Evaluating the potential negative effects of school-based prevention programs aiming to reduce alcohol and drug misuse in adolescents: A systematic review of research articles prior to 2013

Issues: Reviews of alcohol and drug prevention programs commonly focus on positive effects, whilst disregarding possible iatrogenic effects. Our objective was to summarize evidence on iatrogenic effects of alcohol and drug prevention programs targeting adolescents. We systematically investigated the nature of these effects, the number of iatrogenic effects reported on, the sort of impact they have (e.g. in terms of severity) and the type of programs associated with iatrogenic effects.Approach: On January 2013, we searched the Cochrane Central Register of Controlled Trials, Medline, PsycINFO, Web of Science, Eric, Scirus and we actively searched for grey literature via Google Scholar and OpenGrey. Included were (quasi) RCTs that evaluated the effectiveness of school-based alcohol and drug prevention programs for adolescents. Ninety-three articles were eligible for inclusion and were screened for potential iatrogenic effects. Key findings: Ten articles reported on iatrogenic effects, which were predominantly found on substance use outcomes. The quality of these articles was assessed and a meta-analysis was not possible due to the heterogeneity in interventions and outcome measures. An increase in substance use was found in 5 out of 7 RCTs and in 1 quasi RCT. The magnitude of the iatrogenic effects found was not always clear due to the outcome measures used.Implications: Iatrogenic effects were assessed in a limited number of studies. In future studies on prevention programs the number, nature and impact of iatrogenic effects should standardly be assessed and reported. It allows us to detect potential problem areas in the conceptualization of prevention programs.

ISBN:9789067842068

Publication year:2017