adolescents

Importance: Symptoms of obstructive sleep apnea are common in childhood and associated with significant comorbidity. Surgical treatment with adenotonsillectomy is first-line treatment but medical treatments show potential to improve symptoms and reduce the need for surgery.

Objective: To determine the efficacy of 6 weeks of intranasal steroid (INS) compared with saline in children with obstructive sleep-disordered breathing (OSDB) with persistent symptoms after a 6-week intranasal saline run-in.

Design, setting, and participants: This was a double-blind, placebo-controlled, randomized clinical trial involving specialist clinic waitlists at 2 sites in Australia. Included were children aged 3 to 12 years. Study data were analyzed from January to June 2025.

Interventions: All children received once-daily intranasal saline for 6 weeks (run-in). Those with persisting symptoms (SDB score ≥-1) were randomized to either once-daily intranasal mometasone furoate, 50 µg, (INS) or continued saline for a further 6 weeks.

Main outcomes and measures: The primary outcome was symptom resolution (SDB score <-1). Secondary outcomes included behavior, quality of life, and parental perception of need for surgery. Analyses were adjusted for site and baseline measures.

Results: A total of 150 children (mean [SD] age, 6.2 [2.3] years; 93 male [62%]) were recruited. Of 139 children who completed the run-in phase, 41 (29.5%) had symptom resolution after saline run-in. Among 93 children randomized to intervention groups (47 INS; 46 saline), symptom resolution occurred in 35.6% (95% CI, 22.9%-50.6%) and 36.4% (95% CI, 23.5%-51.6%) of the INS and saline group, respectively, with no evidence for a clinically significant difference between groups (risk difference, -0.9%; 95% CI, -20.7% to 19.0%; P = .93). No group differences were found in secondary outcomes. Subgroup analysis did not reveal a group more or less likely to respond to medical treatment.

Conclusions and relevance: Results of this randomized clinical trial show that 6 weeks of intranasal saline resolved OSDB symptoms in nearly one-third of children. An additional 6-week course of INS or saline led to resolution in another one-third (total resolution around 50%), with no added benefit from INS. Intranasal saline is an effective short-term first-line treatment for OSDB before consideration of polysomnography or surgical intervention. Results suggest that saline should be recommended for 3 months before assessing the need for specialist referral.

Trial registration: ClinicalTrials.gov Identifier: NCT05382494.

Author/s:

Gillian M. Nixon, Deborah Anderson, Alice Baker

What Parents Need to Know About Sleep in Children

Megan George — Tue, 06 Jan 2026 14:26:08 +0000

Date Added:

January 6, 2026

Journal/Publication:

JAMA Pediatrics

Publication Date:

December 22, 2025

URL:

What Parents Need to Know About Sleep in Children

Type:

Patient Education Materials

Format:

Poster

DOI (1):

10.1001/jamapediatrics.2025.5376

Keywords

PMID (1):

41428340

MeSH

sleep initiation and maintenance disorders

Information for parents about sleep in children. James W. Mold, MD, MPH

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Half of all children have sleep issues at some point during childhood.

When a child does not sleep well, the entire family feels the impact. Sleep supports growth and development and prevents other illnesses. Poor sleep can lead to daytime irritability, trouble focusing, behavioral issues, and learning difficulties. Poor sleep is also associated with long-term problems, such as obesity, breathing problems, and heart problems.

Childhood sleep problems fall into 4 main categories. The most common is behavioral insomnia. This happens when a child has trouble falling or staying asleep, often because they need a specific habit or aid (like rocking or feeding) to settle. Without this help, they struggle to soothe themselves to sleep.

A second category is parasomnias, which are sleep disturbances like night terrors, sleepwalking, and teeth grinding. Night terrors are sudden episodes in which a child screams or appears panicked early in the night. While frightening to witness, the child is unaware of the episode and will have no memory of it. These are usually harmless and temporary.

A third category is bed-wetting, which is also common up to around age 7 years and is usually normal. If it continues regularly after that, discuss with a health care professional to rule out underlying issues or find strategies to help.

Sleep apnea is the final category and is a more serious condition involving repeated pauses in breathing during sleep. Sleep apnea can be caused by enlarged tonsils or excess weight. Children may snore loudly, gasp, or appear restless at night. This disrupted sleep can affect their mood, behavior, and ability to learn. Some children may need overnight sleep studies to diagnose sleep apnea and provide interventions to decrease lifetime illness.

