Lower Levels Of Substance Use Research Articles

Severity and Number of Substances Used are Independently Associated with Antiretroviral Therapy Adherence Over Time among People with HIV in the Current Treatment Era.

Substance use is associated with decreased antiretroviral therapy (ART) adherence among people with HIV (PWH). Adherence plays a significant role in mediating the negative effects of substance use on HIV suppression and is a principal modifiable patient-level factor in improving HIV suppression and reducing ART drug resistance. Understanding substance use and ART adherence, particularly with rapidly changing substance use epidemiology and ART regimens, is vital to improving HIV care. Among 10,557 PWH (2010-2021) from 8 academic clinical sites nationally we examined longitudinal associations of substance use severity and number of substances used (measured using AUDIT-C and modified ASSIST) with patient-reported ART adherence (visual analog scale). Alcohol (68% any use, 18% unhealthy use [AUDIT-C > 4 men, > 3 women]), marijuana (33%), and methamphetamine (9%) use were most reported. Polysubstance use was common (32%). Both higher severity substance use and higher number of substances used were associated with lower ART adherence. Severity of methamphetamine use had the strongest dose-response association with ART adherence (low severity [ASSIST 1-3]: -3.05%, 95% CI: -4.23%, -1.87%; moderate [ASSIST 4-26]: -6.20%, 95% CI: -7.08%, -5.33%; high [ASSIST > 26]: -10.77%, 95% CI: -12.76%, -8.78%). Severe substance use, especially methamphetamine, and higher number of illicit drugs used were associated with declines in adherence at levels that were likely clinically meaningful in the modern era of ART. Findings support integrating substance use care with HIV care and potential benefits of harm reduction strategies for improving adherence such as encouraging lower levels of substance use and fewer number of substances used.

Family Disadvantage, Education, and Health Outcomes Among Black Youths Over a 20-Year Period

Upward mobility (via educational attainment) is highly valued, but longitudinal associations with mental and physical health among Black youths are less understood. To examine associations of childhood family disadvantage and college graduation with adult mental and physical health in Black youths followed up into adulthood. This longitudinal, prospective cohort study of Black youths from the state of Georgia who were studied for 20 years (ages 11 to 31 years) was conducted between 2001 and 2022. Participants for this study were drawn from the Strong African American Healthy Adults Program. Data analysis was conducted from April 2023 to January 2024. Family economic disadvantage (measured during the adolescent years) and college graduation (indicating upward mobility). Primary outcomes included mental health, substance use, and physical health. Mental health included a composite of internalizing and disruptive problems (anxiety, depression, anger, aggressive behaviors, and emotional reactivity). Substance use included a composite of smoking, drinking, and drug use. Physical health included metabolic syndrome (MetS) and proinflammatory phenotypes (immune cells mounting exaggerated cytokine responses to bacterial challenge and being insensitive to inhibitory signals from glucocorticoids). Mental and physical health measures were taken at age 31 and during the adolescent years. Linear and logistic regression analyses, as well as mediated moderation analyses, were conducted. The study population consisted of 329 Black youths (212 women [64%]; 117 men [36%]; mean [SD] age at follow-up, 31 [1] years). Compared with those who did not graduate college, those who graduated from college had 0.14 SD fewer mental health problems (b = -1.377; 95% CI, -2.529 to -0.226; β = -0.137; P = .02) and 0.13 SD lower levels of substance use (b = -0.114; 95% CI, -0.210 to -0.018; β = -0.131; P = .02). Residualized change scores revealed that college graduates showed greater decreases from age 16 to 31 years in mental health problems (b = -1.267; 95% CI, -2.360 to -0.174; β = -0.133; P = .02) and substance use problems (b = -0.116; 95% CI, -0.211 to -0.021; β = -0.136; P = .02). For physical health, significant interactions between childhood family disadvantage and college completion emerged in association with MetS (OR, 1.495; 95% CI, 1.111-2.012; P = .008) and proinflammatory phenotype (b = 0.051; 95% CI, 0.003 to 0.099; β = 0.131; P = .04). Among youths growing up in disadvantaged households, college completion was associated with a 32.6% greater likelihood of MetS (OR, 3.947; 95% CI, 1.003-15.502; P = .049) and 0.59 SD more proinflammatory phenotype (mean difference, 0.249, 95% CI, 0.001 to 0.497; P = .049). Conversely, among those from economically advantaged backgrounds, college completion was correlated with lower MetS and less proinflammatory phenotype. Findings held after controlling for body mass index at age 19 years. In this longitudinal cohort study of Black youths, graduating from college was associated with an adult profile of better mental health but poorer physical health among those from economic disadvantage. These findings suggest that developing interventions that foster healthy outcomes across multiple life domains may be important for ensuring that striving for upward mobility is not accompanied by unintended cardiometabolic risk.

