An online school program reduced teenagers' intentions to use synthetic cannabis for up to 2 years | Research

The takeaway

A four-lesson internet-based prevention program reduced students' intentions to use synthetic cannabis at 2-year follow-up, with controls 3.5 times more likely to intend use, though full completion of all lessons was key to effectiveness.

Read this if you work with teenagers and want to know about effective prevention programs for synthetic drugs.

Controls 3.56 times more likely to intend synthetic cannabis use at 2-year follow-up

What the researchers found

Researchers tested a web-based prevention program delivered through school health education classes to 1,126 Australian students across 11 schools. The Climate Schools: Ecstasy and Emerging Drugs module used cartoon storylines to deliver harm-minimization information about ecstasy and new psychoactive substances including synthetic cannabinoids.

At the 2-year follow-up, students in the control group were 3.56 times more likely to intend to use synthetic cannabis compared to those who received the intervention. This effect on intentions was the primary significant finding.

Knowledge about ecstasy and new psychoactive substances was also significantly higher in the intervention group, but only among students who completed all four lessons. Students who received an incomplete dose (three or fewer lessons) showed no significant difference from controls, highlighting that the program needs to be delivered in full to be effective.

Why it matters

Synthetic cannabinoids pose unique dangers because of their unpredictable potency and adverse effects. Finding a scalable, web-based prevention program that reduces intentions to use these substances is valuable, especially given the challenges of keeping prevention content current as new synthetic drugs continuously emerge.

The numbers in context

1,126 students from 11 schools. Mean age 14.9 years. Controls 3.56 times more likely to intend synthetic cannabis use (OR = 3.56, p = 0.01). Knowledge significantly higher only in full-dose group (ecstasy p = 0.001, NPS p = 0.04). No significant differences between incomplete dose and controls.

How the study worked

Cluster randomized controlled trial with 1,126 students (mean age 14.9 years) from 11 Australian secondary schools. Five schools received the four-lesson internet-based intervention; six served as controls (health education as usual). Outcomes measured at baseline, post-test, 6, 12, and 24 months included intentions to use, knowledge, and lifetime use of ecstasy and NPS.

What this study cannot tell us

The study measured intentions to use rather than actual use as the primary outcome. Students were not blinded to their assignment. Attrition over 2 years may have biased results. The program was tested in Australian schools and may not generalize to other cultural contexts. Self-reported outcomes are subject to response bias.

How to read the evidence

This is a cluster randomized controlled trial with 2-year follow-up, providing moderate evidence for intention-level effects.

When this study was published

Published in 2018. Web-based prevention programs have continued to evolve.

The bigger picture

Web-based prevention programs offer scalability that traditional classroom programs cannot match. This study demonstrates that internet-delivered content can produce lasting effects on drug use intentions, but the finding about dose-response (all four lessons needed) has important implications for implementation fidelity.

Questions still open

Do reduced intentions to use synthetic cannabis translate to actual use prevention? Can the program be adapted to address newer synthetic drugs as they emerge? What minimum dose is needed for the program to be effective?

Common questions

Can online programs prevent synthetic drug use?

This study found that a four-lesson web-based program reduced teenagers' intentions to use synthetic cannabis at 2-year follow-up. Controls were 3.5 times more likely to intend use. However, the program only worked when all four lessons were completed.

Why focus on intentions rather than actual use?

Intentions to use a substance are a well-established predictor of future use in prevention research. Since synthetic cannabinoid use rates were relatively low, detecting differences in actual use would require much larger samples. Measuring intentions provides an earlier indicator of program effectiveness.

Read the original research

Cluster randomised controlled trial of an online intervention to prevent ecstasy and new psychoactive substance use among adolescents: final results and implications for implementation.

BMJ open, 8(11), e020433

View on PubMed ↗Publisher’s paper ↗

Citation

Champion, Katrina E; Newton, Nicola Clare; Stapinski, Lexine; Teesson, Maree. (2018). Cluster randomised controlled trial of an online intervention to prevent ecstasy and new psychoactive substance use among adolescents: final results and implications for implementation.. BMJ open, 8(11), e020433. https://doi.org/10.1136/bmjopen-2017-020433