (2016). Effective Parenting Interventions to Reduce Youth Substance Use: A Systematic Review. Pediatrics, 138(2), e20154425.

Context: Parenting interventions may prevent adolescent substance use; however, questions remain regarding the effectiveness of interventions across substances and delivery qualities contributing to successful intervention outcomes.

Objective: To describe the effectiveness of parent-focused interventions in reducing or preventing adolescent tobacco, alcohol, and illicit substance use and to identify optimal intervention targeted participants, dosage, settings, and delivery methods.

Data sources: PubMed, PsycINFO, ERIC, and CINAHL.

Study selection: Randomized controlled trials reporting adolescent substance use outcomes, focusing on imparting parenting knowledge, skills, practices, or behaviors.

Data extraction Trained researchers extracted data from each article using a standardized, prepiloted form. Because of study heterogeneity, a qualitative technique known as harvest plots was used to summarize findings.

Results: A total of 42 studies represented by 66 articles met inclusion criteria. Results indicate that parenting interventions are effective at preventing and decreasing adolescent tobacco, alcohol, and illicit substance use over the short and long term. The majority of effective interventions required ≤12 contact hours and were implemented through in-person sessions including parents and youth. Evidence for computer-based delivery was strong only for alcohol use prevention. Few interventions were delivered outside of school or home settings.

Limitations: Overall risk of bias is high.

Conclusions: This review suggests that relatively low-intensity group parenting interventions are effective at reducing or preventing adolescent substance use and that protection may persist for multiple years. There is a need for additional evidence in clinical and other community settings using an expanded set of delivery methods.

Becker, S., Hernandez, L., Spirito, A., & Conrad, S. (2017). Technology-assisted intervention for parents of adolescents in residential substance use treatment: protocol of an open trial and pilot randomized trial. Addiction Science & Clinical Practice, 12(1), 1-13.

Adolescents in residential substance use disorder (SUD) treatment have poor outcomes post-discharge, with follow-up studies suggesting that most adolescents relapse within 90 days. Parenting practices directly influence adolescent SUD outcomes, but parents of adolescents with SUDs are difficult to engage in traditional behavioral treatments. The current study adapts and evaluates a technology-assisted intervention for parents of adolescents in residential SUD treatment. Based on pilot qualitative data with parents, adolescents, and residential staff, we augment an existing computerized intervention (Parenting Wisely; PW) with four in-person coaching sessions, personalized text messages, and an expert-moderated online parent message board. We hypothesize that parents will find enhanced PW (PW+) both feasible and acceptable, and that adolescents whose parents receive PW+ will have better post-discharge outcomes than adolescents who receive standard care (SC) only. A two phase approach is used to adapt and evaluate PW+. Phase 1 consists of an open trial with 10 parents of adolescents (age 12–17) in residential SUD treatment. Post-discharge qualitative and quantitative data from parents and adolescents will support PW+ refinement. Phase 2 is a randomized pilot trial with 60 parents testing the effectiveness of adding PW+ to SC. Adolescents and parents will complete assessments at baseline, 6-, 12-, and 24-weeks post-discharge. Primary outcomes will be measures of feasibility and acceptability. Secondary outcomes will include adolescent substance use, truancy, high-risk sexual behavior, and criminal involvement. Two parenting processes (monitoring and communication) are examined as potential mediators of change. This study will adapt and evaluate a technology-assisted parenting intervention as a means of improving adolescent outcomes following residential SUD treatment. Results have the potential to advance the field by: addressing a high-risk population, improving parental engagement; targeting parenting practices (putative mediators of change) that have been linked to adolescent outcomes; and developing a highly disseminable approach.

Black, J. J., & Chung, T. (2014). Mechanisms of change in adolescent substance use treatment: How does treatment work?. Substance Abuse, 35(4), 344-351.

Background: Adolescent substance use treatment outcome research generally shows small to moderate effects in reducing substance use, with no specific “brand” of treatment emerging as clearly superior to any other, and treatment gains that fade over time. The relatively weak and temporary effects of treatment call for improving the potency and durability of intervention effects. In response to this call, this critical narrative review summarizes research on mechanisms of change for both adults and adolescents in substance use treatment, with a particular focus on reviewing what is known regarding “how” adolescent substance use treatment works.