Substance Use, Sleep Duration, and Health Among Adults in Ohio.

Substance use affects approximately 46.3 million people aged 12 years or older (16.5% of the US population) and is associated with poor sleep health overall. We conducted a cross-sectional secondary analysis of data from the 2020 Behavioral Risk Factor Surveillance System survey in Ohio. The sample comprised 14,676 adults. We examined associations between the use of 2 types of substances (marijuana and nonprescribed prescription pain medication) and short sleep duration (<6 hours per night) and overall health (mental, physical, and general). We used linear and logistic regression modeling while adjusting for individual-level (age, sex, race and ethnicity, education, income, and body mass index) and area-level (socioeconomic deprivation) covariates. Of survey respondents who answered questions, 9.2% (1,140 of 12,362) reported using marijuana, and 1.4% (111 of 8,203) used nonprescribed prescription pain medication. Respondents who used marijuana used it an average 17.3 days per month. In adjusted logistic regression models, the odds of reporting short sleep duration were 2.4 times greater among respondents who used nonprescribed prescription pain medication (vs those who did not). The odds of reporting short sleep duration, poor mental health, poor physical health, and poor general health were 1.5, 1.3, 2.1, and 1.9 times greater, respectively, among respondents who reported marijuana use (vs those who did not). In the linear regression models (adjusted), more days of marijuana use were associated with longer sleep duration, worse mental health, and worse general health. Understanding the connection between substance use and health outcomes is needed to improve trajectories of substance use and recovery. Sleep duration is often underassessed among people who use substances. Expanding diagnostics and treatment options for those who use substances may result in lower levels of substance use and improved overall health.

Social determinants of ethno-racial inequalities in substance use: a decomposition of national survey data.

Similar to the US, mortality due to suicide and the use of opioids, alcohol, and other substances (so-called "Deaths of Despair"), is rising in Canada and has been disproportionately observed among Whites compared to other racial and ethnic groups. This study aimed to assess the determinants of the ethno-racial differences in the use of substances that underlie these deaths. Using nationally representative data from the Canadian Community Health Survey (2003, 2015-2016, 2018 cycles), a decomposition analysis was performed to estimate the contribution of psychosocial determinants, including age, sex, marital status, immigration, education, income, rurality, and affective health on inequalities between White and non-White populations in illicit substance, opioid, and problematic alcohol use and combined use (≥ 2) of substances. Overall, White respondents reported higher levels (by 5% to 10%) of substance use than non-White peers. Over 30% of the ethno-racial inequalities in illicit substance, problematic alcohol, and polysubstance use are explained by the protective role of immigration among those who are not White, whose low levels of substance use lower the prevalence in the non-White population overall. Among those born in Canada, no ethno-racial differences in substance usewere observed. Social determinants, particularly immigrant status, explain a substantial proportion of ethno-racial inequalities in substance use in Canada. The jump in substance use between racialized populations who immigrated to Canada and those Canadian-born highlights the importance of exploring within-group variability in deaths of despair risk and considering how intersecting forces including systemic racism shape substance use patterns across generations.

The impact of COVID-19 on people who inject drugs in New York City: increased risk and decreased access to services

