Longitudinal Effects of Universal Preventive Intervention on Prescription Drug Misuse: Three Randomized Controlled Trials With Late Adolescents and Young Adults

Abstract

Objectives Examine long-term prescription drug misuse outcomes from three RCTs of brief universal preventive interventions conducted during middle school. Methods Study 1 tested the Iowa Strengthening Families Program (ISFP); 22 schools participated, with pretesting at grade 6 (1993) and outcomes measured at age 25. Study 2 evaluated a revised ISFP, renamed Strengthening Families Program: For Parents and Youth 10–14—SFP 10–14, plus the school-based Life Skills Training (SFP 10–14 + LST); 24 schools participated, with pretesting at grade 7 (1998) and outcomes at ages 21–25. Study 3 examined SFP 10–14 plus one of three school-based interventions selected from a menu (SFP 10–14 + School Program); 28 schools participated, with pretesting at grade 6 (2002) and outcomes at 12th grade. Self-reported outcomes were Prescription Opioid Misuse (POM) and Lifetime Prescription Drug Misuse Overall (PDMO). Results Study 1: ISFP showed significant effects on POM and PDMO, Relative Reduction Rates (RRRs) of 65%, and comparable benefits for higher- and lower-risk subgroups. Study 2: SFP 10–14 + LST showed significant or marginally-significant effects on POM/PDMO across all ages; higher-risk participants showed stronger effects (RRRs 43–79%). Study 3: significant results were found for POM/PDMO (RRRs 20–21%); higher-risk and lower-risk participants showed comparable outcomes. Conclusions Brief universal interventions have potential for public health impact by reducing prescription drug misuse among adolescents and young adults.

Prescription pain reliever misuse prevalence, correlates, and origin of possession throughout the life course

“…Second, individuals aged 18 to 25 were more likely than most other groups to possess pain reliever from friends/relatives or through purchase from a drug dealer/stranger. These findings offer further evidence towards interventions intended to communication and awareness among families about the negative consequences of distributing prescription painrelievers to others (Spoth, Trudeau, Shin, et al, 2013).…”

Principles of Precision Prevention Science for Improving Recruitment and Retention of Participants

“…Some of the variation in findings could be because demographics and broad risk factors are proxies for other factors that explain more of the variation in findings. Spoth et al (2013) proposed the Translation Science to Population Impact Framework (TSci Impact Framework) that illuminated the critical importance of examining the creation and implementation of evidence-based interventions at all phases, for different populations, and at all levels of the system. Aligned with this framework is the idea discussed in this paper to examine participant engagement with a similar systems lens.…”

“…The recommendations below align with the TSci Impact Framework including the connections between research and practice, the use of innovative designs, the inclusion of potential participants (and providers) in the earliest phases of development, and consumer or market analysis to examine both preferences and barriers for evidence-based interventions in communities to be successful and sustained (Spoth et al 2013). …”

“…Once a program is in the field continuous quality improvement, techniques can be used to monitor recruitment and retention and test strategies to address any issues (Spoth et al 2013). For example, testing different techniques for overcoming barriers to participation using miniRCTs leveraging existing program administrative data can efficiently optimize program administration (Mayer et al 2015).…”

A systematic review of strategies to improve appropriate use of opioids and to reduce opioid use disorder and deaths from prescription opioids

“…The results showed that those who attended the educational session were 1.8 times more likely to be discharged due to violation of the treatment agreement, and the explanation was that participants in the educational session could perceive a false sense of privilege becaus they had participated in their care beyond a typical first physician office visit. 90 Sixteen strategies had no effect on this outcome, 31,33,35,37,38,47,52,59,61,66,71,73,75,83,86,89 10 strategies had a small positive effect, 37,38,56,62,65,77,78,85,87,92 six strategies (seven studies) had a moderate positive effect, 34,40,44,58,80,95,97 and seven had a large positive effect, which included (1) a standard protocol for buprenorphine with naloxone for patients with low- The aim of study was to demonstrate noninferiority rather than superiority of the intervention.…”