{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T22:55:11Z","timestamp":1793141711250,"version":"4.5.0"},"reference-count":69,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Substance use is a leading cause of burden of disease worldwide. Selective prevention programs can help reduce the development of problematic substance use and disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine effects of a selective, personality-targeted substance use prevention program on alcohol, cannabis, tobacco, nonmedical opioid, and illicit polysubstance use among adolescents with elevated levels of personality traits associated with frequent and risky substance use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This prespecified secondary analysis of a cluster-randomized clinical trial assessed the effectiveness of a personality-targeted cognitive-behavioral intervention (PreVenture) in reducing substance use during adolescence. Participants included grade 7 students attending 31 secondary schools in the Greater Montreal Area, Canada (2012-2013 school year), who screened as having elevated levels of anxiety sensitivity, hopelessness, impulsivity, or sensation seeking. Schools were randomized to either the intervention (15 schools) or the control group (16 schools). Data were analyzed in January to March 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Schools delivered a 2-session, personality-targeted group-based cognitive-behavioral intervention designed to help students recognize, challenge, and manage personality-specific emotions, behaviors, and cognitions associated with substance use in adolescence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Self-reported frequency of alcohol, cannabis, smoking tobacco, nonmedical use of opioids, and illicit polysubstance use were measured by the Detection of Alcohol and Drug Problems in Adolescents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 3861 students from 31 schools were screened; 1669 students (847 [50.7%] female; mean [SD] age, 12.83 [0.47] years) were at elevated risk of substance use and included in the intention-to-treat sample. The 31 schools were randomized, with 16 schools with 964 students in the control group and 15 schools with 705 students in the intervention group. Multilevel bayesian mixed-effects models indicated that students in the intervention group had slower increases in the frequency of alcohol (odds ratio [OR], 0.92; 95% credible interval [CrI], 0.85-1.00), cannabis (OR, 0.75; 95% CrI, 0.66-0.86), tobacco smoking (OR, 0.79; 95% CrI, 0.70-0.96), and illicit polysubstance use (OR, 0.56; 95% CrI, 0.35-0.89) over 4 years. Effects did not differ by sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>This secondary analysis of a cluster-randomized clinical trial found that personality-targeted interventions protected against the escalation in substance use during adolescence, with similar effects for males and females.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      ClinicalTrials.gov Identifier:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/study\/NCT01655615\">NCT01655615<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.50176","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T16:00:27Z","timestamp":1766073627000},"page":"e2550176","source":"Crossref","is-referenced-by-count":2,"title":["Selective Personality-Targeted Intervention and the Escalation of Substance Use During Adolescence"],"prefix":"10.1001","volume":"8","author":[{"given":"Samantha J.","family":"Lynch","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Canada"},{"name":"Azrieli Research Center, CHU Ste Justine Mother-Child University Hospital, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherry H.","family":"Stewart","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, Canada"},{"name":"Department of Psychology and Neuroscience, Faculty of Science, Dalhousie University, Halifax, Canada"},{"name":"Department of Community Health and Epidemiology, Faculty of Medicine; Dalhousie University, Halifax, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Conrod","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Canada"},{"name":"Azrieli Research Center, CHU Ste Justine Mother-Child University Hospital, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"issue":"7","key":"zoi251343r1","doi-asserted-by":"publisher","first-page":"1551","DOI":"10.1017\/S0033291714002888","article-title":"A