BackgroundWhile people who inject drugs (PWID) are vulnerable to the adverse outcomes of events like COVID-19, little is known regarding the impact of the current pandemic on PWID. We examine how COVID-19 has affected PWID in New York City across four domains: substance use, risk behaviors, mental health, and service utilization.MethodsAs part of a randomized trial to improve access to HCV treatment for PWID, we recruited 165 participants. Eligibility criteria included detectable HCV RNA and recent drug injection. The present cross-sectional analysis is based on a subsample of 106 participants. We compared responses between two separate samples: 60 participants interviewed prior to the pandemic (pre-COVID-19 sample) and 46 participants interviewed during the pandemic (COVID-19 sample). We also assessed differences by study group [accessible care (AC) and usual care (UC)].ResultsCompared to the pre-COVID-19 sample, those interviewed during COVID-19 reported higher levels of mental health issues, syringe reuse, and alcohol consumption and greater reductions in syringe-service programs and buprenorphine utilization. In the analysis conducted by study group, the UC group reported significantly higher injection risk behaviors and lower access to buprenorphine treatment during COVID-19, while during the same period, the AC group reported lower levels of substance use and injection risk behaviors.ConclusionThe current study provides insight on how COVID-19 has negatively affected PWID. Placing dispensing machines of harm-reduction supplies in communities where PWID live and increasing secondary exchange, mobile services, and mail delivery of supplies may help maintain access to lifesaving supplies during big events, such as COVID-19.Trial registration ClinicalTrials.gov NCT03214679. Registered July 11 2017. https://clinicaltrials.gov/ct2/show/NCT03214679.

A qualitative study of perceptions of risk and protective factors for suicide among Bhutanese refugees.

Over 100,000 ethnically Nepalese, "Lhotshampa," people experienced systematic oppression, disenfranchisement, and violence during the latter part of the 20th century. The Lhotshampa people were forced to flee their homes in southern Bhutan and enter refugee camps in Nepal for over 20 years. As of this writing, most Bhutanese refugees have been resettled in other countries (primarily the United States, Canada, and Australia). As the two remaining Nepalese refugee camps prepare to close, a growing suicide crisis is developing among many Bhutanese refugees. Bhutanese refugees resettled in the United States are dying by suicide at approximately twice the rate of the general U.S. population. It is crucial to examine, qualitatively, the nature of both risk and protective factors from the perspective of Bhutanese refugees, themselves. Our study included 15 Bhutanese refugees (8 men, 7 women) recruited from a community sample as part of a parent project examining culturally responsive suicide risk assessment. Mean age across both genders was 38.4 years (range of 22-55 years). Participants in our study were asked open-ended questions about suicide risk and prevention. We conducted a thematic analysis, synthesized risk and protective themes, and applied a socio-ecological framework to the data. We found risk themes included psychological distress and vulnerability, substance use, social and familial discord, interpersonal violence, isolation, and postmigration stressors. Protective themes included low levels of substance use, de-stigmatization of mental health concerns, strong social connections, reduced postmigration stressors, increased access to mental health care, and strong awareness within the host community of migration-related challenges.

Understanding the Unique Effects of Identity in Adjustment Among Veterans

Reintegration to civilian life among service members can be understood through the lens of a transformation in an individual’s identity structure. However, limited research has examined the unique impact of military, U.S., and personal identity on mental health and substance use among veterans. The goal of the present study was to examine the relationship between personal, military and U.S. identity dimensions (i.e., commitment, affirmation, and centrality) on substance use and mental health symptoms (i.e., posttraumatic stress, suicidal ideation, anxiety, and depression) in a sample of U.S. military veterans. Within our sample of military veterans (n = 195), a plurality were female (53.3%), White (73.3%), and veterans of the Navy (45.1%) who reported a mean age of 35.12 years (SD = 9.60). Results indicated personal identity commitment, and U.S. affirmation were associated with lower levels of substance use and symptoms of PTSD, suicidal ideation, anxiety, and depression. Military identity centrality was associated with higher levels of PTSD symptoms. Taken together, our findings provide preliminary cross-sectional support for the role that personal, military and U.S. identity play in mental health. Future longitudinal research is necessary to establish the directional relationship between identity (across various domains) and mental health and substance abuse across the transition to civilian life.

An examination of the joint effects of adolescent interpersonal styles and parenting styles on substance use.

The current study examined how parenting and adolescent interpersonal styles jointly influence youths' abilities to form close relationships - a central developmental milestone - yet avoid substance use, which predominantly occurs in the presence of peers. Nine annual waves from an adolescent sample (N = 387) were used to assess (a) combinations of interpersonal and parenting styles from early to middle adolescence using longitudinal latent profile analysis, (b) the validity of these profiles on indicators of adjustment, and (c) the relationships between the profiles and growth in substance use across adolescence as well as substance-related consequences in late adolescence. The results supported five distinct combinations of interpersonal and parenting styles, and validity analyses identified both risk and protective profiles. The protective profile submissive-communal interpersonal style + high-warmth-authoritative parenting style was associated with indicators of positive social adjustment (e.g., friendship quality, resistance to peer influence) as well as lower levels of substance use. Significant differences also emerged with respect to substance-related consequences. The findings of this study highlight how combinations of adolescent interpersonal style and parenting render adolescents more or less successful at navigating peer relationships while avoiding substance use behaviors.

