Preventing problematic substance use among youth

Background: Risk and protective factors for substance use disorders do not occur equally among young people. We identify factors that influence the development of substance use disorders as well as programs with the best potential for helping young people at risk. Methods: We used systematic review methods to identify randomized control trials (RCTs) evaluating interventions aimed to prevent problematic substance use among at-risk youth. Applying our inclusion criteria to the 82 studies identified from our searches, we accepted six RCTs evaluating five prevention interventions.Results: Three programs made a significant impact on substance use. CHAT reduced the negative consequences of young people’s alcohol and cannabis use. Middle School Success reduced the frequency of girls’ cannabis use. Across the two Preventure RCTs, the program reduced alcohol use and binge drinking frequency, drug use frequency and number of drugs used as well as alcohol use problems. In contrast, Brief Intervention and Strengthening Families did not have a significant impact on substance use. Conclusions: Even though many young people experiment with alcohol or cannabis, most do not develop problematic use. For those who are at-risk for their use escalating, there are effective interventions to curtail substance use. Moreover, by investing in effective prevention programs, unnecessary costs for young people, their families and society can be avoided.