A social cascades model of addiction: Examining effects of psychological interventions on social and substance use outcomes via meta-analytic review.

This study tested a cascading model of bidirectional relationships between social environment and substance misuse by analyzing 79 randomized intervention trials involving 13,946 patients. Substance misuse interventions yielded modest improvements in social outcomes (d = 0.15). Social and substance use outcomes were correlated across multiple levels, with intervention-related social improvements preceding substance use improvements and vice versa. Social intervention components demonstrated significant cross-domain effects (d = 0.12), with stronger effects observed for interventions involving close relationships such as family members (d = 0.23). These findings provide support for an integrative understanding of social processes in addiction.