Journal of Addiction & Prevention
Research Article
Treating Children Ages 7–12 in India for Drug Problems: Randomized Clinical Trial Outcomes
Jones HE1,2*, Middlesteadt-Ellerson R1, Browne T3, Naqati BA4, Kumar M4, Agarwal A5 and Kumar R4
1Department of Obstetrics and Gynecology, University of North
Carolina at Chapel Hill, Chapel Hill, NC, USA
2Departments of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
3Colombo Plan Secretariat, Colombo, Sri Lanka
4Society for Promotion of Youth and Masses (SPYM), New Delhi, India
5National Drug Dependence Treatment Centre, All India Institute of Medical Sciences (AIIMS), New Delhi, India
2Departments of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
3Colombo Plan Secretariat, Colombo, Sri Lanka
4Society for Promotion of Youth and Masses (SPYM), New Delhi, India
5National Drug Dependence Treatment Centre, All India Institute of Medical Sciences (AIIMS), New Delhi, India
*Address for Correspondence:Hendrée E. Jones, Department of Obstetrics and Gynecology,
University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. E-mail Id: hendree_jones@med.unc.edu
Submission: 17 August, 2026
Accepted: 12 September, 2026
Published: 14 September, 2026
Copyright: © 2026 Jones HE, et al. This is an open access article
distributed under the Creative Commons Attribution License, which
permits unrestricted use, distribution, and reproduction in any medium,
provided the original work is properly cited.
Keywords:Cannabis; India; Opioids; Solvents; Street Children;
Substance Use Treatment; Child; Randomized Controlled Trial
Abstract
Background: India has the world’s largest child population, and
children living in street circumstances there report among the highest
childhood substance use rates globally. Culturally appropriate,
rigorously tested treatments for children with substance use problems
remain scarce. This parallel-group, two-arm randomized controlled
trial tested whether CHILD (Child Intervention for Living Drug-free),
a structured curriculum combining one-to-one, attachmentbased
motivational-interviewing counseling with developmentally
sequenced group life-skills modules, added to Usual Care, improved
substance use and psychosocial outcomes compared with Usual Care
alone among children in residential substance use treatment in New
Delhi, India.
Methods: 344 children aged 7–12 entering residential treatment at the Society for Promotion of Youth and Masses (SPYM) in New Delhi were randomized to Usual Care + CHILD (n=183; 28 girls, 155 boys) or Usual Care alone (n=161; 13 girls, 148 boys). Usual Care was a childmodified therapeutic-community program with medical treatment, group psychoeducation, counseling, and aftercare. CHILD added individual motivational-interviewing counseling and eight repeating, developmentally sequenced life-skills modules. Outcomes of substance use, trauma, anxiety, adjustment, distress, and quality of life were tracked through 12 months, with urine drug screens (UDS) objectively confirming substance use at 12 months.
Results: The two arms were well balanced at baseline. Children in both groups showed improvement from baseline to treatment completion across substance use and psychosocial measures. Where the arms diverged, CHILD was associated with more consistent maintenance of these gains through the 12-month followup, particularly in quality-of-life domains related to mental health, friendships, and home life. This pattern was corroborated by urine drug screening at 12 months: children in the CHILD arm showed significantly lower positivity rates than Usual Care across opiates (3.0% vs. 15.6%), amphetamine (0.0% vs. 12.7%), methamphetamine (0.0% vs. 7.9%), and any substance (16.7% vs. 36.9%; all p<.05).
Conclusion: In this first randomized trial of a substance use treatment for children aged 7–12 in India, self-report, clinician-rated, and toxicology data converged to show that residential treatment benefits children, and that adding CHILD further strengthens outcomes. These findings support continued evaluation and scale-up of the intervention. The marked reduction in use of opiates, amphetamine, and methamphetamine is particularly meaningful given the serious toxic effects these substances have on children’s developing brains and bodies.
Methods: 344 children aged 7–12 entering residential treatment at the Society for Promotion of Youth and Masses (SPYM) in New Delhi were randomized to Usual Care + CHILD (n=183; 28 girls, 155 boys) or Usual Care alone (n=161; 13 girls, 148 boys). Usual Care was a childmodified therapeutic-community program with medical treatment, group psychoeducation, counseling, and aftercare. CHILD added individual motivational-interviewing counseling and eight repeating, developmentally sequenced life-skills modules. Outcomes of substance use, trauma, anxiety, adjustment, distress, and quality of life were tracked through 12 months, with urine drug screens (UDS) objectively confirming substance use at 12 months.
Results: The two arms were well balanced at baseline. Children in both groups showed improvement from baseline to treatment completion across substance use and psychosocial measures. Where the arms diverged, CHILD was associated with more consistent maintenance of these gains through the 12-month followup, particularly in quality-of-life domains related to mental health, friendships, and home life. This pattern was corroborated by urine drug screening at 12 months: children in the CHILD arm showed significantly lower positivity rates than Usual Care across opiates (3.0% vs. 15.6%), amphetamine (0.0% vs. 12.7%), methamphetamine (0.0% vs. 7.9%), and any substance (16.7% vs. 36.9%; all p<.05).
Conclusion: In this first randomized trial of a substance use treatment for children aged 7–12 in India, self-report, clinician-rated, and toxicology data converged to show that residential treatment benefits children, and that adding CHILD further strengthens outcomes. These findings support continued evaluation and scale-up of the intervention. The marked reduction in use of opiates, amphetamine, and methamphetamine is particularly meaningful given the serious toxic effects these substances have on children’s developing brains and bodies.