Disorders - Cannabis Use
McRae-Clark, A. L., Baker, N. L., Gray, K. M., Killeen, T., Hartwell, K. J., Simonian, S. J.
Background and Objectives: The purpose of this study was to evaluate the efficacy of vilazodone, a selective serotonin receptor inhibitor and partial 5-HT1A agonist, for treatment of cannabis dependence. Methods: Seventy-six cannabis-dependent adults were randomized to receive either up to 40 mg/day of vilazodone (n=41) or placebo (n=35) for 8 weeks combined with a brief motivational enhancement therapy intervention and contingency management to encourage study retention. Cannabis use outcomes were assessed via weekly urine cannabinoid tests; secondary outcomes included cannabis use self-report and cannabis craving. Results: Participants in both groups reported reduced self-reported cannabis use over the course of the study; however, vilazodone provided no advantage over placebo in reducing cannabis use. Men had significantly lower creatinine-adjusted cannabinoid levels and a trend for increased negative urine cannabinoid tests than women. Discussion and Conclusions: Vilazodone was not more efficacious than placebo in reducing cannabis use. Important gender differences were noted, with women having worse cannabis use outcomes than men. Scientific Significance: Further medication development efforts for cannabis use disorders are needed, and gender should be considered as an important variable in future trials. Copyright © American Academy of Addiction Psychiatry.
American Journal on Addictions, 25(1) : 69-75
- Year: 2016
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Antidepressants (any)
, Medications used to treat substance abuse, Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, Contingency management
Squeglia, L. M., Baker, N. L., McClure, E. A., Tomko, R. L, Adisetiyo, V., Gray, K. M.
Aims Current adolescent alcohol treatments have modest effects and high relapse rates. Evaluation of novel pharmacotherapy treatment is warranted. N-acetylcysteine (NAC), an over-the-counter antioxidant supplement with glutamatergic properties, is a promising treatment for marijuana cessation in adolescents; however, its effects on adolescent drinking have not been examined. To that end, this secondary analysis evaluated: (1) the effect of NAC vs. placebo on alcohol use over an eight-week adolescent marijuana cessation trial and (2) the role of marijuana cessation and reduction on subsequent alcohol use. Methods Marijuana-dependent adolescents (ages 15-21; N = 116) interested in treatment were randomized to NAC 1200 mg or matched placebo twice daily for eight weeks. Participants were not required to be alcohol users or interested in alcohol cessation to qualify. Results There were no demographic or baseline alcohol use differences between participants randomized to NAC vs. placebo (ps > 0.05). Of the 89 participants returning for > one visit following randomization, 77 reported > one alcoholic drink in the 30 days prior to study entry and averaged 1.3 (SD = 1.4) binge drinking days per week. During treatment, less marijuana use (measured via urine cannabinoid levels) was associated with less alcohol use in the NAC-treated group but not in the placebo-treated group (p = 0.016). Conclusions There was no evidence of compensatory alcohol use during marijuana treatment. In fact, in the NAC group, lower levels of marijuana use were associated with less alcohol use, suggesting NAC effects may generalize to other substances and could be useful in decreasing adolescent alcohol use. NAC trials specifically focused on alcohol-using adolescents are warranted. Copyright © 2016 Elsevier Ltd
Addictive Behaviors, 63 : 172-177
- Year: 2016
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Other biological interventions, Complementary & Alternative Interventions (CAM)
, Vitamins and supplements
Yurasek, A., Fernandez, A., Miller, M. B., Metrik, J., Borsari, B.
Aims: Marijuana use among college students is highly prevalent and associated with poorer academic outcomes. Although brief motivational interventions (BMIs) have been shown to be efficacious with reducing alcohol use in college students, little is known about the utility of alcohol BMIs in reducing other addictive behaviors, such as marijuana use, that often co-occur with drinking. The purpose of the current study was to examine the impact of alcohol-focused BMIs implemented within a stepped care approach in reducing marijuana use. Methods: Participants were 530 college students who violated campus alcohol policy and were mandated to receive an alcoholfocused brief advice (BA) session. Of the 530 participants, 39% (N= 208) reported baseline marijuana use and were included in the current analyses. Participants who reported continued risky alcohol use (4 or more heavy drinking episodes and/or 5 or more alcohol-related problems in the past month) six weeks following the BA session were randomized to BMI (n = 92) or assessment only (n = 90). Follow-up assessments were conducted 3, 6, and 9 months post-intervention. Results: Repeated measures ANOVA revealed that students did not reduce their frequency of marijuana use following a BA session, nor did the BMI significantly reduce marijuana use compared to the assessment-only group. Conclusions: Despite reductions in alcohol use, marijuana use did not change following alcohol-focused intervention efforts. This suggests that marijuana users can still benefit from alcohol-related interventions yet may need a more intense and targeted marijuana focused intervention to induce changes in marijuana use.
