***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: IMPORTANCE Medical treatment setting s such as emergency departments ( EDs ) present important opportunities to address problematic substance use . Currently , EDs do not typically intervene beyond acute medical stabilization . OBJECTIVE To contrast the effects of a brief intervention with telephone boosters ( BI-B ) with those of screening , assessment , and referral to treatment ( SAR ) and minimal screening only ( MSO ) among drug-using ED patients . DESIGN , SETTING , AND PARTICIPANTS Between October 2010 and February 2012 , 1285 adult ED patients from 6 US academic hospitals , who scored 3 or greater on the 10-item Drug Abuse Screening Test ( indicating moderate to severe problems related to drug use ) and who were currently using drugs , were r and omized to MSO ( n = 431 ) , SAR ( n = 427 ) , or BI-B ( n = 427 ) . Follow-up assessment s were conducted at 3 , 6 , and 12 months by blinded interviewers . INTERVENTIONS Following screening , MSO participants received only an informational pamphlet . The SAR participants received assessment plus referral to addiction treatment if indicated , and the BI-B participants received assessment and referral as in SAR , plus a manual-guided counseling session based on motivational interviewing principles and up to 2 " booster " sessions by telephone during the month following the ED visit . MAIN OUTCOMES AND MEASURES Outcomes evaluated at follow-up visits included self-reported days using the patient-defined primary problem drug , days using any drug , days of heavy drinking , and drug use based on analysis of hair sample s. The primary outcome was self-reported days of use of the patient-defined primary problem drug during the 30-day period preceding the 3-month follow-up . RESULTS Follow-up rates were 89 % , 86 % , and 81 % at 3 , 6 , and 12 months , respectively . For the primary outcome , estimated differences in number of days of use ( 95 % CI ) were as follows : MSO vs BI-B , 0.72 ( -0.80 to 2.24 ) , P ( adjusted ) = .57 ; SAR vs BI-B , 0.70 ( -0.83 to 2.23 ) , P ( adjusted ) = .57 ; SAR vs MSO , -0.02 ( -1.53 to 1.50 ) , P ( adjusted ) = .98 . There were no significant differences between groups in self-reported days using the primary drug , days using any drug , or heavy drinking days at 3 , 6 , or 12 months . At the 3-month follow-up , participants in the SAR group had a higher rate of hair sample s positive for their primary drug of abuse ( 265 of 280 [ 95 % ] ) than did participants in the MSO group ( 253 of 287 [ 88 % ] ) or the BI-B group ( 244 of 275 [ 89 % ] ) . Hair analysis differences between groups at other time points were not significant . CONCLUSIONS AND RELEVANCE In this sample of drug users seeking emergency medical treatment , a relatively robust brief intervention did not improve substance use outcomes . More work is needed to determine how drug use disorders may be addressed effectively in the ED . TRIAL REGISTRATION clinical trials.gov Identifier : NCT01207791 Background Psychostimulants and cannabis are two of the three most commonly used illicit drugs by young Australians . As such , it is important to deliver prevention for these substances to prevent their misuse and to reduce associated harms . The present study aims to evaluate the feasibility and effectiveness of the universal computer-based Climate Schools : Psychostimulant and Cannabis Module . Methods A cluster r and omised controlled trial was conducted with 1734 Year 10 students ( mean age = 15.44 years ; SD = 0.41 ) from 21 secondary schools in Australia . Schools were r and omised to receive either the six lesson computer-based Climate Schools program or their usual health classes , including drug education , over the year . Results The Climate Schools program was shown to increase knowledge of cannabis and psychostimulants and decrease pro-drug attitudes . In the short-term the program was effective in subduing the uptake and plateauing the frequency of ecstasy use , however there were no changes in meth/amphetamine use . In addition , females who received the program used cannabis significantly less frequently than students who received drug education as usual . Finally , the Climate Schools program was related to decreasing students ’ intentions to use meth/amphetamine and ecstasy in the future , however these effects did not last over time . Conclusions These findings provide support for the use of a harm-minimisation approach and computer technology as an innovative platform for the delivery of prevention education