heavy burden on young minds: the global burden of mental and substance use disorders in children and youth.","volume":"45","author":"Erskine","year":"2015","journal-title":"Psychol Med"},{"issue":"9904","key":"zoi251343r2","doi-asserted-by":"publisher","first-page":"1575","DOI":"10.1016\/S0140-6736(13)61611-6","article-title":"Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010.","volume":"382","author":"Whiteford","year":"2013","journal-title":"Lancet"},{"key":"zoi251343r3","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2024.112495","article-title":"The burden of alcohol and substance use disorders in adolescents and young adults.","volume":"266","author":"Danpanichkul","year":"2025","journal-title":"Drug Alcohol Depend"},{"issue":"4","key":"zoi251343r4","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1017\/S003329171800137X","article-title":"Accelerated alcohol use across adolescence predicts early adult symptoms of alcohol use disorder via reward-related neural function.","volume":"49","author":"Waller","year":"2019","journal-title":"Psychol Med"},{"key":"zoi251343r5","doi-asserted-by":"publisher","DOI":"10.1016\/j.dadr.2023.100181","article-title":"Population-based examination of substance use disorders and treatment use among US young adults in the National Survey on Drug Use and Health, 2011-2019.","volume":"8","author":"Lu","year":"2023","journal-title":"Drug Alcohol Depend Rep"},{"issue":"3","key":"zoi251343r6","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1016\/S2215-0366(15)00508-8","article-title":"The increasing global health priority of substance use in young people.","volume":"3","author":"Degenhardt","year":"2016","journal-title":"Lancet Psychiatry"},{"key":"zoi251343r7","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/j.dcn.2016.10.004","article-title":"Sensitive periods of substance abuse: early risk for the transition to dependence.","volume":"25","author":"Jordan","year":"2017","journal-title":"Dev Cogn Neurosci"},{"issue":"9","key":"zoi251343r8","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1016\/j.jaac.2017.06.011","article-title":"National trends in substance use and use disorders among youth.","volume":"56","author":"Han","year":"2017","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"9","key":"zoi251343r9","doi-asserted-by":"publisher","first-page":"1677","DOI":"10.1111\/acer.14914","article-title":"Temporal trends in alcohol, cannabis, and simultaneous use among 12th-grade U.S. adolescents from 2000 to 2020: differences by sex, parental education, and race and ethnicity.","volume":"46","author":"Keyes","year":"2022","journal-title":"Alcohol Clin Exp Res"},{"key":"zoi251343r10","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1016\/j.addbeh.2016.08.027","article-title":"The paradox of decreasing nonmedical opioid analgesic use and increasing abuse or dependence - An assessment of demographic and substance use trends, United States, 2003-2014.","volume":"65","author":"Jones","year":"2017","journal-title":"Addict Behav"},{"issue":"4","key":"zoi251343r11","doi-asserted-by":"publisher","first-page":"926","DOI":"10.1111\/dar.13629","article-title":"Trends in alcohol-attributable hospitalisations and emergency department visits by age, sex, drinking group and health condition in Ontario, Canada.","volume":"42","author":"Smith","year":"2023","journal-title":"Drug Alcohol Rev"},{"issue":"2","key":"zoi251343r12","doi-asserted-by":"publisher","first-page":"e2457852","DOI":"10.1001\/jamanetworkopen.2024.57852","article-title":"Cannabis use disorder emergency department visits and hospitalizations and 5-year mortality.","volume":"8","author":"Myran","year":"2025","journal-title":"JAMA Netw Open"},{"issue":"4","key":"zoi251343r15","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1007\/s40429-016-0127-6","article-title":"Personality-targeted interventions for substance use and misuse.","volume":"3","author":"Conrod","year":"2016","journal-title":"Curr Addict Rep"},{"issue":"2","key":"zoi251343r16","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1111\/j.1469-7610.2007.01826.x","article-title":"Personality-targeted interventions delay the growth of adolescent drinking and binge drinking.","volume":"49","author":"Conrod","year":"2008","journal-title":"J Child Psychol