Antiretroviral prescription, retention in care and viral suppression by place of birth among adults with diagnosed HIV in the United States—2015–2017, medical monitoring project

ABSTRACT HIV clinical outcomes have not been fully assessed by place of birth at the national level. We analyzed the Medical Monitoring Project data, an annual cross-sectional survey designed to produce nationally representative estimates on adults with diagnosed HIV in the United States, collected during 2015–2017 (n = 7617). We compared sociodemographic, behavioral, and clinical outcomes by place of birth using Rao-Scott chi-square tests (P < .05). Overall, 13.6% of adults with diagnosed HIV were non-US-born. During the past 12 months, a higher percentage of non-US-born than US-born adults, respectively, were prescribed ART (89.4% vs. 84.1%), retained in care (87.1% vs. 80.0%), virally suppressed at the last test (77.2% vs. 70.9%), and had sustained viral suppression (70.9% vs. 63.3%). A lower percentage of non-US-born adults reported binge drinking (13.0% vs. 16.1%), using non-injection drugs (15.3% vs. 31.7%), and suffering from depression (15.9% vs. 23.3%) or anxiety (10.0% vs. 20.2%). A significantly higher percentage of non-US-born adults had Ryan White HIV/AIDS Program (RWHAP) coverage (54.4% vs. 43.1%) and attended a RWHAP-funded health care facility (73.9% vs. 66.6%). Factors contributing to better HIV clinical outcomes among non-US-born persons may include access to RWHAP coverage, lower levels of substance use, and better mental health.

Is substance abuse treatment actually ‘treating’? The effectiveness of pre- and post-release substance abuse programming within the reentry process

ABSTRACTThe process of reintegrating back into society can be a difficult time for formerly incarcerated individuals in desisting from substance use. Although prior work has shown that experiences like securing employment or abstaining from criminal peers can help individuals desist from substance use, one aspect about which criminologists know considerably less concerns the role of substance abuse treatment programming during reentry. Using the Serious and Violent Offender Reentry Initiative data, we explore the role of substance treatment programming on substance use through multiple avenues. Namely, we investigate the impact of substance abuse treatment during prison, during reentry, and over time. Results of longitudinal models demonstrate that individuals who participated in pre-release substance abuse treatment programming report significantly lower levels of substance use than those who did not participate in pre-release substance programming. Yet, we find that individuals who participated in substance treatment programming post-release reported significantly higher levels of substance use than those who did not participate in post-release programming. Finally, we find no evidence that substance use treatment programming relates to decreases in substance use across time.

Genetic influences on delayed reward discounting: A genome-wide prioritized subset approach.

Delayed reward discounting (DRD) is a behavioral economic measure of impulsivity that has been consistently associated with addiction. It has also been identified as a promising addiction endophenotype, linking specific sources of genetic variation to individual risk. A challenge in the studies to date is that levels of DRD are often confounded with prior drug use, and previous studies have also had limited genomic scope. The current investigation sought to address these issues by studying DRD in healthy young adults with low levels of substance use (N = 986; 62% female, 100% European ancestry) and investigating genetic variation genome-wide. The genome-wide approach used a prioritized subset design, organizing the tests into theoretically and empirically informed categories and apportioning power accordingly. Three subsets were used: (a) a priori loci implicated by previous studies; (b) high-value addiction (HVA) markers from the recently developed SmokeScreen array; and (c) an atheoretical genome-wide scan. Among a priori loci, a nominally significant association was present between DRD and rs521674 in ADRA2A. No significant HVA loci were detected. One statistically significant genome-wide association was detected (rs13395777, p = 2.8 × 10-8), albeit in an intergenic region of unknown function. These findings are generally not supportive of the previous candidate gene studies and suggest that DRD has a complex genetic architecture that will require considerably larger samples to identify genetic associations more definitively. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Family Matters: Moving Beyond "If" Family Support Matters to "Why" Family Support Matters during Reentry from Prison.

