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.