The effectiveness of psychosocial interventions at reducing the frequency of alcohol and drug use in parents: findings of a Cochrane review and meta-analyses

Abstract

Background and aim: Parental substance use is a major public health and safeguarding concern. There have been a number of trials examining interventions targeting this risk factor. We aimed to estimate the effectiveness of psychosocial interventions at reducing parental substance use. Design: Meta-analysis. We used systematic methods to identify trials of psychosocial interventions including those that targeted drug and alcohol use only, and drug and alcohol use in combination with associated issues. We pooled data using a random-effects model. Moderator analyses examined influence of parent gender, presence of child in treatment, and intervention type. Setting: No restrictions on setting. Participants: Substance using parents of children below the age of 21 years. Measurements: Frequency of alcohol use and frequency of drug use. Findings: We included 8 unique studies with a total of 703 participants. Psychosocial interventions were more effective at reducing the frequency of parental alcohol use than comparison conditions at 6-month (standardised mean difference [SMD] - 0.32, 95% confidence interval [CI] -0.51 to -0.13, P = 0.001) and 12-month follow-up (SMD -0.25, 95% CI -0.47 to -0.03, P = 0.02), and frequency of parental drug use at 12 months only (SMD-0.21, 95% CI -0.41 to -0.01, P = 0.04). Integrated interventions which combined both parenting and substance use targeted components were effective at reducing the frequency of alcohol use (6 months: SMD -0.56, 95% CI -0.96 to -0.016, P = 0.006; 12 months: SMD -0.42, 95% CI -0.82 to -0.03, P = 0.04) and drug use (6 months: SMD -0.39, 95% CI -0.75 to -0.03, P = 0.04; 12 months: SMD -0.43, 95% CI -0.80 to -0.07, P = 0.02). Interventions targeting only substance use or parenting skills were not effective at reducing frequency of alcohol or drug use at either time point. Conclusion: Integrated psychosocial interventions targeting parenting and substance use may be superior at reducing parental alcohol and drug use than treatment as usual or other comparison conditions.