Protective behavioral strategies associated with psychoactive substance use in different contexts and populations. A literature review

Introduction
Protective behavioral strategies (PBS) are behaviours that can be applied before, during or after psychoactive substance use to reduce the likeli­hood of associated negative consequences. Most of previous PBS research was limit­ed to college students’ drinking. However, this is not the only context in which research on PBS has been conducted. This article sought to identify and cha­racterise the contexts in which PBS has been studied and/or applied in practice to date. This objective was carried out through a narrative literature review.

Critical review
PBS have been conceptualised as a practical application of the behavioral self-control concept and/or harm reduction approach, in the context of psychoactive substance use. Six contexts were identified: problematic substance use treatment, harm reduction programmes, recreational substance use, substance use among high-school students, substance use among college students and chemsex. The identified contexts refer to po­pulations representing at-risk groups specific to different patterns of psychoactive substance use. For most of these contexts/populations, no eva­luation of the frequency and effectiveness of specific PBS use was conducted. Only the studies among college students used validated measures of PBS use.

Conclusions
Recommendations for further research developed from this review include: unifying the terminology used to refer to PBS, developing validated measurement tools, conducting prospective studies and studies assessing the effectiveness of specific PBS as part of evaluations of PBS-based interventions, conducting research among high-school adolescents and carrying out systematic lite­rature reviews.