for illicit drugs in schools . The current study indicated that teachers and students enjoyed the program and that it is feasible to extend the successful Climate Schools model to the prevention of other drugs , namely cannabis and psychostimulants . Trial registration Australian and New Zeal and Clinical Trials Registry ACTRN12613000492752 OBJECTIVE To compare computer-delivered and therapist-delivered treatments for people with depression and comorbid addictive disorders . DESIGN R and omised controlled clinical trial . SETTING AND PARTICIPANTS Our study was conducted between January 2005 and August 2007 at seven study clinics in rural and urban New South Wales . Participants were 274 people who had a Beck Depression Inventory II ( BDI-II ) score ≥ 17 and were using alcohol and /or cannabis at harmful levels in the month before baseline . They were self-referred or referred from other sources such as outpatient drug treatment clinics , general practice s and non-government support agencies . INTERVENTIONS Participants were r and omly allocated to receive ( 1 ) integrated cognitive behaviour therapy and motivational interviewing ( CBT/MI ) delivered by a therapist ; ( 2 ) integrated CBT/MI delivered by computer , with brief therapist assistance at the end of each session ( clinician-assisted computerised [ CAC ] treatment ) , or ( 3 ) person-centred therapy ( PCT ) , consisting of supportive counselling given by a therapist ( the control group ) . All three treatments were delivered according to a manual developed specifically for the study . MAIN OUTCOME MEASURES Changes in depression , alcohol use and cannabis use at 3 months after baseline ; significant predictors of change in the primary outcome variables . RESULTS Compared with computer- or therapist-delivered CBT/MI , PCT was associated with significantly less reduction in depression and alcohol consumption at 3 months . CAC therapy was associated with improvement at least equivalent to that achieved by therapist-delivered treatment , with superior results as far as reducing alcohol consumption . Change in depression was significantly predicted by change in alcohol use ( in the same direction ) and an ability to determine primacy , irrespective of whether this was for drug use or depression . Change in alcohol use was significantly predicted by changes in cannabis use and depression , and change in cannabis use by change in alcohol use . In the regression model , treatment allocation did not independently predict change , but was associated with significant reduction in depression and alcohol use at 3 months . CONCLUSIONS Over a 3-month period , CBT/MI was associated with a better treatment response than supportive counselling . CAC therapy was associated with greater reduction in alcohol use than therapist-delivered treatment . TRIAL REGISTRATION NUMBER ACTRN12610000274077 Throughout the world , drug and alcohol use has a clear adolescent onset ( Degenhardt et al. , 2008 ) . Alcohol continues to be the most popular drug among teens and emerging adults , with almost a third of 12th grade rs and 40 % of college students reporting recent binge drinking ( Johnston et al. , 2009 , 2010 ) , and marijuana ( MJ ) is the second most popular drug in teens ( Johnston et al. , 2010 ) . The initiation of drug use is consistent with an overall increase in risk-taking behaviors during adolescence that coincides with significant neurodevelopmental changes in both gray and white matter ( Giedd et al. , 1996a ; Paus et al. , 1999 ; Sowell et al. , 1999 , 2002 , 2004 ; Gogtay et al. , 2004 ; Barnea-Goraly et al. , 2005 ; Lenroot and Giedd , 2006 ) . Animal studies have suggested that compared to adults , adolescents may be particularly vulnerable to the neurotoxic effects of drugs , especially alcohol and MJ ( see Schneider and Koch , 2003 ; Barron et al. , 2005 ; Monti et al. , 2005 ; Cha et al. , 2006 ; Rubino et al. , 2009 ; Spear , 2010 ) . In this review , we will provide a detailed overview of studies that examined the impact of early adolescent onset of alcohol and MJ use on neurocognition ( e.g. , Ehrenreich et al. , 1999 ; Wilson et al. , 2000 ; Tapert et al. , 2002a ; Hartley et al. , 2004 ; Fried et al. , 2005 ; Townshend and Duka , 2005 ; Medina et al. , 2007a ; McQueeny et al. , 2009 ; Gruber et al. , 2011 , 2012 ; Hanson et al. , 2011 ; Lisdahl and Price , 2012 ) , with a special emphasis on recent prospect i ve longitudinal studies ( e.g. , White et al. , 2011 ; Hicks et al. , 2012 ; Meier et al. , 2012 ) . Finally , we will explore potential clinical