Drug & Alcohol Dependence, 156 : e243-e244
- Year: 2015
- Problem: Alcohol Use, Cannabis Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy
Secades-Villa, R., Garcia-Rodriguez, O., Fernandez-Hermida, J. R.
Objective: We provide a narrative review of published studies evaluating voucher-based contingency management (CM) treatment for cocaine, nicotine and cannabis use disorders in Spain and discuss the concerns and future challenges. Method: Published studies between 2008 and 2015 that evaluated the impact of incentives for SUD in Spain and included an appropriate control or comparison condition were identified and reviewed. Results: Adding voucher-based CM to standard treatments obtained better treatment retention and cocaine abstinence than standard care alone. CM also improved psychosocial functioning. Economic status or depressive symptoms did not affect the results of CM treatment for cocaine dependence. The addition of a CM protocol to cognitive behavioral treatment (CBT) also improved treatment effectiveness for smoking cessation. Available data on the effect of CM on cannabis use disorders (CUD) with young people did not allow confirmation of its superiority to date. Conclusion: The research conducted to date in Spain confirms and expands the findings of studies conducted in the US supporting the effectiveness of CM in the context of community settings with cocaine- and nicotine-dependents. However, CM has not yet been readily adopted into general clinical practice in Spain or the rest of Europe. The limited effectiveness of CM for CUD is likely due to the scarcity of data and may change with more studies, taking into account recent research on this topic in the US. Continued efforts are warranted to further develop and disseminate incentive-based treatments for SUD across clinical settings and populations in Spain.
Preventive Medicine, 80 : 82-88
- Year: 2015
- Problem: Cannabis Use
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Contingency management
Treloar, H., Blanchard, A., Justus, A., Monti, P., Chun, T., Swift, R., Tidey, J., Gwaltney, C., Miranda, R.
Topiramate (TPM) reduced alcohol use among heavy-drinking and dependent adults in several clinical trials. Based on TPM's facilitation of GABA and antagonism of glutamate, which suppresses dopaminergic activity in the nucleus accumbens, the present, proof-of-concept study examined the potential of TPM to reduce cannabis use among youth and explored possible mechanisms of TPM's effects. We hypothesized that TPM would reduce cannabis use and dampen subjective responses following cannabis use. Youth ages 15-24 (M = 19.71, SD = 2.16; 56.1% White; 25.8% Black; 51.5% female) were randomized to TPMor placebo for 6 weeks in addition to a 3-session, manual-driven, behavioral intervention. Given TPM's adverse neurocognitive profile, side effects were assessed throughout the trial and participants completed a neuropsychological test battery at baseline, week 3, and week 6. Subjective responses to cannabis were captured in real time using ecological momentary assessment (EMA), whereby participants completed random assessments throughout the day and self-initiated reports before and after cannabis use. Analyses focused on weeks 5 and 6 when youths randomized to TPM were stabilized at 200 mg/day. Thirty-nine youth completed the trial (placebo = 20; TPM = 19). Baseline characteristics did not differ between youth who completed the trial and those who attrited. Multilevel models with EMA reports nested within persons were estimated in SAS 9.3 PROCMIXED and indirect-effect tests of multilevel mediation were implemented with Mplus 7.0. Multilevel analyses tested the effect of TPM on frequency and quantity of cannabis use. Analyses of subjective responses compared youth's reports of craving, "high," stimulation, and sedation before and after cannabis use. TPM reduced the amount (grams) of cannabis youth smoked on days they used. Across conditions, youth reported reduced craving following cannabis use, increased "high," and increased sedation. Reports of subjective "high" were attenuated in the TPM group. TPM did not affect craving, stimulation, or sedation. Multilevel structural equation modeling showed that TPM's effects on cannabis use were potentiallymediated by its effects on "high." This initial study suggests that TPM may reduce cannabis use by altering subjective responses to smoking, which is similar to how it appears to reduce drinking. Findings support the need for additional trials implemented in larger samples and with longer stabilization at target dose.
