Although the use of illicit drugs among persons aged 12 to 25 years is common, the United States Preventive Services Task Force (USPSTF) concludes that the current evidence available is insufficient to assess the benefits and harms of primary care-based behavioral counseling interventions to prevent drug use in this age group. The updated evidence report and recommendation statement were both published in JAMA.1,2
The current recommendation replaces the 2014 recommendation; the updated version includes more recent evidence as well as information for those aged 18 to 25 years.
To review the benefits and harms of interventions to prevent illicit and nonmedical drug use in this population, researchers reviewed MEDLINE, PubMED, PsycINFO, and the Cochrane Central Register of Controlled Trials. Critical appraisal was completed independently by 2 researchers; data were extracted by a single reviewer. The primary outcome was the number of times illicit drugs were used; illicit drugs included cannabis, inhalants, hallucinogens, amphetamines, prescription drugs used for nonmedical purposes, and heroin.
The total number of studies that met inclusion criteria was 29. After reviewing 26 studies that identified illicit drug use in nonpregnant youth, researchers found that the pooled result did not show a clinically important or statistically significant association with primary intervention measures that reduced illicit drug use.
The remaining 3 trials provided a perinatal home-visiting intervention to pregnant Native American youth; 1 trial found a reduction in illicit drug use (cannabis) at 38 months but not at earlier follow-up assessments. Little evidence was identified for interventions to prevent illicit drug use to improve health outcomes such as mortality, educational attainment, or legal outcomes.
Across all 29 trials, only 1 trial reported on harms and found no statistically significant group differences.
“Because of limited and inadequate evidence, the [USPSTF] concludes that the benefits and harms of primary care–based interventions to prevent illicit drug use in children, adolescents, and young adults are uncertain and that the evidence is insufficient to assess the balance of benefits and harms,” concluded the authors. “More research is needed.”
1. Krist AH, Davidson KW, Mangione CM, et al; US Preventive Services Task Force. Primary care-based interventions to prevent illicit drug use in children, adolescents, and young adults: US Preventive Services Task Force recommendation statement. JAMA. 2020;323(20):2060-2066.
2. O’Connor E, Thomas R, Senger CA, Perdue L, Robalino S, Patnode C. Interventions to prevent illicit and nonmedical drug use in children, adolescents, and young adults: Updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2020;323(20):2067–2079