Speak to your child’s pediatrician if you have concerns. Note if your child snores loudly 3 or more nights per week, especially if they gasp or choke during sleep. Excessive daytime sleepiness, frequent headaches or stomachaches, or sleep consistently lasting less than the recommended amount (less than 9 hours for school-aged children) are also signs that your child may have a more serious sleep condition.

All sleep problems need attention. The best way to support better sleep is to create consistent routines that support sleep, known as good sleep hygiene. Keep the same bedtime and waking time every day, including weekends. Establish a calm wind-down routine (like a bath or quiet reading) for 20 to 45 minutes before bed. Turn off all screens and end exciting activities at least 1 hour before bedtime, and make sure the bedroom is cool, dark, and quiet without televisions and screens. Pay attention to both nighttime signs (like snoring or waking) and daytime behaviors (like crankiness, trouble concentrating, or hyperactivity). For children who have trouble falling asleep on their own, put them to bed when they are drowsy but still awake so they learn how to independently fall asleep. They will need this skill every time they wake up in the middle of the night, which could happen 2 to 3 times. With consistency, many sleep issues improve, helping your child rest well at night and feel their best during the day.

Author/s:

Cynthia-Mae M Hunt, Lindsay A Thompson

Diagnosis and management of depression in adolescents

Alex Haga — Wed, 06 Nov 2024 14:34:56 +0000

Date Added:

November 6, 2024

Journal/Publication:

Canadian Medical Association Journal

Publication Date:

May 29, 2023

Issue:

Volume:

195

Pages:

E739-E746

URL:

Diagnosis and management of depression in adolescents

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1503/cmaj.220966

Keywords

PMID (1):

37247881

MeSH

depression

child

A concise review of the diagnosis and treatment of adolescents who are depressed. James W. Mold, MD, MPH

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KEY POINTS
Depression is common among adolescents in Canada and has the potential to negatively affect long-term function and quality of life; despite this, in most affected adolescents depression remains undetected and untreated.

Management requires a multimodal approach, including risk assessment, psychoeducation, psychotherapeutic and pharmacologic treatment, and interventions to address contributing factors.

Support from child and adolescent psychiatrists may be required in the case of diagnostic uncertainty and complex presentations, as well as for patients who do not respond to first-line treatments.

Author/s:

Daphne J Korczak, Clara Westwell-Roper, Roberto Sassi

Obesity in Adolescents: A Review

Alex Haga — Sat, 10 Aug 2024 18:21:58 +0000

Date Added:

August 10, 2024

Journal/Publication:

JAMA

Publication Date:

August 5, 2024

URL:

Obesity in Adolescents: A Review

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2024.11809

Keywords

PMID (1):

39102244

MeSH

cardiovascular diseases

diabetes mellitus

diabetes mellitus, type 2

depression

Life Style

exercise

A review of obesity management in adolescents. James W. Mold, MD, MPH

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Importance: Obesity affects approximately 21% of US adolescents and is associated with insulin resistance, hypertension, dyslipidemia, sleep disorders, depression, and musculoskeletal problems. Obesity during adolescence has also been associated with an increased risk of mortality from cardiovascular disease and type 2 diabetes in adulthood.

Observations: Obesity in adolescents aged 12 to younger than 18 years is commonly defined as a body mass index (BMI) at the 95th or greater age- and sex-adjusted percentile. Comprehensive treatment in adolescents includes lifestyle modification therapy, pharmacotherapy, and metabolic and bariatric surgery. Lifestyle modification therapy, which includes dietary, physical activity, and behavioral counseling, is first-line treatment; as monotherapy, lifestyle modification requires more than 26 contact hours over 1 year to elicit approximately 3% mean BMI reduction. Newer antiobesity medications, such as liraglutide, semaglutide, and phentermine/topiramate, in combination with lifestyle modification therapy, can reduce mean BMI by approximately 5% to 17% at 1 year of treatment. Adverse effects vary, but severe adverse events from these newer antiobesity medications are rare. Surgery (Roux-en-Y gastric bypass and vertical sleeve gastrectomy) for severe adolescent obesity (BMI ≥120% of the 95th percentile) reduces mean BMI by approximately 30% at 1 year. Minor and major perioperative complications, such as reoperation and hospital readmission for dehydration, are experienced by approximately 15% and 8% of patients, respectively. Determining the long-term durability of all obesity treatments warrants future research.