Alcoholism: Clinical & Experimental Research, 39 : 265A
- Year: 2015
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Anticonvulsants/mood stabilisers (excl. lithium), Medications used to treat substance abuse, Service Delivery & Improvement, Other service delivery and improvement interventions
Smeerdijk, M., Keet, R., van-Raaij, B., Koeter, M., Linszen, D., de-Haan, L., Schippers, G.
Background: There is a clear need for effective interventions to reduce cannabis use in patients with first-episode psychosis. This follow-up of a randomized trial examined whether an intervention for parents, based on motivational interviewing and interaction skills (Family Motivational Intervention, FMI), was more effective than routine family support (RFS) in reducing cannabis use in patients with recent-onset schizophrenia.; Method: In a single-blind trial with 75 patients in treatment for recent-onset schizophrenia, 97 parents were randomly assigned to either FMI or RFS. Assessments were conducted at baseline and at 3 and 15 months after the interventions had been ended. Analyses were performed on an intention-to-treat basis using mixed-effect regression models.; Results: From baseline to the 15-month follow-up, there was a significantly greater reduction in FMI compared to RFS in patients' quantity (p = 0.01) and frequency (p < 0.01) of cannabis use. Patients' craving for cannabis use was also significantly lower in FMI at 15 months follow-up (p < 0.01). Both groups improved in parental distress and sense of burden; however, only FMI parents' appraisal of patients' symptoms showed further improvement at the 15-month follow-up (p < 0.05).; Conclusions: The results support the sustained effectiveness of FMI in reducing cannabis use in patients with recent-onset schizophrenia at 15 months follow-up. Findings were not consistent with regard to the long-term superiority of FMI over RFS in reducing parents' distress and sense of burden.;
Psychological Medicine, 45(13) : 2839-2848
- Year: 2015
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, Psychoeducation, Other Psychological Interventions
Miovsky, M., Vonkova, H., Gabrhelik, R., Stastna, L.
This study aims to examine the effect of school-based preventive intervention on cannabis use in Czech adolescents with different levels of risk factors and provide evidence of its universality. A randomized controlled prevention trial with six waves was conducted over a period of 33 months. We used a two-level logistic random-intercept model for panel data; we first looked at the statistical significance of the effect of the intervention on cannabis use, controlling for the characteristics of the children and time dummies. Then we analyzed the effects of the interactions between the intervention and the characteristics of the children on cannabis use and related it to the definition of universal preventive interventions. The setting for the study was in basic schools in the Czech Republic in the years 2007-2010. A total of 1,874 sixth-graders (mean age 11.82 years) who completed the baseline testing. According to our results, the prevention intervention was effective. We found all the selected characteristics of the children to be relevant in relation to cannabis use, except their relationships with their friends. We showed empirically that the intervention is universal in two dimensions for the selected characteristics of the children. First, all adolescents who undergo the intervention are expected to benefit. Second, with respect to the effect of the intervention on cannabis use, the total level of individual risk of cannabis use is superior to the composition of the risk factors in the individual risk profile. We present indicative evidence that the drug prevention intervention may be considered a true universal preventive intervention. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Prevention Science, 16(2) : 189-199
- Year: 2015
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Skills training, Other Psychological Interventions
Piehler, T. F., Winters, K. C.
Adolescents (aged 12-18 years) identified in a school setting as abusing marijuana and other drugs were randomly assigned to complete 1 of 2 brief interventions (BIs). Adolescents and their parent (N = 259) were randomly assigned to receive either a 2-session adolescent only (BI-A) or a 2-session adolescent and additional parent session (BI-AP). Interventions were manualized and delivered in a school setting by trained counselors. Adolescents were assessed at intake and at 6 months following the completion of the intervention. Using a latent construct representing 6-month marijuana use outcomes, current findings supported previous research that BI-AP resulted in superior outcomes when compared to BI-A. The presence of a marijuana dependence diagnosis at baseline predicted poorer outcomes when compared to youth without a diagnosis. Both baseline diagnostic status and co-occurring conduct problems interacted with intervention condition in predicting marijuana use outcomes. A marijuana dependence diagnosis resulted in poorer marijuana use outcomes within the BI-A condition when compared to BI-AP. Co-occurring conduct problems were associated with poorer marijuana use outcomes within the BI-AP intervention when compared to BI-A. Implications for implementing BIs given diagnostic status, parent involvement, and co-occurring conduct problems are discussed.; (c) 2015 APA, all rights reserved).