Methods: A comprehensive review of the adolescent (ages 11–18) substance use treatment literature was conducted to identify empirical studies that examined mediators of intervention effects. Relevant databases (e.g., PsychINFO, Medline) were searched using key words (e.g., “mediator”), and relevant articles from reference sections of identified studies and review papers were considered.

Results: Studies of mechanisms of psychotherapy change are rare in the adult, and particularly adolescent, substance use treatment outcome literature. The four adolescent studies that examined substance use treatment mechanisms found that positive social support, motivation to abstain, and positive parenting behaviors mediated treatment effects. To date, research has not supported therapy-specific mechanisms of change, finding instead that “common” processes of change largely account for improvements in outcome across distinct “brands” of treatment.

Conclusions: The lack of empirical support for treatment-specific mechanisms of change may be due to the need for greater precision in defining and measuring treatment-specific causal chains. Future directions include neuroscience approaches to examining changes in brain functioning that are associated with treatment response and recovery and examining mechanisms in adaptive treatment designs, which can accommodate individual differences in targets for intervention and response to treatment.

Das, J. K., Salam, R. A., Arshad, A., Finkelstein, Y., & Bhutta, Z. A. (2016). Interventions for adolescent substance abuse: An overview of systematic reviews. Journal of Adolescent Health, 59(4), S61-S75.

Many unhealthy behaviors often begin during adolescence and represent major public health challenges. Substance abuse has a major impact on individuals, families, and communities, as its effects are cumulative, contributing to costly social, physical, and mental health problems. We conducted an overview of systematic reviews to evaluate the effectiveness of interventions to prevent substance abuse among adolescents. We report findings from a total of 46 systematic reviews focusing on interventions for smoking/tobacco use, alcohol use, drug use, and combined substance abuse. Our overview findings suggest that among smoking/tobacco interventions, school-based prevention programs and family-based intensive interventions typically addressing family functioning are effective in reducing smoking. Mass media campaigns are also effective given that these were of reasonable intensity over extensive periods of time. Among interventions for alcohol use, school-based alcohol prevention interventions have been associated with reduced frequency of drinking, while family-based interventions have a small but persistent effect on alcohol misuse among adolescents. For drug abuse, school-based interventions based on a combination of social competence and social influence approaches have shown protective effects against drugs and cannabis use. Among the interventions targeting combined substance abuse, school-based primary prevention programs are effective. Evidence from Internet-based interventions, policy initiatives, and incentives appears to be mixed and needs further research. Future research should focus on evaluating the effectiveness of specific interventions components with standardized intervention and outcome measures. Various delivery platforms, including digital platforms and policy initiative, have the potential to improve substance abuse outcomes among adolescents; however, these require further research.

Goorden, M., Schawo, S., Bouwmans-Frijters, C., van der Schee, E., Hendriks, V., & Hakkaart-van Roijen, L. (2016). The cost-effectiveness of family/family-based therapy for treatment of externalizing disorders, substance use disorders and delinquency: a systematic review. BMC Psychiatry, 16(1), 1-22.

Family therapy and family-based treatment has been commonly applied in children and adolescents in mental health care and has been proven to be effective. There is an increased interest in economic evaluations of these, often expensive, interventions. The aim of this systematic review is to summarize and evaluate the evidence on cost-effectiveness of family/family-based therapy for externalizing disorders, substance use disorders and delinquency. A systematic literature search was performed in PubMed, Education Resource information Centre (ERIC), Psycinfo and Cochrane reviews including studies conducted after 1990 and before the first of August of 2013. Full economic evaluations investigating family/family-based interventions for adolescents between 10 and 20 years treated for substance use disorders, delinquency or externalizing disorders were included. Seven hundred thirty-one articles met the search criteria and 51 studies were initially selected. The final selection resulted in the inclusion of 11 studies. The quality of these studies was assessed. Within the identified studies, there was great variation in the specific type of family/family-based interventions and disorders. According to the outcomes of the checklists, the overall quality of the economic evaluations was low. Results varied by study. Due to the variations in setting, design and outcome it was not feasible to pool results using a meta-analysis. The quality of the identified economic evaluations of family/family-based therapy for treatment of externalizing disorders, adolescent substance use disorders and delinquency was insufficient to determine the cost-effectiveness. Although commonly applied, family/family-based therapy is costly and more research of higher quality is needed.