Informed by social control and differential coercion and social support theories, we examine how multiple theoretically and methodologically distinct factors of family support relate to reincarceration, substance use, and criminal offending during prison reentry. Using four waves of data from the Serious and Violent Offender Reentry Initiative, we identified three separate factors of family support-interactional (e.g., providing guidance and support), instrumental (e.g., providing housing and transportation), and emotional (e.g., providing love and belongingness). A series of mixed-effects models examined how each form of family support related to reincarceration, substance use, and criminal offending. Findings demonstrated that instrumental, but not interactional or emotional, support related to significantly lower odds of reincarceration and lower levels of substance use and criminal offending. Interaction terms revealed that the effect of instrumental family support is almost entirely independent, and not interactive, on each outcome. Family support appears to relate to prosocial reentry outcomes not because of emotional or interactional bonds, but because families provide for the basic needs of returning individuals. Instrumental familial support mechanisms such as providing housing and financial support appear more salient in promoting prosocial reentry outcomes than mechanisms of emotional or interactional support.

Examining the Association Between Resilience and Risk Behaviors Among South Asian Minority Students in Hong Kong: A Quantitative Study

The relationship between risk behaviors and resilience among South Asian minority youth identifying themselves as Pakistani, Indian, Pakistani-Hong Konger, or Indian-Hong Konger (N = 405) in a Hong Kong school setting was investigated using hierarchical linear regression analysis. Lower neighborhood disorganization, higher neighborhood characteristics, and higher individual resilience predicted lower likelihood of substance use in all ethnic groups. Stronger relationship with caregivers was associated with lower levels of substance use in all ethnic groups except for Pakistani-Hong Kongers (p > .05). Stronger multigroup ethnic identity predicted lower likelihood of substance use in Indians (p = .021) and Indian-Hong Kongers (p = .039). Resilience-based research, practical, and social policy implications are discussed.

Childhood Cancer Survivorship and Substance Use Behaviors: A Matched Case-Control Study Among Hispanic Adolescents and Young Adults

PurposeThis case-control study compared substance use behaviors between Hispanic adolescent and young adult survivors of childhood cancers (cases) and a community sample of participants without cancer (controls). MethodsA total of 100 cases were matched to controls (200 participants) one to one by ethnicity, age, and sex (mean age at survey 19.27, standard deviation = 1.92). Differences in self-reported previous 30-day use of tobacco, alcohol, binge drinking of alcohol, and marijuana were examined using conditional multivariable logistic regression. ResultsThe odds of tobacco, alcohol, binge drinking, and marijuana use were significantly lower for cases than for controls (all p's <.05). When stratified by age, cases (vs. controls) under 21 years of age reported lower levels of substance use (all p's <.05), whereas differences over the age of 21 were nonsignificant. ConclusionsLower levels of substance use among Hispanic adolescent and young adult survivors of childhood cancers (vs. controls) are most apparent at younger ages. Future work needs to examine a potential delay in initiation of use among survivors.

Uniting needs, responses, and theory during reentry: The distinct and joint contributions of peer influence and religious/spiritual support on substance use

ABSTRACTUsing a dual framework of differential association and the risk-need-responsivity model, this study uses data from the Serious and Violent Offender Reentry Initiative to investigate how peer criminality, peer support, and religious or spiritual support impact substance use during reentry. Results indicate that less peer criminality and more religious/spiritual support relate to lower levels of substance use, and in both independent and interdependent ways. However, results also suggest that religious/spiritual support interacts with high amounts of peer support to increase substance use. Collectively, the three elements of risks, needs, and responses may be intertwined in the case of peer influence and religious/spiritual support.

Is Technology-Mediated Parental Monitoring Related to Adolescent Substance Use?

ABSTRACTBackground: Prevention researchers have identified parental monitoring leading to parental knowledge to be a protective factor against adolescent substance use. In today's digital society, parental monitoring can occur using technology-mediated communication methods, such as text messaging, email, and social networking sites. Objectives: The current study aimed to identify patterns, or clusters, of in-person and technology-mediated monitoring behaviors, and examine differences between the patterns (clusters) in adolescent substance use. Methods: Cross-sectional survey data were collected from 289 parents of adolescents using Facebook and Amazon Mechanical Turk (MTurk). Cluster analyses were computed to identify patterns of in-person and technology-mediated monitoring behaviors, and chi-square analyses were computed to examine differences in substance use between the identified clusters. Results: Three monitoring clusters were identified: a moderate in-person and moderate technology-mediated monitoring cluster (moderate-moderate), a high in-person and high technology-mediated monitoring cluster (high-high), and a high in-person and low technology-mediated monitoring cluster (high-low). Higher frequency of technology-mediated parental monitoring was not associated with lower levels of substance use. Conclusions: Results show that higher levels of technology-mediated parental monitoring may not be associated with adolescent substance use.

