best practice

A systematic review with no meta-analysis (Esrick et al 2018, 17 studies) found that scare tactics and fear-based messages may be effective in preventing substance misuse. The studies focused on campaigns addressing the use of tobacco, alcohol, cannabis, or methamphetamine.

Parental training, not associated with children training resulted in a narrative report of 9 studies (Bühler and Kröger, 2006):

• improved children’s educational behaviour;
• reduced children’s problem behaviour

MDFT was compared to IP in one study (INCANT study- N= 450, Rigter et al., 2012, cited in EMCDDA 2014) and was found to be more effective in:

• reducing the frequency of cannabis consumption in the high-severity MDFT group more than the corresponding IP group across assessments points (differential slope coefficient on treatment=3.8 [95% CI=1.4 to 7.6], p=0.002)
• reducing the prevalence of cannabis use disorders at 12-month follow-up. Namely, 38% of MDFT adolescents met the criteria for cannabis dependence and 33% for cannabis abuse, with 18% no longer having a cannabis disorder. In IP, the corresponding numbers were 52%, 22%, and 15% (differential slope coefficient on treatment=0.9 [95 % CI=0.2 to 1.7], p=0.015). 
• decreasing the number of dependence symptoms from baseline to 12-month follow-up. The 12-month symptoms average was 2.4 for MDFT (SD=2.0) and 3.0 for IP (SD=2.0). The drop in symptoms was larger in MDFT than in IP (differential slope coefficient on treatment=0.27 [95 % CI=0.13 to 0.41], p<0.001).
• retaining patients in treatment. A higher proportion (90%) of MDFT patients completed therapy in comparison to IP (48%) (OR=9.8 [95 % CI=5.7 to 16.7], p<0.001).

Combining CBT with antidepressants was found in a comprehensive review (EMCDDA 2015) to be effective in:

•    improving outcomes for comorbid opioid and anxiety disorders patients