Digital interventions for substance use disorders in young people: rapid review

Abstract

Background Young people are disproportionately more likely than other age groups to use substances. The rise in substance use and related harms, including overdose, during the Covid-19 pandemic has created a critical need for more innovative and accessible substance use interventions. Digital interventions have shown effectiveness and can provide more engaging, less stigmatizing, and accessible interventions that meet the needs of young people. This review provides an overview of recent literature on the nature of recently published digital interventions for young people in terms of technologies used, substances targeted, intended outcomes and theoretical or therapeutic models employed. Methods Rapid review methodology was used to identify and assess the literature on digital interventions for young people. An initial keyword search was conducted using MEDLINE the Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment Database (HTA) and PROSPERO for the years 2015–2020, and later updated to December 2021. Following a title/abstract and full-text screening of articles, and consensus decision on study inclusion, the data extraction process proceeded using an extraction grid developed for the study. Data synthesis relied on an adapted conceptual framework by Stockings, et al. that involved a three-level treatment spectrum for youth substance use (prevention, early intervention, and treatment) for any type of substance. Results In total, the review identified 43 articles describing 39 different digital interventions. Most were early interventions (n = 28), followed by prevention interventions (n = 6) and treatment interventions (n = 5). The identified digital technologies included web-based (n = 14), game-based (n = 10), mobile-based (n = 7), and computer-based (n = 5) technologies, and virtual reality (n = 3). Most interventions targeted alcohol use (n = 20) followed by tobacco/nicotine (n = 5), cannabis (n = 2), opioids (n = 2), ketamine (1) and multiple, or any substances (n = 9). Most interventions used a personalized or normative feedback approach and aimed to effect behaviour change as the intended outcome. Interestingly, a harm reduction approach guided only one of the 39 interventions. Conclusions While web-based interventions represented the most common type of technology, more recently developed immersive and interactive technologies such as virtual reality and game-based interventions call for further exploration. Digital interventions focused mainly on alcohol use, reflecting less concern for tobacco, cannabis, co-occurring substance use, and illicit drug use. Specifically, the recent exacerbation in the opioid crisis throughout North American underlines the urgent need for more prevention-oriented digital interventions for opioid use. The uptake of digital interventions among youth also depends on the incorporation of harm reduction approaches.

Leveraging Natural Language Processing to Evaluate Young Adults’ User Experiences with a Digital Sleep Intervention for Alcohol Use

“…Our study suggests that digital interventions improving overall health may represent a more appealing treatment approach to young adults for potentially stigmatizing diagnoses, such as AUDs. Most available digital SUD interventions for young adults involve web-based advice explicitly targeting alcohol use to the exclusion of other substance use or wellness factors 27 . Whereas young adults may not be concerned about alcohol use or seek traditional alcohol treatment 5 , they are concerned about improving sleep quality 6,8 and other aspects of their general wellness.…”

Prevalence of alcohol use and associated factors since COVID-19 among school-going adolescents within the Southern African Development Community: a systematic review protocol

“…The consumption of alcohol by adolescents is a significant public health concern due to its adverse impact on their physical and mental well-being 2 7. Notably, recent studies have shown that there has been an increase in alcohol use among school-going adolescents during the COVID-19 lockdown period 8 9. While several efforts have been made globally (during and in the post-COVID-19 era) to control and prevent adolescent alcohol (mis)use, the problem persists 10–12…”

Prevalence of probable substance use disorders among children in Ugandan health facilities

“…Furthermore, a systematic review found that those who begin using substances before age 13 years are much more likely to frequently drink to intoxication or die from an overdose [ 20 , 21 ]. These children and adolescents also often exhibit behaviours that pose a risk to themselves and others, such as being injured in fights and suicide attempts and experimenting with risky sexual behaviour [ 22 – 25 ].…”