Emotional well-being amongst female inmates in prisons: the relevance of their addictive history and their country of origin.

To know more about the emotional well-being of women held in prisons in Spain by analyzing the state of mental health they present and investigating the factors that affect them. A sample of 434 inmates in Spanish penitentiary centers was studied. An ad hoc designed questionnaire was used and a logistic regression analysis was conducted to determine the variables and to what extent they influence emotional well-being. The existence of a statistically significant relationship between the well-being stages and the origin variables (region of origin of the women) and the history of substance addiction were confirmed. No significant relationship has been found for well-being levels from other variables (maternity, social or family support, gender violence or having or not having a partner). Having a problematic history of drug use negatively affects the levels of emotional well-being of women detained in prisons. The low levels of substance use in women of Latin American origin is related to their more positive levels of emotional well-being.

Substance use among bi/multiracial youth in the United States: Profiles of psychosocial risk and protection

ABSTRACTBackground: Bi/multiracial youth face higher risk of engaging in substance use than most monoracial youth. Objectives: This study contrasts the prevalence of substance use among bi/multiracial youth with that of youth from other racial/ethnic groups, and identifies distinct profiles of bi/multiracial youth by examining their substance use risk. Methods: Using data from the National Survey on Drug Use and Health (collected between 2002 and 2014), we analyze data for 9,339 bi/multiracial youth ages 12–17 living in the United States. Analyses use multinomial regression and latent class analysis. Results: With few exceptions, bi/multiracial youth in general report higher levels of tobacco, alcohol, marijuana, and other illicit drug use compared to other youth of color. Bi/multiracial youth also report higher levels of marijuana use compared to non-Hispanic white adolescents. However, latent class modeling also revealed that a majority (54%) of bi/multiracial youth experience high levels of psychosocial protection (i.e., strong antidrug views and elevated parental engagement) and low levels of psychosocial risk (i.e., low peer substance use, school-related problems, and social-environmental risk), and report very low levels of substance use. Substance use was found to be particularly elevated among a minority of bi/multiracial youth (28%) reporting elevated psychosocial risk and low levels of protection. Bi/multiracial youth characterized by both elevated psychosocial risk and elevated psychosocial protection (22%) reported significantly elevated substance use as well. Conclusions: While bi/multiracial youth in general exhibit elevated levels of substance use, substantial heterogeneity exists among this rapidly-growing demographic.

Parental Monitoring Moderates the Relation Between Radio Exposure and Adolescent Alcohol and Tobacco Use: Preliminary Findings From a National Survey

ABSTRACTMedia exposure is a risk factor and parental monitoring is a protective factor against adolescent alcohol and tobacco use. Music-related media, however, are underexplored. The National Survey of Parents and Youth was utilized to examine music-related media as a risk factor and parental monitoring as a protective factor for alcohol and cigarette use. Multilevel modeling demonstrated that music exposure was related to higher levels and parental monitoring was related to lower levels of substance use. Parental monitoring attenuated the effect of radio exposure on alcohol and cigarette use. Further investigation of music, parental monitoring, and adolescent substance use is needed.

Effects of a brief, parent-focused intervention for substance using adolescents and their sibling

The purpose of this study was to evaluate the efficacy of the Family Check-up (FCU), a parent-focused brief motivational intervention, in families where parents were concerned about one adolescent's alcohol or marijuana use and the referred adolescent also had a sibling close in age. The primary goal of the FCU was to provide individualized feedback on specific parenting skills, including monitoring and supervision, limit setting, and alcohol-related communication. A total of 92 adolescents (37 female) between the ages of 12–19years of age along with a sibling (48 female) between the ages of 11–21years old, were randomized to the FCU or a psychoeducation (PE) comparison condition. Findings indicated that the FCU did not produce better effects on alcohol and other drug use outcomes than the PE condition, in either the adolescent or sibling. Brief interventions addressing parenting behaviors may not be sufficient to reduce alcohol use in adolescent drinkers not referred due to an alcohol-related incident. Future research might be conducted to explore whether brief parent interventions, such as those in the present study, could be useful as a preventive intervention for parents whose teens report low levels of substance use.