Conclusions and relevance: The prevalence of adolescent obesity is approximately 21% in the US. Treatment options for adolescents with obesity include lifestyle modification therapy, pharmacotherapy, and metabolic and bariatric surgery. Intensive lifestyle modification therapy reduces BMI by approximately 3% while pharmacotherapy added to lifestyle modification therapy can attain BMI reductions ranging from 5% to 17%. Surgery is the most effective intervention for adolescents with severe obesity and has been shown to achieve BMI reduction of approximately 30%.

Author/s:

Aaron S Kelly, Sarah C Armstrong, Marc P Michalsky, Claudia K Fox

Interventions for High Body Mass Index in Children and Adolescents: US Preventive Services Task Force Recommendation Statement

Alex Haga — Sun, 23 Jun 2024 19:40:54 +0000

Date Added:

June 23, 2024

Journal/Publication:

US Preventive Services Task Force

Publication Date:

June 18, 2024

URL:

Interventions for High Body Mass Index in Children and Adolescents: US Preventive Services Task Force Recommendation Statement

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2024.11146

Keywords

PMID (1):

38888912

MeSH

body mass index

Growth Charts

weight loss

New USPSTF recommendation regarding treatment of obesity in children and adolescents. James W. Mold, MPH

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Importance: Approximately 19.7% of children and adolescents aged 2 to 19 years in the US have a body mass index (BMI) at or above the 95th percentile for age and sex, based on Centers for Disease Control and Prevention growth charts from 2000. The prevalence of high BMI increases with age and is higher among Hispanic/Latino, Native American/Alaska Native, and non-Hispanic Black children and adolescents and children from lower-income families.

Objective: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the evidence on interventions (behavioral counseling and pharmacotherapy) for weight loss or weight management in children and adolescents that can be provided in or referred from a primary care setting.

Population: Children and adolescents 6 years or older.

Evidence assessment: The USPSTF concludes with moderate certainty that providing or referring children and adolescents 6 years or older with a high BMI to comprehensive, intensive behavioral interventions has a moderate net benefit.

Recommendation: The USPSTF recommends that clinicians provide or refer children and adolescents 6 years or older with a high BMI (≥95th percentile for age and sex) to comprehensive, intensive behavioral interventions. (B recommendation).

Author/s:

Wanda K Nicholson, US Preventive Services Task Force, Michael Silverstein, John B Wong, David Chelmow, Tumaini Rucker Coker, Esa M Davis, Katrina E Donahue

Marijuana and Youth: The Impact of Marijuana Use on Teen Health and Wellbeing

Erin Blanchette — Thu, 07 Mar 2024 02:26:51 +0000

Date Added:

March 6, 2024

Publisher:

Centers for Disease Control and Prevention

URL:

Marijuana and Youth: The Impact of Marijuana Use on Teen Health and Wellbeing

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Web Page

Keywords

marijuana

recreational marijuana

MeSH

A concise summary of what is known about use and abuse of marijuana by teenagers. James W. Mold, MD, MPH

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National Cannabis Awareness Month is observed in April to increase awareness and education about marijuana. While scientists are still learning about the risks and benefits of using marijuana, we know that marijuana use can harm a teen’s health and wellbeing.

NIAAA for Middle School

Erin Blanchette — Mon, 19 Feb 2024 16:29:17 +0000

Date Added:

February 19, 2024

Publisher:

National Institute of Health

URL:

NIAAA for Middle School

Type:

Patient Education Materials

Format:

Web Page

Keywords

MeSH

national institute on alcohol abuse and alcoholism (U.S.)

alcoholism

Parents

caregivers

Guidance for families with middle school children regarding prevention of alcohol use and abuse. James W. Mold, MD, MPH

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Underage drinking is a significant public health problem in the United States.

This webpage contains interactive activities to help parents, caregivers, and teachers introduce and reinforce key messages about peer pressure, resistance skills, and other important topics related to underage drinking.

These engaging activities are designed for middle schoolers ages 11 to 13. They can be used at home, in classrooms, or in after-school programs.

The content is based on a curriculum for grades 6–8 developed by the University of Michigan. The curriculum was created for the Alcohol Misuse Prevention Study (AMPS), a large-scale project supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

One goal of AMPS was to give students a clearer picture about alcohol use among their peers. Many middle schoolers tend to overestimate how much other students their age really drink. When they learn more accurate information, some of the pressure to drink can subside. Other goals of AMPS were to help students learn skills to resist pressure to drink and to give them reasons not to drink. This site incorporates AMPS goals in these and other features.

