Drug counseling by PCPs still lacks evidence, USPSTF says

There is insufficient evidence to assess the balance of benefits and harms of primary care-based interventions to prevent illicit drug use in young people, the U.S. Preventive Services Task Force reported.

The “I” statement came after Elizabeth O’Connor, PhD, associate director of the Kaiser Permanente Research Affiliates Evidence-based Practice Center, and colleagues reviewed 29 trials with 18,353 participants. All but one was a randomized controlled trial.

The task force came to the same conclusion in a draft statement made in 2019.

“The evidence ... was inconsistent and imprecise, with some interventions associated with reduction in use and others associated with no benefit or increased use,” O’Connor and colleagues wrote in JAMA. “Health, social and legal outcomes were sparsely reported, and few showed improvements.”

The USPSTF identified other areas where research is needed:

• cannabis prevention, deliberately addressing both the benefits and harms of the intervention;
• interventions that include clinician training, education, personal coaching and continuous quality improvement components;
• reducing illicit drug use in children aged younger than 10 years and adults aged 18 to 25 years; and
• implementation and effectiveness of text-based messaging, smartphone apps, games, web-based and social media interventions.

“Clinicians should continue to use their judgment on how best to address this issue with young patients and their families,” Martha Kubik, PhD, RN, task force member and director of the department of nursing at the Temple University College of Public Health, said in a press release. – by Janel Miller

Disclosures: O’Connor reports no relevant financial disclosures. Please see study for all other authors’ relevant financial disclosures.