Disorders - Cannabis Use
Bonsack, C., Gibellini-Manetti, S., Favrod, J., Montagrin, Y., Besson, J., Bovet, P., Conus, P.
Background: Cannabis use has a negative impact on psychosis. Studies are needed to explore the efficacy of psychological interventions to reduce cannabis use in psychosis. Our aim is to study the efficacy of a specific motivational intervention on young cannabis users suffering from psychosis. Methods: Participants (aged less than 35 years) were randomly assigned to treatment as usual (TAU) alone, or treatment as usual plus motivational intervention (MI + TAU). TAU was comprehensive and included case management, early intervention and mobile team when needed. Assessments were completed at baseline and at 3, 6 and12 months follow-up. Results: Sixty-two participants (32 TAU and 30 MI + TAU) were included in the study. Cannabis use decreased in both groups at follow-up. Participants who received MI in addition to TAU displayed both a greater reduction in number of joints smoked per week and greater confidence to change cannabis use at 3 and 6 months follow-up, but differences between groups were nonsignificant at 12 months. Conclusions: MI is well accepted by patients suffering from psychosis and has a short-term impact on cannabis use when added to standard care. However, the differential effect was not maintained at 1-year follow-up. MI appears to be a useful active component to reduce cannabis use which should be integrated in routine clinical practice. (copyright) 2011 S. Karger AG, Basel.
Psychotherapy & Psychosomatics, 80(5) : 287-297
- Year: 2011
- Problem: Psychosis Disorders, Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy
Douaihy, A., Cornelius, J., Chung, R. T., Daley, D., Wood, D., Kirisci, L., Hayes, J., et-al
The authors recently completed a first double-blind, placebo-controlled trial of fluoxetine (20 mg) in 70 adolescents and young adults with comorbid major depressive disorder (MDD) and an cannabis use disorder (CUD), most of whom also demonstrated an alcohol use disorder (AUD). All participants also received cognitive behavior therapy (CBT) and motivation enhancement therapy (MET) during the 12-week trial. The results of that acute phase study suggested efficacy for CBT-MET therapy but not for fluoxetine (Cornelius et al., 2010, in DAD). A one-year follow-up (F/U) evaluation was conducted to assess whether the improvements noted during the acute phase study persist. 68 of the 70 youth (97%) participated in the F/U evaluation. Increases in days of marijuana use, binge days of alcohol, and days of alcohol use were noted between the end of the acute phase trial and the 1-year F/U (p < 0.01). However, days of marijuana use and level of depressive symptoms continued to be lower at the 1-year F/U than at the acute phase baseline. No significant differences were noted between the fluoxetine group and the placebo group during the follow-up phase, just as none had been noted during the acute phase trial. These finding suggest that many of the clinical improvements noted during the acute phase trial persisted at the 1-year F/U assessment.
Alcoholism: Clinical & Experimental Research, 35 : 20A
- Year: 2011
- Problem: Depressive Disorders, Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Motivational interviewing, includes Motivational Enhancing Therapy
Cornelius, J. R., Bukstein, O. G., Douaihy, A. B., Clark, D. B., Chung, T. A., Daley, D. C., Wood, D. S., Brown, S. J.
Objective: This study compared the acute phase (12-week) efficacy of fluoxetine versus placebo for the treatment of the depressive symptoms and the cannabis use of adolescents and young adults with comorbid major depression (MDD) and a cannabis use disorder (CUD) (cannabis dependence or cannabis abuse). We hypothesized that fluoxetine would demonstrate efficacy versus placebo for the treatment of the depressive symptoms and the cannabis use of adolescents and young adults with comorbid MDD/CUD. Methods: We conducted the first double-blind placebo-controlled study of fluoxetine in adolescents and young adults with comorbid MDD/CUD. All participants in both treatment groups also received manual-based cognitive behavioral therapy (CBT) and motivation enhancement therapy (MET) during the 12-week course of the study. Results: Fluoxetine was well tolerated in this treatment population. No significant group-by-time interactions were noted for any depression-related or cannabis-use related outcome variable over the 12-week study. Subjects in both the fluoxetine group and the placebo group showed significant within-group improvement in depressive symptoms and in number of DSM diagnostic criteria for a CUD. Large magnitude decreases in depressive symptoms were noted in both treatment groups, and end-of-study levels of depressive symptoms were low in both treatment groups. Conclusions: Fluoxetine did not demonstrate greater efficacy than placebo for treating either the depressive symptoms or the cannabis-related symptoms of our study sample of comorbid adolescents and young adults. The lack of a significant between-group difference in these symptoms may reflect limited medication efficacy, or may result from efficacy of the CBT/MET psychotherapy or from limited sample size. (copyright) 2010 Elsevier Ireland Ltd.