This website contains three sections focused on different aspects of alcohol, peer pressure, and resistance skills, followed by a resource list in section 4. The first three sections contain an overview, handouts, and role-playing exercises. The overviews provide background information to help you prepare to discuss alcohol and peer pressure with middle schoolers. The handouts are designed to be given to middle schoolers. The role-playing exercises are designed to be led by an adult and consist of two parts—a guide for the adult leader and a script for the middle schooler to read aloud.

Immunization Schedules

Erin Blanchette — Mon, 27 Nov 2023 18:53:02 +0000

Date Added:

January 31, 2024

Journal/Publication:

National Center for Immunization and Respiratory Diseases

Publisher:

U.S. Department of Health & Human Services

Publication Date:

November 16, 2023

URL:

Immunization Schedules

Type:

Public Health Announcements

Format:

Web Page

Keywords

Immunization Schedule

MeSH

Immunization Schedule

child

Adult

2024 Immunization guidelines from CDC. James W. Mold, MD, MPH

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Child, adolescent, and adult immunization schedules from the CDC for 2024.

Diagnosis and management of depression in adolescents

Aubrey Delammermore — Wed, 31 May 2023 05:00:00 +0000

Date Added:

May 31, 2023

Journal/Publication:

CMAJ

Publisher:

CMA Impact Inc

Publication Date:

May 29, 2023

Issue:

Volume:

195

Pages:

E739-E746

URL:

Diagnosis and management of depression in adolescents

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1503/cmaj.220966

Keywords

depression

diagnosis and management

adolescents

adolescent psychiatry

quality of life

PMID (1):

37247881

MeSH

Humans

adolescent

Depression* / diagnosis

Depression* / therapy

Psychotropic Drugs

A concise review of what we know about screening and treatment of adolescents suffering with depression. James W. Mold, MD, MPH

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Depression is common among adolescents in Canada and has the potential to negatively affect long-term function and quality of life; despite this, in most affected adolescents depression remains undetected and untreated.

Management requires a multimodal approach, including risk assessment, psychoeducation, psychotherapeutic and pharmacologic treatment, and interventions to address contributing factors.

Support from child and adolescent psychiatrists may be required in the case of diagnostic uncertainty and complex presentations, as well as for patients who do not respond to first-line treatments.

Author/s:

Korczak, D. J., Westwell-Roper, C., Sassi, R.

Dynamics of Naturally-Acquired Immunity Against SARS-CoV-2 in Children and Adolescents

Aubrey Delammermore — Sat, 04 Mar 2023 06:00:00 +0000

Date Added:

March 4, 2023

Journal/Publication:

The Journal of Pediatrics

Publisher:

Elsevier

Publication Date:

March 2, 2023

URL:

Dynamics of Naturally-Acquired Immunity Against SARS-CoV-2 in Children and Adolescents

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1016/j.jpeds.2023.02.016

Keywords

COVID-19

SARS-CoV-2

waning immunity

naturally aquired immunity

infection-induced immunity

MeSH

retrospective studies

Children and adolescents appear to develop long-lasting immunity after natural infection with COVID-19. James W. Mold, MD, MPH

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Background
To evaluate the duration of protection against reinfection conferred by a previous SARS-CoV-2 infection in children and adolescents.
Methods
We applied two complementary approaches: a matched test-negative, case-control design and a retrospective cohort design. 458,959 unvaccinated individuals aged 5-18 years were included. Analyses focused on July 1 to December 13, 2021, a period of Delta variant dominance in Israel. We evaluated three SARS-CoV-2-related outcomes: documented PCR confirmed infection or reinfection, symptomatic infection or reinfection, and SARS-CoV-2-related hospitalization or death.
Findings
Overall, children and adolescents who were previously infected acquired durable protection against reinfection with SARS-CoV-2 for at least 18 months. Importantly, no SARS-CoV-2-related deaths were recorded in either the SARS-CoV-2 naïve group or the previously infected group. Effectiveness of naturally-acquired immunity against a recurrent infection reached 89.2% (95% CI: 84.7%-92.4%) three to six months after first infection, mildly declining to 82.5% (95% CI, 79.1%-85.3%) 9-12 months after infection, with a slight non-significant waning trend up to 18 months after infection. Additionally, we found that ages 5-11 years exhibited no significant waning of naturally acquired protection throughout the outcome period, whereas waning protection in the 12-18 year-old age group was more prominent, but still mild.
Interpretation
Children and adolescents who were previously infected with SARS-CoV-2 remain protected to a high degree for 18 months. Further research is needed to examine naturally-acquired immunity against Omicron and newer emerging variants.