Liddle, H. A., Dakof, G. A., Rowe, C. L., Henderson, C., Greenbaum, P., Wang, W., & Alberga, L. (2018). Multidimensional Family Therapy as a community-based alternative to residential treatment for adolescents with substance use and co-occurring mental health disorders. Journal of Substance Abuse Treatment, 90(1), 47-56.

This randomized clinical trial (RCT) compared Multidimensional Family Therapy (MDFT) with residential treatment (RT) for adolescents with co-occurring substance use and mental health disorders on substance use, delinquency, and mental health symptoms. Using an intent-to-treat design, 113 adolescents who had been referred for residential treatment were randomly assigned to either RT or MDFT in the home/community. The sample was primarily male (75%) and Hispanic (68%) with an average age of 15.4 years. Seventy-one percent of youth had at least one previous residential treatment placement. Participants were assessed at baseline and at 2, 4, 12 and 18 months post-baseline. During the early phase of treatment (baseline to 2 months), youth in both treatments showed significant reductions in substance use [substance use problems (d = 1.10), frequency of use (d = 1.36)], delinquent behaviors (d = 0.18) and externalizing symptoms (d = 0.77), and youth receiving MDFT reported significantly greater reductions in internalizing symptoms than youth receiving RT (d = 0.42). In phase 2, from 2 to 18 months after baseline, youth in MDFT maintained their early treatment decreases in substance use problems (d = 0.51), frequency of use (d = 0.24), and delinquent behaviors (d = 0.42) more effectively than youth in RT. During this period, there were no significant treatment differences in maintenance of gains for externalizing and internalizing symptoms. Results suggest that Multidimensional Family Therapy is a promising alternative to residential treatment for youth with substance use and co-occurring disorders. The results, if supported through replication, are important because they challenge the prevailing assumption that adolescents who meet criteria for residential treatment cannot be adequately managed in a non-residential setting.

Stanger, C., Lansing, A. H., & Budney, A. J. (2016). Advances in research on contingency management for adolescent substance use. Child and Adolescent Psychiatric Clinics, 25(4), 645-659.

Multiple interventions for treating adolescents with substance use disorders have demonstrated efficacy, but the majority of teens do not show an enduring positive response to these treatments. Contingency-management (CM) based strategies provide a promising alternative, and clinical research focused on the development and testing of innovative CM models continues to grow. This article provides an updated review on the progress made in this area since we last commented on the published literature in 20101. Areas covered include: controlled trials of treatment for adolescents referred to substance use treatment, innovative applications of CM to tobacco cessation among youth, analyses of moderators and mechanisms of CM treatment outcomes, the emerging literature on dissemination and implementation, and other literature suggesting a growing acceptance of CM as viable and effective intervention. The literature in this area continues to progress at a moderate pace, with many indicators of budding interest in the application of CM, and in finding cost effective models to enhance dissemination and implementation. As with other types of substance use disorder treatments, we need to continue to search for more effective models, focus on post-treatment maintenance (reduce relapse), and strive for high levels of integrity and fidelity during dissemination efforts to optimize outcomes.

Stockings, E., Hall, W. D., Lynskey, M., Morley, K. I., Reavley, N., Strang, J., … & Degenhardt, L. (2016). Prevention, early intervention, harm reduction, and treatment of substance use in young people. The Lancet Psychiatry, 3(3), 280-296.

We did a systematic review of reviews with evidence on the effectiveness of prevention, early intervention, harm reduction, and treatment of problem use in young people for tobacco, alcohol, and illicit drugs (eg, cannabis, opioids, amphetamines, or cocaine). Taxation, public consumption bans, advertising restrictions, and minimum legal age are effective measures to reduce alcohol and tobacco use, but are not available to target illicit drugs. Interpretation of the available evidence for school-based prevention is affected by methodological issues; interventions that incorporate skills training are more likely to be effective than information provision—which is ineffective. Social norms and brief interventions to reduce substance use in young people do not have strong evidence of effectiveness. Roadside drug testing and interventions to reduce injection-related harms have a moderate-to-large effect, but additional research with young people is needed. Scarce availability of research on interventions for problematic substance use in young people indicates the need to test interventions that are effective with adults in young people. Existing evidence is from high-income countries, with uncertain applicability in other countries and cultures and in subpopulations differing in sex, age, and risk status. Concerted eff orts are needed to increase the evidence base on interventions that aim to reduce the high burden of substance use in young people.

