Addressing Substance Abuse Disorders: A Systematic Review Of Evidence-Based Interventions And Efficacy Across Various Clinical Contexts

Abstract

Substance use disorders (SUDs) in adolescents and young adults is a major public health issue, with cannabis and alcohol use increasing. Interventions have included cognitive behavioural therapy (CBT), contingency management (CM), and technology-based interventions. This study examined the effectiveness of a variety of interventions, focusing on outcomes such as coping skills and substance use. A systematic review guided by the PRISMA 2020 checklist was performed, investigated studies published between 2013 and 2025 on the interventions to reduce substance use in adolescents and young adults. Eligible studies incorporated experimental, quasi-experimental, or longitudinal designs with measures of substance use outcomes. We searched PubMed, PsycINFO, and Scopus and identified 500 studies and 19 studies were determined to be eligible after screening. All studies were assessed for quality using the Joanna Briggs Institute (JBI) Critical Appraisal Tool, and found to narratively synthesise the findings. A variety of interventions were found, including MI, CBT, CM, and digital health apps. Most studies reported positive short-term outcomes, MI, CBT, and CM reported reductions in substance use and engagement. That said, motivational interviewing in psychiatric adolescents [2] and the A-CHESS app for adults with an Opioid Use Disorder [11] found positive effects. Some studies include mixed or negative effects, for instance, online school-based or harm reduction programmes [8]. Others are more concerning because they did not have a sustained effect, reinforcing the idea of utilising more bespoke and integrated approaches. Overall, the review suggests evidence of the effectiveness of interventions, particularly CBT and technology-based interventions, in decreasing substance use by adolescents and young adults. However, the differences in outcomes indicate a clear need to advance the research culture to develop and test more robust interventions; especially interventions with populations from diverse cultures while considering the growing evidence of the need to implement evidence-based interventions in a manner that is culturally relevant and responsive. In addition, it is paramount that researchers document and evaluate the long-term effects of substance use impact in their research. 1. INTRODUCTION Substance use disorders (SUDs) continue to be a major contributor to global disease burden, influencing individuals' physical health, psychological health and social functioning. The United Nations Office on Drugs and Crime estimates that in the last year, 296 million people, at least once, have used drugs, while over 39 million people had drug use disorders [34]. SUDs have high comorbidity with other mental disorders, unemployment, incarceration and early mortality. Regardless of our history of a war on substance use, we are still inundated with evidence of high relapse rates demonstrating the need for more effective evidence-based interventions; As a chronic, relapsing disorder, addiction operates on different dimensions that allow it to be treated in a multitude of manners with considerations tailored to the individual circumstances and needs of the person with an SUD. Improved evidence of the relative effectiveness of substance use interventions will improve treatment outcomes and contribute meaningful information. Psychosocial therapies (especially CBT) remain a critical influencing factor in the treatment of SUDs. CBT works toward changing the maladaptive thinking patterns and behaviours that help fuel substance use. In a meta-analysis of 53 studies performed by [16], CBT resulted in a small, but statistically significant, effect on the reduction of substance use when accompanied by other intervention approaches (i.e., MI). In a different recent study, [9], found that CBT was effective for reduction in the use of over a variety of substances, including alcohol, cannabis, or stimulants, as well as reducing relapse rates. Although a very widely used