Psychiatry"},{"issue":"3","key":"zoi251343r17","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1001\/jamapsychiatry.2013.651","article-title":"Effectiveness of a selective, personality-targeted prevention program for adolescent alcohol use and misuse: a cluster randomized controlled trial.","volume":"70","author":"Conrod","year":"2013","journal-title":"JAMA Psychiatry"},{"key":"zoi251343r18","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2021.106794","article-title":"Personality-targeted prevention for adolescent tobacco use: three-year outcomes for a randomised trial in Australia.","volume":"153","author":"Debenham","year":"2021","journal-title":"Prev Med"},{"issue":"JAN","key":"zoi251343r19","doi-asserted-by":"publisher","first-page":"770","DOI":"10.3389\/fpsyt.2018.00770","article-title":"A review of personality-targeted interventions for prevention of substance misuse and related harm in community samples of adolescents.","volume":"9","author":"Edalati","year":"2019","journal-title":"Front Psychiatry"},{"key":"zoi251343r20","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.addbeh.2017.02.030","article-title":"Effectiveness of a selective alcohol prevention program targeting personality risk factors: Results of interaction analyses.","volume":"71","author":"Lammers","year":"2017","journal-title":"Addict Behav"},{"issue":"3","key":"zoi251343r21","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1177\/0004867419877948","article-title":"Evaluating the differential effectiveness of social influence and personality-targeted alcohol prevention on mental health outcomes among high-risk youth: a novel cluster randomised controlled factorial design trial.","volume":"54","author":"Newton","year":"2020","journal-title":"Aust N Z J Psychiatry"},{"issue":"April","key":"zoi251343r22","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1016\/j.addbeh.2017.07.015","article-title":"The impact of youth internalising and externalising symptom severity on the effectiveness of brief personality-targeted interventions for substance misuse: a cluster randomised trial.","volume":"75","author":"Perrier-M\u00e9nard","year":"2017","journal-title":"Addict Behav"},{"issue":"3","key":"zoi251343r23","doi-asserted-by":"publisher","first-page":"514","DOI":"10.1111\/add.15178","article-title":"The long-term effectiveness of universal, selective and combined prevention for alcohol use during adolescence: 36-month outcomes from a cluster randomized controlled trial.","volume":"116","author":"Slade","year":"2021","journal-title":"Addiction"},{"issue":"5","key":"zoi251343r24","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1176\/appi.ajp.20240042","article-title":"Five-year outcomes of a school-based personality-focused prevention program on adolescent substance use disorder: a cluster randomized trial.","volume":"182","author":"Conrod","year":"2025","journal-title":"Am J Psychiatry"},{"key":"zoi251343r27","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2024.111266","article-title":"Effect of a selective personality-targeted prevention program on 7-year illicit substance related outcomes: a secondary analysis of a cluster randomized controlled trial.","volume":"258","author":"Champion","year":"2024","journal-title":"Drug Alcohol Depend"},{"issue":"1","key":"zoi251343r28","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1001\/archgenpsychiatry.2009.173","article-title":"Brief, personality-targeted coping skills interventions and survival as a non-drug user over a 2-year period during adolescence.","volume":"67","author":"Conrod","year":"2010","journal-title":"Arch Gen Psychiatry"},{"issue":"10","key":"zoi251343r29","doi-asserted-by":"publisher","first-page":"1625","DOI":"10.1111\/add.12991","article-title":"Can cannabis use be prevented by targeting personality risk in schools: twenty-four-month outcome of the adventure trial on cannabis use: a cluster-randomized controlled trial.","volume":"110","author":"Mahu","year":"2015","journal-title":"Addiction"},{"issue":"1","key":"zoi251343r30","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1186\/s13011-018-0171-4","article-title":"Universal cannabis outcomes from the Climate and Preventure (CAP) study: a cluster randomised controlled trial.","volume":"13","author":"Newton","year":"2018","journal-title":"Subst Abuse Treat Prev Policy"},{"issue":"10","key":"zoi251343r31","doi-asserted-by":"publisher","first-page":"1871","DOI":"10.1111\/add.13876","article-title":"A