Long-term effects of the Focus on Families project on substance use disorders among children of parents in methadone treatment

ABSTRACT Aims This study examines the efficacy of the Focus on Families project (currently called Families Facing the Future), a preventive intervention to reduce substance use disorders among children in families with a parent in methadone treatment. Design One hundred and thirty families were assigned randomly to a methadone clinic treatment‐as‐usual control condition or treatment‐as‐usual plus the Focus on Families intervention between 1991 and 1993. Setting Participants were recruited from two methadone clinics in the Pacific Northwest. Participants This study examines the development of substance use disorders among the 177 children (56.84% male) involved in the program using data from a long‐term follow‐up in 2005, when these participants ranged in age from 15 to 29 years. Intervention The intervention was delivered through group parent‐training workshops at the methadone clinics and through individualized home‐based services. The intervention taught parenting skills and skills for avoiding relapse to drug abuse. Measurements At long‐term follow‐up, substance use disorders were measured by the Composite International Diagnostic Interview (CIDI). Survival analyses were used to assess intervention versus control differences in the hazard of developing substance use disorders. Findings Overall, intervention and control participants did not differ significantly in risk of developing substance use disorders. However, there was evidence of a significant difference in intervention effect by gender. There was a significant reduction in the risk of developing a substance use disorder for intervention group males compared to control group males (hazard ratio = 0.53, P = 0.03), while intervention versus control differences among females were non‐significant and favored the control condition. Conclusions Results from this study suggest that helping parents in recovery focus on both reducing their drug use and improving their parenting skills may have long‐term effects on reducing substance use disorders among their male children. However, the overall long‐term benefits of this program are not supported by the results for female children.