pregnant women

Technology-based interventions for  women between 18 and 44 years old were found in a systematic review with meta-analysis (Hai et al., 2019, 15 studies, N = 3 488) to have an effect when compared to control conditions in:

• reducing substance use (alcohol and/or drugs) in the short term (follow-up ranged from 2 to 6 months) (d = 0.19, 95% CI = 0.02, 0.35, 13 studies)

The effect size estimates calculated separately for alcohol use and illicit drug use were 0.13 and 0.30 respectively and neither was statistically significant possibly due to low power of the studies.

Interventions examined included brief interventions modeled after the motivational interviewing approach or involving  periodically sending participants text messages to provide educational information to reduce substance use.

A systematic review (Wilson et al 2019) found no evidence to support an association between prescription monitoring programmes (PMPs) and:

• reduced opioid prescribing and dispensing;
• reduced non-medical prescription opioid use.

There were limited but inconsistent evidence supporting an association between PMPs and reduced Scedule II opioid prescribing and dispensing and reduced multiple provider use. Further studies are needed to determine the effectiveness of PMPs.

A systematic review without meta-analysis (Lin et al 2019, 13 studies) found no evidence of effect of telemedicine-delivered treatment (psychotherapy or pharmacotherapy) interventions for substance use disorders.

Studies examined suggest this type of intervention is an effective alternative, particularly where face-to-face treatment is less available, but more research is needed on their effectiveness.

A systematic review without meta-analysis  (Vold et al 2019, 7 RCT and 3 cohort studies, high risk of bias), found uncertain results on the effects of integrated care models on the treatment of infectious diseases in people with substance use disorders.

A systematic review without meta-analysis (Penzenstadler et al 2019, 5 datasets) found no clear superiority of results of assertive community treatment (ACT) in reducing substance use (compared to control group).

ACT originally developed for patients with severe mental illness, providing personalized, high intensity, holistic and integrated multidisciplinary community care services.

Las directrices internacionales basadas en la evidencia (OMS, 2014) no recomiendan la farmacoterapia para el tratamiento rutinario de la dependencia de los estimulantes y del cannabis en mujeres embarazadas