cluster-randomized controlled trial evaluating the effects of delaying onset of adolescent substance abuse on cognitive development and addiction following a selective, personality-targeted intervention programme: the Co-Venture trial.","volume":"112","author":"O\u2019Leary-Barrett","year":"2017","journal-title":"Addiction"},{"key":"zoi251343r34","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.640766","article-title":"Personality to prescription drug misuse in adolescents: testing affect regulation, psychological dysregulation, and deviance proneness pathways.","volume":"12","author":"Stewart","year":"2021","journal-title":"Front Psychiatry"},{"issue":"2","key":"zoi251343r36","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1056\/NEJMra1508490","article-title":"Relationship between nonmedical prescription-opioid use and heroin use.","volume":"374","author":"Compton","year":"2016","journal-title":"N Engl J Med"},{"issue":"1","key":"zoi251343r37","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1186\/s12889-022-12678-z","article-title":"Polysubstance use poisoning deaths in Canada: an analysis of trends from 2014 to 2017 using mortality data.","volume":"22","author":"Konefal","year":"2022","journal-title":"BMC Public Health"},{"issue":"1","key":"zoi251343r38","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1038\/s41380-020-00949-3","article-title":"Polysubstance use in the U.S. opioid crisis.","volume":"26","author":"Compton","year":"2021","journal-title":"Mol Psychiatry"},{"key":"zoi251343r39","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2022.107586","article-title":"Coping strategies as mediating mechanisms between adolescent polysubstance use classes and adult alcohol and substance use disorders.","volume":"139","author":"Elam","year":"2023","journal-title":"Addict Behav"},{"key":"zoi251343r40","doi-asserted-by":"publisher","DOI":"10.3389\/fnbeh.2021.797473","article-title":"Polysubstance use in early adulthood: patterns and developmental precursors in an urban cohort.","volume":"15","author":"Steinhoff","year":"2022","journal-title":"Front Behav Neurosci"},{"issue":"12","key":"zoi251343r41","doi-asserted-by":"publisher","first-page":"881","DOI":"10.1177\/07067437221089810","article-title":"Interventions to reduce opioid use in youth at-risk and in treatment for substance use disorders: a scoping review.","volume":"67","author":"Nairn","year":"2022","journal-title":"Can J Psychiatry"},{"key":"zoi251343r42","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.cpr.2017.10.012","article-title":"Sex and gender differences in substance use disorders.","volume":"66","author":"McHugh","year":"2018","journal-title":"Clin Psychol Rev"},{"key":"zoi251343r43","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.jsat.2018.05.001","article-title":"Cannabis use, other substance use, and co-occurring mental health concerns among youth presenting for substance use treatment services: sex and age differences.","volume":"91","author":"Hawke","year":"2018","journal-title":"J Subst Abuse Treat"},{"issue":"1","key":"zoi251343r44","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1097\/ADM.0b013e3181d8dc62","article-title":"Gender differences in adolescent marijuana use and associated psychosocial characteristics.","volume":"5","author":"Schepis","year":"2011","journal-title":"J Addict Med"},{"issue":"1","key":"zoi251343r45","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1038\/npp.2017.140","article-title":"Sex-dependent effects of cannabis and cannabinoids: a translational perspective.","volume":"43","author":"Cooper","year":"2018","journal-title":"Neuropsychopharmacology"},{"issue":"1","key":"zoi251343r46","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1016\/j.jhealeco.2008.09.001","article-title":"Why parents worry: initiation into cannabis use by youth and their educational attainment.","volume":"28","author":"van Ours","year":"2009","journal-title":"J Health Econ"},{"key":"zoi251343r48","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmph.2022.101208","article-title":"Structural gender inequality and gender differences in adolescent substance use: a multilevel study from 45 countries.","volume":"19","author":"Cosma","year":"2022","journal-title":"SSM Popul Health"},{"key":"zoi251343r49","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.drugalcdep.2015.08.025","article-title":"Past 