Tanner-Smith, E. E., Wilson, S. J., & Lipsey, M. W. (2013). The comparative effectiveness of outpatient treatment for adolescent substance abuse: A meta-analysis. Journal of Substance Abuse Treatment, 44(2), 145-158.

Meta-analysis was used to synthesize research on the effects of outpatient treatment on substance use outcomes for adolescents with substance use disorders. An extensive literature search located 45 eligible experimental or quasi-experimental studies reporting 73 treatment–comparison group pairs, with many of the comparison groups also receiving some treatment. The first analysis examined 250 effect sizes for the substance use outcomes of adolescents receiving different types of treatment relative to the respective comparison groups. As a category, family therapy programs were found to be more effective than their comparison conditions, whereas no treatment programs were less effective. However, not all treatment types were compared with each other in the available research, making it difficult to assess the comparative effectiveness of the different treatments. To provide a more differentiated picture of the relative improvement in substance use outcomes for different treatments, a second analysis examined 311 pre–post effect sizes measuring changes in substance use for adolescents in the separate treatment and comparison arms of the studies. The adolescents in almost all types of treatment showed reductions in substance use. The greatest improvements were found for family therapy and mixed and group counseling. Longer treatment duration was associated with smaller improvements, but other treatment characteristics and participant characteristics had little relationship to the pre–post changes in substance use. Based on these findings family therapy is the treatment with the strongest evidence of comparative effectiveness, although most types of treatment appear to be beneficial in helping adolescents reduce their substance use.

Van Ryzin, M. J., Roseth, C. J., Fosco, G. M., Lee, Y. K., & Chen, I. C. (2016). A component-centered meta-analysis of family-based prevention programs for adolescent substance use. Clinical Psychology Review, 45, 72-80.

Although research has documented the positive effects of family-based prevention programs, the field lacks specific information regarding why these programs are effective. The current study summarized the effects of family-based programs on adolescent substance use using a component-based approach to meta-analysis in which we decomposed programs into a set of key topics or components that were specifically addressed by program curricula (e.g., parental monitoring/behavior management, problem solving, positive family relations, etc.). Components were coded according to the amount of time spent on program services that targeted youth, parents, and the whole family; we also coded effect sizes across studies for each substance-related outcome. Given the nested nature of the data, we used hierarchical linear modeling to link program components (Level 2) with effect sizes (Level 1). The overall effect size across programs was .31, which did not differ by type of substance. Youth-focused components designed to encourage more positive family relationships and a positive orientation toward the future emerged as key factors predicting larger than average effect sizes. Our results suggest that, within the universe of family-based prevention, where components such as parental monitoring/behavior management are almost universal, adding or expanding certain youth-focused components may be able to enhance program efficacy.

 

 

 

September PD Blog

Professional development

You can add to the professional development post by commenting below or emailing the library.

Online resources

Webpage

The Cultural Atlas developed by SBS is an online educational resource that provides comprehensive cultural information on the countries that Australia’s biggest migrant populations have originated from. When working with young people and families of different cultural backgrounds to our own, it helps to develop a cultural reference to inform how you approach interactions. Part of practicing from a culturally competent framework is acknowledging the impact of culture. The Cultural Atlas includes a broad range of cultural information, for example common etiquette, religious considerations and greetings.

Read – professional reading

Available from the library database

George, A. M., & Zamboanga, B. L. (2018). Drinking game participation and outcomes in a sample of Australian university students. Drug and Alcohol Review37(5), 599-606.

Heiman, T., & Olenik Shemesh, D. (2018). Predictors of cyber-victimization of higher-education students with and without learning disabilities. Journal of Youth Studies, 1-18.

Hennessy, M. J., Patrick, J. C., & Swinbourne, A. L. (2018). Improving Mental Health Outcomes Assessment with the Mental Health Inventory‐21. Australian Psychologist, 53(4), 313-324.

Krakouer, J., Wise, S., & Connolly, M. (2018). “We Live and Breathe Through Culture”: Conceptualising Cultural Connection for Indigenous Australian Children in Out-of-home Care. Australian Social Work71(3), 1-12.

LaBrie, J. W., Boyle, S., Earle, A., & Almstedt, H. C. (2018). Heavy Episodic Drinking Is Associated With Poorer Bone Health in Adolescent and Young Adult Women. Journal of studies on alcohol and drugs, 79(3), 391-398.