Drug & Alcohol Dependence, 112(1-2) : 39-45
- Year: 2010
- Problem: Depressive Disorders, Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Motivational interviewing, includes Motivational Enhancing Therapy
Lee, Christine M., Neighbors, Clayton, Kilmer, Jason R., Larimer, Mary E.
Despite clear need, brief web-based interventions for marijuana-using college students have not been evaluated in the literature. The current study was designed to evaluate a brief, web-based personalized feedback intervention for at-risk marijuana users transitioning to college. All entering first-year students were invited to complete a brief questionnaire. Participants meeting criteria completed a baseline assessment (N = 341) and were randomly assigned to web-based personalized feedback or assessment-only control conditions. Participants completed 3-month (95.0%) and 6-month (94.4%) follow-up assessments. Results indicated that although there was no overall intervention effect, moderator analyses found promising effects for those with a family history of drug problems and, to a smaller extent, students who were higher in contemplation of changing marijuana use at baseline. Implications of these findings for selective intervention of college marijuana use and web-based interventions in general are discussed.
(PsycINFO Database Record (c) 2010 APA, all rights reserved).
Psychology of Addictive Behaviors, 24(2) : 265-273
- Year: 2010
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Personalised feedback, normative feedback
, Technology, interventions delivered using technology (e.g. online, SMS)
Porath-Waller, Amy J., Beasley, Erin, Beirness, Douglas J.
This investigation used meta-analytic techniques to evaluate the effectiveness of school-based prevention programming in reducing cannabis use among youth aged 12 to 19. It summarized the results from 15 studies published in peer-reviewed journals since 1999 and identified features that influenced program effectiveness. The results from the set of 15 studies indicated that these school-based programs had a positive impact on reducing students' cannabis use (d = 0.58, CI: 0.55, 0.62) compared to control conditions. Findings revealed that programs incorporating elements of several prevention models were significantly more effective than were those based on only a social influence model. Programs that were longer in duration (≥15 sessions) and facilitated by individuals other than teachers in an interactive manner also yielded stronger effects. The results also suggested that programs targeting high school students were more effective than were those aimed at middle-school students. Implications for school-based prevention programming are discussed.
Health Education & Behavior, 37(5) : 709-723
- Year: 2010
- Problem: Cannabis Use
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
Stanger, Catherine, Budney, Alan J., Kamon, Jody L., Thostensen, Jeff
An initial efficacy test of an innovative behavioral outpatient treatment model for adolescents with problematic use of marijuana enrolled 69 adolescents, aged 14-18, and randomly assigned them to one of two treatment conditions. Both conditions received individualized Motivational Enhancement and Cognitive Behavioral Therapy (MET/CBT) and a twice-weekly drug-testing program. The experimental contingency management condition involved a clinic-delivered, abstinence-based incentive program, and weekly behavioral parent training sessions that included a parent-delivered, abstinence-based, substance monitoring contract. The comparison condition included an attendance-based incentive program, and weekly psychoeducational parent sessions. Follow-up assessments were performed at 3, 6, and 9 months post-treatment. The experimental condition showed greater marijuana abstinence during treatment, e.g., 7.6 vs. 5.1 continuous weeks and 50% vs. 18% achieved > or = 10 weeks of abstinence. Improvements were found in parenting and youth psychopathology across treatment conditions, and improvements in negative parenting uniquely predicted post-treatment abstinence. The outcomes observed in the experimental condition are consistent with adult substance-dependence treatment literature, and suggest that integrating CM abstinence-based approaches with other empirically based outpatient interventions provides an alternative and efficacious treatment model for adolescent substance abuse/dependence. Replication and continued development of more potent interventions remain needed to further advance the development of effective substance abuse treatments for adolescents.
Drug & Alcohol Dependence, 105(3) : 240-247
- Year: 2009
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Motivational interviewing, includes Motivational Enhancing Therapy, Other Psychological Interventions, Contingency management
Bernstein, E., Edwards, E., Dorfman, D., Heeren, T., Bliss, C., Bernstein, J.