Author/s:

Patalon, T., Saciuk, Y., Perez, G., Peretz, A., Ben-Tov, A., Gazit, S.

Screening for Depression and Suicide Risk in Children and Adolescents

Rowan Hutchins — Sun, 16 Oct 2022 05:00:00 +0000

Date Added:

October 16, 2022

Journal/Publication:

JAMA

Publisher:

US Department of Preventative Services

Publication Date:

October 11, 2022

Pages:

E1 - E9

URL:

Screening for Depression and Suicide Risk in Children and Adolescents

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2022.16946

Keywords

depression screening

adolescents

PMID (1):

36219439

MeSH

adolescent

Adolescent Psychiatry

child

depression

Depressive Disorder

USPSTF recommends screening adolescents (age 12 – 18) for depression and suicide risk. James W. Mold, MD, MPH

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Depression is a leading cause of disability in the US. Children and adolescents with depression typically have functional impairments in their performance at school or work as well as in their interactions with their families and peers. Depression can also negatively affect the developmental trajectories of affected youth. Major depressive disorder (MDD) in children and adolescents is strongly associated with recurrent depression in adulthood; other mental disorders; and increased risk for suicidal ideation, suicide attempts, and suicide completion. Suicide is the second-leading cause of death among youth aged 10 to 19 years. Psychiatric disorders and previous suicide attempts increase suicide risk.

Author/s:

Jin, Jill

Screening for Anxiety in Adolescent and Adult Women: A Recommendation From the Women's Preventive Services Initiative

Brian Desmarais — Fri, 12 Jun 2020 19:58:10 +0000

Date Added:

June 12, 2020

Journal/Publication:

Annals of Internal Medicine

Publication Date:

June 9, 2020

URL:

Screening for Anxiety in Adolescent and Adult Women: A Recommendation From the Women's Preventive Services Initiative

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.7326/M20-0580

Keywords

Health services administration and management

The Women’s Preventive Services Initiative (WPSI) recommends screening for anxiety in women and adolescent girls aged 13 years or older who are not currently diagnosed with anxiety disorders, including pregnant and postpartum women. Optimal screening intervals are unknown, and clinical judgment should be used to determine frequency. When screening suggests the presence of anxiety, further evaluation is necessary to establish the diagnosis and determine appropriate treatment and follow-up. James W. Mold, MD, MPH

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Abstract

Description: The Women's Preventive Services Initiative (WPSI), a national coalition of women's health professional organizations and patient representatives, developed a recommendation on screening for anxiety in adolescent and adult women to improve detection; achieve earlier diagnosis and treatment; and improve health, function, and well-being. The WPSI's recommendations are intended to guide clinical practice and coverage of services for the Health Resources and Services Administration and other stakeholders. The target audience for this recommendation includes all clinicians providing preventive health care to women, particularly in primary care settings. This recommendation applies to women and adolescent girls aged 13 years or older who are not currently diagnosed with anxiety disorders, including pregnant and postpartum women.

Methods: The WPSI developed this recommendation after evaluating results of a systematic review of the effectiveness of screening, accuracy of screening instruments, and benefits and harms of treatments in adolescent girls and adult women. No studies directly evaluated the overall effectiveness or harms of screening for anxiety. Twenty-seven screening instruments and their variations were moderately to highly accurate in identifying anxiety (33 individual studies and 2 systematic reviews; 171 studies total). Symptoms improved and relapse rates decreased with psychological therapies (246 randomized controlled trials [RCTs] in 5 systematic reviews) and with selective serotonin reuptake inhibitors or selective serotonin and norepinephrine reuptake inhibitors (126 RCTs in 3 systematic reviews). The WPSI also considered the effect of screening on symptom progression and identification of associated and underlying conditions, as well as implementation factors.

Recommendation: The WPSI recommends screening for anxiety in women and adolescent girls aged 13 years or older who are not currently diagnosed with anxiety disorders, including pregnant and postpartum women. Optimal screening intervals are unknown, and clinical judgment should be used to determine frequency. When screening suggests the presence of anxiety, further evaluation is necessary to establish the diagnosis and determine appropriate treatment and follow-up.