15-year trends in adolescent marijuana use: differences by race\/ethnicity and sex.","volume":"155","author":"Johnson","year":"2015","journal-title":"Drug Alcohol Depend"},{"issue":"2","key":"zoi251343r50","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1001\/archpediatrics.2010.191","article-title":"Cultural and gender convergence in adolescent drunkenness: evidence from 23 European and North American countries.","volume":"165","author":"Kuntsche","year":"2011","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"5","key":"zoi251343r51","doi-asserted-by":"publisher","first-page":"785","DOI":"10.1007\/s00038-013-0447-4","article-title":"Gender convergence in adolescent drunkenness in different Italian regions.","volume":"58","author":"Vieno","year":"2013","journal-title":"Int J Public Health"},{"key":"zoi251343r52","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/j.drugalcdep.2014.10.003","article-title":"Sex differences in drug use among polysubstance users.","volume":"145","author":"Lewis","year":"2014","journal-title":"Drug Alcohol Depend"},{"key":"zoi251343r53","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2019.105972","article-title":"Prescription opioid misuse among adolescents and emerging adults in the United States: a scoping review.","volume":"132","author":"Bonar","year":"2020","journal-title":"Prev Med"},{"key":"zoi251343r54","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.108978","article-title":"Gender differences in the prevalence of heroin and opioid analgesic misuse in the United States, 2015-2019.","volume":"227","author":"McHugh","year":"2021","journal-title":"Drug Alcohol Depend"},{"issue":"12","key":"zoi251343r55","doi-asserted-by":"publisher","first-page":"1042","DOI":"10.1016\/j.addbeh.2009.07.001","article-title":"The Substance Use Risk Profile Scale: a scale measuring traits linked to reinforcement-specific substance use profiles.","volume":"34","author":"Woicik","year":"2009","journal-title":"Addict Behav"},{"issue":"6","key":"zoi251343r56","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1080\/14659890412331333050","article-title":"French validity of two substance-use screening tests among adolescents: a comparison of the CRAFFT and DEP-ADO.","volume":"10","author":"Bernard","year":"2005","journal-title":"J Subst Use"},{"key":"zoi251343r58","doi-asserted-by":"publisher","DOI":"10.1016\/j.abrep.2019.100189","article-title":"Trends of poly-substance use among Canadian youth.","volume":"10","author":"Zuckermann","year":"2019","journal-title":"Addict Behav Rep"},{"issue":"1","key":"zoi251343r59","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1177\/2515245918823199","article-title":"Ordinal regression models in psychology: a tutorial.","volume":"2","author":"B\u00fcrkner","year":"2019","journal-title":"Adv Methods Pract Psychol Sci"},{"key":"zoi251343r60","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v080.i01","article-title":"brms: an R package for bayesian multilevel models using Stan.","volume":"80","author":"B\u00fcrkner","year":"2017","journal-title":"J Stat Softw"},{"issue":"1","key":"zoi251343r61","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1080\/21642850.2018.1428102","article-title":"Bayesian evaluation of behavior change interventions: a brief introduction and a practical example.","volume":"6","author":"Heino","year":"2018","journal-title":"Health Psychol Behav Med"},{"issue":"3","key":"zoi251343r62","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1016\/j.annepidem.2003.08.003","article-title":"Estimation of cumulative odds ratios.","volume":"14","author":"Cole","year":"2004","journal-title":"Ann Epidemiol"},{"issue":"1","key":"zoi251343r63","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1214\/14-BA884","article-title":"Bayesian model choice in cumulative link ordinal regression models.","volume":"10","author":"McKinley","year":"2015","journal-title":"Bayesian Anal"},{"issue":"5","key":"zoi251343r65","doi-asserted-by":"publisher","first-page":"1314","DOI":"10.1002\/jad.12498","article-title":"Time spent on social media and the risk of substance use among US adolescents.","volume":"97","author":"Li","year":"2025","journal-title":"J Adolesc"},{"key":"zoi251343r66","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2023.116387","article-title":"Social media influencers and adolescents\u2019 health: a scoping review of the research