Short-term intervention programs have potential to reduce teen methamphetamine use

Brief school- and family-based intervention programs may reduce methamphetamine use among adolescents, according to a report in the September issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

Methamphetamine use reached epidemic proportions in the United States by the mid-1990s, and use among adolescents has decreased but remained prevalent since then, according to background information in the article. The drug can impair social functioning and cause a wide variety of health problems. Teens in small towns and rural areas, including those in the Midwest, have been shown to be at higher risk for methamphetamine use. Because of the devastating consequences, prevention is key, the authors write; however, few studies have assessed the effect of preventive programs on the methamphetamine problem.

Richard L. Spoth, Ph.D., and colleagues at Iowa State University, Ames, conducted two studies of preventive programs involving rural public school students in the Midwest from 1993 to 2004. One program, Preparing for the Drug-Free Years, is a five-session course designed to enhance parent-child interaction and reduce the risk for early drug use. The seven-session Iowa Strengthening Families Program aims to promote healthy interactions among family members.

In the first study, 667 sixth-graders were assigned to a control group (208) or to one of the two programs (238 to Iowa Strengthening Families Program and 221 to Preparing for the Drug-Free Years). Of those, 457 families participated in a follow-up when the children were in 12th grade. In the second study, 679 seventh-graders were also divided into three groups: 226 completed a revised version of the Iowa Strengthening Families Program plus a separate program called Life Skills Training; 231 did Life Skills Training only; and 222 served as controls. In this study, 588 families were followed up in 11th grade and 597 in 12th grade.

Methamphetamine use rates among the control groups were similar to rates found in national surveys--in study one, five students (3.2 percent) of the 156 in the control group had used methamphetamines in the past year at the 12th-grade follow-up. In study two, 10 (5.2 percent) of the 193 control students reported ever having used methamphetamines by 11th grade, including eight (4.2 percent) who had used them in the past year; nine (4.6 percent) reported past-year use at the 12th-grade follow-up.

Preparing for the Drug-Free Years did not significantly reduce methamphetamine use; the Iowa Strengthening Families Program, with or without the Life Skills Training course, produced a statistically significant decrease in both short-term use and lifetime use; and Life Skills Training by itself was effective in addressing lifetime use. At the 12th-grade follow-up for study one, none of the students who had participated in the Iowa Strengthening Families Program and five (3.6 percent) of those participating in Preparing for the Drug-Free Years had used methamphetamines in the past year. In study two, among the students in the 11th grade completing the revised Iowa Strengthening Families Program plus Life Skills Training, one (.5 percent) reported using methamphetamines in the past year or ever using them and four (2.1 percent) reported past-year use in 12th grade; of those who completed Life Skills Training only, 5 (2.5 percent) reported using in the past year when asked in 11th grade and three (1.4 percent) reported using in the past year when asked in 12th grade.

"Given the lack of previous preventive intervention outcome research on methamphetamine use, the results of the current study are welcome, indicating the effectiveness of three of four universal interventions on lifetime or annual methamphetamine use across two randomized studies," the authors write. "It is noteworthy in this context that none of the interventions had content specific to the prevention of methamphetamine use; the observed intervention effects were obtained by addressing general risk and protective factors for drug use associated with family and school environments."

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(Arch Pediatr Adolesc Med. 2006;160:876-882. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: This study was supported by a research grant from the National Institute on Drug Abuse, by a grant from the National Institute of Mental Health and by a grant from the National Institute on Alcohol Abuse and Alcoholism. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

For more information, contact JAMA/Archives Media Relations at 312/464-JAMA (5262) or e-mail mediarelations@jama-archives.org.


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