Keywords: Adolescents; Anxiety; Anxiety disorders; Forecasting; Health services administration and management; Quality of life; Questionnaires; Reuptake inhibitors; Serotonin; Systematic reviews.

Author/s:

Gregory, K.D., Chelmow, C., Nelson, H.D., Sayres Van Niel, M., Conry, J.A., Garcia, F., Kendig, S.M., O'Reilly, N., Qaseem, A., Ramos, D., Salganicoff , A., Son, S., Wood, J.K, Zahn, C.

Interventions for Substance Use Disorders in Adolescents: A Systematic Review. Comparative Effectiveness Review No. 225

John Bayhi — Tue, 26 May 2020 22:01:32 +0000

Date Added:

May 26, 2020

Journal/Publication:

AHRQ Publication No. 20-EHC014

Publisher:

Agency for Healthcare Research and Quality

Publication Date:

May 21, 2020

URL:

Interventions for Substance Use Disorders in Adolescents: A Systematic Review. Comparative Effectiveness Review No. 225

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.23970/AHRQEPCCER225

Keywords

substance use disorder

adolescents

alcohol use disorder

cannabis use

motivational interviewing

pharmacological interventions

A concise summary of the findings of a systematic review of interventions to address substance misuse in adolescents. James W. Mold, MD, MPH

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Objectives. This systematic review (SR) synthesizes the literature on behavioral, pharmacologic, and combined interventions for adolescents ages 12 to 20 years with problematic substance use or substance use disorder. We included interventions designed to achieve abstinence, reduce use quantity and frequency, improve functional outcomes, and reduce substance-related harms.

Data sources. We conducted literature searches in MEDLINE, the Cochrane CENTRAL Trials Registry, Embase, CINAHL, and PsycINFO to identify primary studies meeting eligibility criteria through November 1, 2019.

Review methods. Studies were extracted into the Systematic Review Data Repository. We categorized interventions into seven primary intervention components: motivational interviewing (MI), family focused therapy (Fam), cognitive behavioral therapy (CBT), psychoeducation, contingency management (CM), peer group therapy, and intensive case management. We conducted meta-analyses of comparative studies and evaluated the strength of evidence (SoE). The PROSPERO protocol registration number is CRD42018115388 .

Results. The literature search yielded 33,272 citations, of which 118 studies were included. Motivational interviewing reduced heavy alcohol use days by 0.7 days/month, alcohol use days by 1.2 days/month, and overall substance use problems by a standardized mean difference of 0.5, compared with treatment as usual. Brief MI did not reduce cannabis use days (net mean difference of 0). Across multiple intensive interventions, Fam was most effective, reducing alcohol use days by 3.5 days/month compared with treatment as usual. No intensive interventions reduced cannabis use days. Pharmacologic treatment of opioid use disorder led to a more than 4 times greater likelihood of abstinence with extended courses (2 to 3 months) of buprenorphine compared to short courses (14 to 28 days).

Conclusions. Brief interventions: MI reduces heavy alcohol use (low SoE), alcohol use days (moderate SoE), and substance use–related problems (low SoE) but does not reduce cannabis use days (moderate SoE). Nonbrief interventions: Fam may be most effective in reducing alcohol use (low SoE). More research is needed to identify other effective intensive behavioral interventions for alcohol use disorder. Intensive interventions did not appear to decrease cannabis use (low SoE). Some interventions (CBT, CBT+MI, and CBT+MI+CM) were associated with increased cannabis use (low SoE). Both MI and CBT reduce combined alcohol and other drug use (low SoE). Combined CBT+MI reduces illicit drug use (low SoE). Subgroup analyses of interest (male vs. female, racial and ethnic minorities, socioeconomic status, and family characteristics) were sparse, precluding conclusions regarding differential effects. Pharmacological interventions: longer courses of buprenorphine (2–3 months) are more effective than shorter courses (14–28 days) to reduce opioid use and achieve abstinence (low SoE). SRs in the college settings support use of brief interventions for students with any use, heavy or problematic use. More research is needed to identify the most effective combinations of behavioral and pharmacologic treatments for opioid, alcohol, and cannabis use disorders.

Author/s:

Steele, CW, Becker, SJ, Danko, KJ, Balk, EM, Saldanha, IJ, Adam, GP, Bagley, SM, Friedman, C, Spirito, A, Scott, K, Ntzani, EE, Saeed, I, Smith, B, Popp, J, Trikalinos, TA