and public health implication s of these findings This pilot study sought to test the feasibility of procedures to screen students for marijuana use in Student Health Services ( SHS ) and test the efficacy of a web-based intervention design ed to reduce marijuana use and consequences . Students were asked to participate in voluntary screening of health behaviors upon arrival at SHS . One hundred and twenty-three students who used marijuana at least monthly completed assessment s and were r and omized to one of four intervention conditions in a 2 ( intervention : Marijuana eCHECKUP TO GO vs. control) × 2 ( site of intervention : on-site vs. off-site ) between-groups design . Follow-up assessment s were conducted online at 3 and 6 months . Latent growth modeling was used to provide effect size estimates for the influence of intervention on outcomes . One thous and and eighty undergraduate students completed screening . The intervention did not influence marijuana use frequency . However , there was evidence of a small overall intervention effect on marijuana-related consequences and a medium effect in stratified analyses in the on-site condition . Analyses of psychological variables showed that the intervention significantly reduced perceived norms regarding peer marijuana use . These findings demonstrate that it is feasible to identify marijuana users in SHS and deliver an automated web-based intervention to these students in different context s. Effect size estimates suggest that the intervention has some promise as a means of correcting misperceptions of marijuana use norms and reducing marijuana-related consequences . Future work should test the efficacy of this intervention in a full scale r and omized controlled trial With the increasing legalization of cannabis , underst and ing the consequences of cannabis use is particularly timely . We examined the association between cannabis use and dependence , prospect ively assessed between ages 18 and 38 , and economic and social problems at age 38 . We studied participants in the Dunedin Longitudinal Study , a cohort ( N = 1,037 ) followed from birth to age 38 . Study members with regular cannabis use and persistent dependence experienced downward socioeconomic mobility , more financial difficulties , workplace problems , and relationship conflict in early midlife . Cannabis dependence was not linked to traffic-related convictions . Associations were not explained by socioeconomic adversity , childhood psychopathology , achievement orientation , or family structure ; cannabis-related criminal convictions ; early onset of cannabis dependence ; or comorbid substance dependence . Cannabis dependence was associated with more financial difficulties than was alcohol dependence ; no difference was found in risks for other economic or social problems .  Cannabis dependence is not associated with fewer harmful economic and social problems than alcohol dependence Background The relationship between tobacco and cannabis use is strong . When co-smokers try to quit only one substance , this relationship often leads to a substitution effect , that is , the increased use of the remaining substance . Stopping the use of both substances simultaneously is therefore a reasonable strategy , but co-smokers rarely report feeling ready for simultaneous cessation . Thus , the question of how co-smokers can be motivated to attempt a simultaneous cessation has arisen . To reach as many co-smokers as possible , we developed brief Web-based interventions aim ed at enhancing the readiness to simultaneously quit tobacco and cannabis use . Objective Our aim was to analyze the efficacy of three different Web-based interventions design ed to enhance co-smokers ’ readiness to stop tobacco and cannabis use simultaneously . Methods Within a r and omized trial , three brief Web-based and fully automated interventions were compared . The first intervention combined the assessment of  cigarette dependence  and problematic cannabis use with personalized , normative feedback . The second intervention was based on principles of motivational interviewing . As an active psychoeducational control group , the third intervention merely provided information on tobacco , cannabis , and the co-use of the two substances . The readiness to quit tobacco and cannabis simultaneously was measured before and after the inter 
    Output:
    
Digital prevention and treatment interventions showed small , significant reduction effects on Cannabis use in diverse target population s at post-treatment compared to controls .