Psychology of Addictive Behaviors, 29(3) : 512-521
- Year: 2015
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, Other service delivery and improvement interventions
Stewart, D.G., Felleman, B. I., Arger, C. A.
Journal of Substance Abuse Treatment, 58 : 43-50
- Year: 2015
- Problem: Cannabis Use
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, Contingency management
, Personalised feedback, normative feedback
Stanger, C., Ryan, S. R., Scherer, E. A., Norton, G. E., Budney, A. J.
Objective The aim of this study was to conduct a randomized test comparing 2 multicomponent, contingency management interventions, 1 with and 1 without a full parent training curriculum, and an individual treatment for adolescent cannabis use disorders. Method A total of 153 adolescents who met DSM-IV criteria for cannabis abuse or dependence were randomized to motivational enhancement therapy/cognitive-behavioral therapy (MET/CBT), MET/CBT+abstinence-based contingency management (CM), or MET/CBT+CM+Parent Training (PT). Results Overall, during treatment, abstinence was greater for youth receiving clinic- and home-based CM without PT compared to those who received individual MET/CBT. There was no additional benefit of the full PT curriculum on marijuana use, youth externalizing problems, or parenting. Conclusion These results suggest that clinic- plus home-based CM for cannabis use disorders can increase rates of abstinence during treatment over and above an evidence-based treatment (individual MET/CBT), but in this study the addition of a comprehensive parenting training curriculum did not further enhance efficacy. Clinical trial registration information Treatment for Adolescent Marijuana Abuse; http://clinicaltrials.gov; NCT00580671.
Journal of the American Academy of Child & Adolescent Psychiatry, 54(6) : 445-453.e2
- Year: 2015
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Motivational interviewing, includes Motivational Enhancing Therapy, Other Psychological Interventions, Contingency management
, Other service delivery and improvement interventions
Malmberg, M., Kleinjan, M., Overbeek, G., Vermulst, A., Lammers, J., Monshouwer, K., Vollebergh, W.A., Engels, R.C.
Aim: To assess the effectiveness of the Healthy School and Drugs (HSD) program for secondary schools on the development of substance use among Dutch early adolescents and to explore whether boys, adolescents of lower educational backgrounds, or adolescents high on personality risk traits, would benefit more from the HSD program than others. Design: Randomized clustered trial with two intervention conditions (i.e., lessons and integral) among a general population of adolescents in the Netherlands. Participants: A total of 3784 students of 23 Dutch secondary schools. Measurements: Structured digital questionnaires were administered pre-intervention and at 8, 20, and 32months follow-ups. The outcome measure was the rate of change in substance use across follow-ups. Differential effectiveness of the HSD program was examined for sex, educational level, and personality traits. Findings: Our results show no HSD intervention effects on the development of substance use. Sex, education level, and personality characteristics of the participants did not moderate the intervention effects. Conclusion: The absence of effects of the Healthy School and Drugs program on the development of substance use indicates that the program should be renewed and redeveloped. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Addictive Behaviors, 42 : 194-202
- Year: 2015
- Problem: Alcohol Use, Cannabis Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Other Psychological Interventions
Mason, M., Light, J., Campbell, L., Keyser-Marcus, L., Crewe, S., Way, T., Saunders, H., King, L., Zaharakis, N. M., McHenry, C.
Close peer networks can affect adolescents' health behaviors by altering their social environments, and thus their risk for and protection against substance use involvement. We tested a 20. minute intervention named Peer Network Counseling that integrates motivational interviewing and peer network strategies with 119 urban adolescents who reported occasional or problem substance use. Adolescents presenting at primary care clinic were randomized to intervention or control conditions and followed for 6. months. Mixed-effect latent growth models were used to evaluate intervention effects on trajectories of alcohol and marijuana use, offers to use substances, and moderation models to test for interactions between intervention condition and peer network characteristics. A significant intervention effect was found for boys for offers to use alcohol from friends (p < .05), along with a trend significant effect for alcohol use (p < .08). Intervention was more effective in reducing marijuana use, vs. control, for participants with more peer social support (p< .001) and with more peer encouragement for prosocial behavior (school, clubs, sports, religious activities); however, intervention did not affect these network characteristics. Results provide support to continue this line of research to test brief interventions that activate protective peer network characteristics among at-risk adolescents, while also raising some interesting gender-based intervention questions for future research.
Journal of Substance Abuse Treatment, 58 : 16-24
- Year: 2015
- Problem: Alcohol Use, Cannabis Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, Other Psychological Interventions, Personalised feedback, normative feedback