Sharmin, S., Kypri, K., Wadolowski, M., Bruno, R., Khanam, M., Aiken, A., … & Attia, J. (2018). Parent characteristics associated with approval of their children drinking alcohol from ages 13 to 16 years: prospective cohort study. Australian and New Zealand Journal of Public Health42(4), 347-353.

Open Access Articles

Amodeo, A. L., Picariello, S., Valerio, P., & Scandurra, C. (2018). Empowering transgender youths: Promoting resilience through a group training program. Journal of Gay & Lesbian Mental Health, 22(1), 3-19.

Canham, S. L., Mahmood, A., Stalman, M. N., King, D., & O’Rourke, N. (2018). Personal theories of substance use among middle-aged and older adults with bipolar disorder. Aging & Mental Health, 22(6), 813-818.

Doñamayor, N., Strelchuk, D., Baek, K., Banca, P., & Voon, V. (2018). The involuntary nature of binge drinking: goal directedness and awareness of intention. Addiction Biology, 23(1), 515-526.

Tsirigotis, K., & Łuczak, J. (2018). Resilience in women who experience domestic violence. Psychiatric Quarterly, 89(1), 201-211.

Open access online journal

Produced by the Penington institute the Anex Bulletin is a specialty publication for workers in Australia’s needle and syringe programs (NSPs)

Useful resources

Tx! Mag is a free to download magazine about viral hepatitis which is published 3 times a year

Headspace has launched a national mental health campaign for young men called Headcoach.  Headcoach seeks to educate young men that maintaining their mental health is just as important as maintaining their physical health.  Some of Australia’s top athletes share stories, tips and advice from their own experiences to help educate young men about the importance of looking after their mental health and knowing when to ask for help.  These videos may be beneficial to show to young men to identify early warning signs and promote help-seeking for better mental health.

e-Book of the month

Out of this world: suicide examined by Antonia Murphy

This book is intended for anyone with either an interest in suicide or suicidal behaviour. It is not aimed solely at the professional psychotherapist but at a broad range of professionals who encounter suicidal people in their work. It is also intended for those of us who have been touched by suicide personally. The book approaches suicide from the point of view of the suicidal state of mind and is intended to help us understand more about this condition. In its essence suicide is examined as a largely unconscious aggressive act having its roots in a perceived or real experience of thwarted childhood needs. The wounds of the suicidal person are often long held and deep. The suicidal person is pursued by haunting losses and the suicidal act comes from deep disturbance created by this and from the idea of death as an acting out of some form of suicidal fantasy. The quasi delusional and split quality of the act is examined – namely that suicide is both an act for and against the self (from publisher).

Free to download for all HOA staff from the library catalogue on work computers

Attend – informal learning sessions, journal club, seminar series

Insight Queensland

Free training sessions at Biala Community Health Centre in Brisbane, unless otherwise specified including:

7 September, 8:30-16:00. AOD Clinical Assessment at Townsville. Prerequisite online induction module 4.

10 September, 9:00-16:30. Introduction to Withdrawal Management at Ipswich (Goodna)

11 September, 9:00-16:30. Advanced Harm Reduction at the Gold Coast (Southport)

Online induction modules are a prerequisite to some of the courses. To access and download them visit www.insightqld.org

Attend – conferences 

NDARC 2018 Annual Research Symposium: Clinical, Community and Policy Responses to Emerging Problems in Drug and Alcohol Use. October 8, 08:30-18:15 at UNSW, Sydney. Cost $275. For more details and registration click here

2018 NDRI Annual Symposium: Alcohol and Other Drug Research, Policy and Practice, November 22, 08:30-17:00 at Melbourne. Cost from $210. For more details and registration click here

Listen – podcasts, webinars

Podsocs: podcasts for social workers. An initiative of the School of Human Services and Social Work, Griffith University that consists of up-to-the minute research, diverse and sometimes controversial perspectives on social phenomena and focus on knowledge and skills needed in the human services.

Insight webinars. Wednesdays, 10:00-11:00 AEST

September 5: Domestic violence and its relationship with alcohol and drug abuse. Findings from the Queensland Death and Homicide Review board

September 12: Past, present and future in the regulation of prescription opioids

September 19: Testing times. Drug checking in the UK with “The Loop”

September 26: Opioids, scaling up the analgesic ladder wrong by wrong