field.","volume":"340","author":"Engel","year":"2024","journal-title":"Soc Sci Med"},{"issue":"2","key":"zoi251343r67","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1002\/wps.21073","article-title":"Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention.","volume":"22","author":"Volkow","year":"2023","journal-title":"World Psychiatry"},{"issue":"1","key":"zoi251343r68","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/1471-2288-9-37","article-title":"Comparison of Bayesian and classical methods in the analysis of cluster randomized controlled trials with a binary outcome: the Community Hypertension Assessment Trial (CHAT).","volume":"9","author":"Ma","year":"2009","journal-title":"BMC Med Res Methodol"},{"issue":"1","key":"zoi251343r69","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1186\/s13643-021-01637-1","article-title":"Bayesian statistics in the design and analysis of cluster randomised controlled trials and their reporting quality: a methodological systematic review.","volume":"10","author":"Jones","year":"2021","journal-title":"Syst Rev"},{"key":"zoi251343r13","volume-title":"Monitoring the Future national survey results on drug use, 1975-2023: overview and detailed results for secondary school students","author":"Miech","year":"2023"},{"key":"zoi251343r14","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/978-1-4614-3375-0_4","volume-title":"Drug Abuse and Addiction in Medical Illness","author":"Castellanos-Ryan","year":"2012"},{"key":"zoi251343r25","doi-asserted-by":"crossref","DOI":"10.1037\/e506452014-001","volume-title":"Drug Use Among Ontario Students, 1977-2013: Detailed Findings from the Ontario Student Drug Use and Health Survey","author":"Boak","year":"2013"},{"key":"zoi251343r47","volume-title":"A Focus on Adolescent Substance Use in Europe, Central Asia and Canada: Health Behaviour in School-Aged Children International Report From the 2021\/2022 Survey","author":"Charrier","year":"2024"},{"key":"zoi251343r64","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1037\/0000298-033","volume-title":"APA Handbook of Adolescent and Young Adult Development","author":"Maggs","year":"2023"},{"key":"zoi251343r26","unstructured":"Boak? A, Hamilton? HA, Adlaf? EM, Mann? RE. Drug Use Among Ontario Students, 1977-2017: Detailed Findings from the Ontario Student Drug Use and Health Survey. Published 2017. Accessed April 13, 2025. https:\/\/www.camh.ca\/-\/media\/files\/pdf---osduhs\/drug-use-among-ontario-students-1977-2017---detailed-findings-from-the-osduhs.pdf"},{"key":"zoi251343r32","unstructured":"Health Canada. Canadian Tobacco Alcohol and Drugs (CTADS): 2015 summary. Updated March 2017. Accessed April 9, 2025. https:\/\/www.canada.ca\/en\/health-canada\/services\/canadian-alcohol-drugs-survey\/2015-summary.html"},{"key":"zoi251343r33","unstructured":"Health Canada. Alcohol and drug use among students in Canada, 2023\u201324: key findings from the Canadian Student Alcohol and Drugs Survey. Updated March 2025. Accessed March 9, 2025. https:\/\/www.canada.ca\/en\/health-canada\/services\/canadian-student-tobacco-alcohol-drugs-survey\/2023-2024-key-findings.html"},{"key":"zoi251343r35","unstructured":"Muhuri? PK, Gfroerer? JC, Davies? MC. CBHSQ data review: associations of nonmedical pain reliever use and initiation of heroin use in the United States. Published August 2013. Accessed March 26, 2025. https:\/\/www.samhsa.gov\/data\/sites\/default\/files\/DR006\/DR006\/nonmedical-pain-reliever-use-2013.htm"},{"key":"zoi251343r57","unstructured":"Germain? M, Guyon? L, Landry? M, Tremblay? J, Brunelle? N. Bergeron J. Grille de D\u00e9pistage de Consommation Probl\u00e9matique d\u2019alcool et de Drogues Chez Les Adolescents et Les Adolescentes (DEP-ADO), Version 3.1. Accessed March 26, 2025. https:\/\/apimed-pl.org\/contenu\/uploads\/2019\/11\/Grille-RISQ.2003-d%C3%A9pistage-alcool-drogues-ado.pdf"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2842890\/lynch_2025_oi_251343_1765387223.3337.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T16:00:31Z","timestamp":1766073631000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2842890"}},"subtitle":["A Secondary Analysis of A Cluster-Randomized Clinical Trial"],"short-title":[],"issued":{"date-parts":[[2025,12,18]]},"references-count":69,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.50176","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,18]]}}}