Can Brief Alcohol Interventions for Youth Also Address Concurrent Illicit Drug Use: A Systematic Review and Meta-Analysis

Introduction: Alcohol and other illicit drug use are major public health concerns during the cricial develompental periods of adolescence and early adulthood. Brief interventions, defined as those delivered in a relatively circumscribed time frame, offer one promising approach for reducing alcohol and other drug use among youth.

Objectives: This systematic review and meta-analysis examined the effects of brief alcohol interventions for adolescents and young adults, some of which targeted only alcohol and others that also targeted illicit drug use during the intervention.

Methods: Studies eligible for inclusion in the systematic review were those using randomized or controlled quasi-experimental designs to examine the effects of brief alcohol interventions on illicit drug use outcomes among youth. A comprehensive literature search identified 30 eligible study samples that, on average, included participants age 17, with 57% male participants, and 56% White youth. Three-level random-effects meta-analyses using a structural equation modeling approach were used to estimate mean effect sizes and explore variability in effects.

Results: Overall, both brief alcohol and brief multi-target (i.e., alcohol and other illicit drug use) interventions were effective in reducing alcohol consumption (mean g  = 0.20, 95% CI [0.13, 0.26]; mean g = 0.17, 95% CI [0.05, 0.30], respectively). The brief interventions targeting only alcohol had no significant secondary effects on untargeted illicit drug use (mean g  = -0.00, 95% CI [-0.14, 0.13]). However, brief interventions targeting both alcohol and illicit drugs led to significant reductions in illicit drug use (mean g  = 0.13, 95% CI [0.03, 0.22]). For brief interventions targeting both alcohol and illicit drugs, there was no evidence that follow-up timing or intervention length were associated with effects on illicit drug use outcomes. However, among those interventions, those that focused on identifying high-risk drinking situations, provided information about the consequences of heavy drinking, or discussed moderation strategies for illicit drug use were associated with larger beneficial effects on subsequent illicit drug use.

Conclusions: In conclusion, brief interventions for youth yield modest beneficial effects on outcomes that are targeted by the interventions, but the evidence does not show that those effects generalize to untargeted illicit drug use outcomes.