Objectives: Marijuana was involved in 209,563 emergency department (ED) visits in 2006, according to the Drug Abuse Warning Network. Although screening and brief intervention (SBI) has been effective in changing drinking among ED patients in a number of studies, tests of marijuana SBI in a pediatric emergency department (PED) have not yet been reported. The aim of this pilot study was to test whether SBI is effective in reducing marijuana consumption among youth and young adults presenting to a PED with a diverse range of clinical entities. Methods: A three-group randomized controlled preliminary trial was structured to test 1) differences between Intervention (Int) and standard Assessed Control (AC) groups in marijuana consumption, from baseline to 12 months, and 2) the feasibility of adding a Nonassessed Control (NAC) group to evaluate regression to the mean and assessment reactivity. Patients aged 14-21 years in an urban, academic PED were screened during 2006-2007, using standardized risk factor questions. Subjects were eligible if they used marijuana three or more times in the past 30 days, but were excluded for co-occurring high-risk alcohol use. Consented enrollees were randomized to NAC, AC, and Int groups in a two-stage process that permitted blinding to status during assessment and follow-up. NACs received a resource handout, written advice about marijuana use risks, and a 12-month follow-up appointment. ACs were assessed using standardized instruments and received resources, written advice, and 3- and 12-month follow-up appointments. The Int group received assessment, resources, written advice, 3- and 12-month appointments, a 20-minute structured conversation conducted by older peers, and a 10-day booster telephone call. A peer educator utilized a motivational style interview protocol adapted for adolescents to elicit daily life context and future goals, provide feedback, review pros and cons of marijuana use, assess readiness to change, evaluate strengths and assets, negotiate a contract for change, and make referrals to treatment and/or other resources. Measurements included demographic information; 30-day self-report of marijuana use; attempts to quit, cut back, or change conditions of use; and risk factor questions repeated at follow-up. Results: Among 7,804 PED patients screened, 325 were eligible; 210 consented and enrolled (Int, n = 68; AC, n = 71; NAC, n = 71), with a 12-month follow-up rate of 71%. For the primary objective, we compared Int to AC. At 12 months, Int participants were more likely to be abstinent for the past 30 days than ACs (odds ratio [OR] for reported abstinence = 2.89, 95% confidence interval [CI] = 1.22 to 6.84, p < 0.014). The Int group had greater reduction in days used, baseline to 12 months, controlling for baseline (Int = -7.1 vs. AC = -1.8), were less likely to have been high among those who smoked (OR = 0.39, 95% CI = 0.17 to 0.89, p < 0.05), and were more likely to receive referrals. In a linear regression model controlling for baseline use, NACs smoked 4 fewer days per month than ACs, but consumption was not significantly different, suggesting no assessment reactivity effect. Conclusions: A preliminary trial of SBI promoted marijuana abstinence and reduced consumption among PED patients aged 14-21 years. A no-contact condition for the NAC group over the year after enrollment was insufficient to capture enrollees for follow-up across a range of baseline acuity. (copyright) 2009 by the Society for Academic Emergency Medicine.
Academic Emergency Medicine, 16(11) : 1174-1185
- Year: 2009
- 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, Other Psychological Interventions
D'Amico, E. J., Orlando-Edelen, M.
The current study reports findings from a pilot evaluation of a voluntary alcohol and marijuana intervention for young teens. Students at 2 middle schools completed 4 surveys over 2 years. During Year 2, an intervention, Project CHOICE (PC), was implemented at 1 school and was voluntarily attended by 13% of adolescents. Participants ranged from 10 to 15 years of age and were approximately 45% male, 45% White, 30% Latino, and 15% of mixed ethnic origin. Outcomes included assessments of self use and perceptions of friends' and schoolmates' past-month use of alcohol and marijuana. Analyses that compared PC participants (n= 64) with a matched control sample of students (n= 264) revealed that PC participants reported lower rates of alcohol use and lower perceptions of friends' marijuana use and of schoolmates' use of these substances. Random-effects growth models indicated that self use and perceptions of friends' use of alcohol and marijuana increased more sharply among control school students (n= 178) relative to students from the PC school (n= 270), regardless of participation. Results suggest that a brief voluntary intervention attended by a small proportion of students can impact both individual and schoolwide substance-related outcomes. copyright 2007 American Psychological Association.
Psychology of Addictive Behaviors, 21(4) : 592-598
- Year: 2007
- Problem: Alcohol Use, Cannabis Use
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Personalised feedback, normative feedback
Carroll, Kathleen M., Easton, Caroline J., Nich, Charla, Hunkele, Karen A., Neavins, Tara M., Sinha, Rajita, Ford, Haley L., et-al
Marijuana-dependent young adults (N = 136), all referred by the criminal justice system, were randomized to 1 of 4 treatment conditions: a motivational/skills-building intervention (motivational enhancement therapy/cognitive-behavioral therapy; MET/CBT) plus incentives contingent on session attendance or submission of marijuana-free urine specimens (contingency management; CM), MET/CBT without CM, individual drug counseling (DC) plus CM, and DC without CM. There was a significant main effect of CM on treatment retention and marijuana-free urine specimens. Moreover, the combination of MET/CBT plus CM was significantly more effective than MET/CBT without CM or DC plus CM, which were in turn more effective than DC without CM for treatment attendance and percentage of marijuana-free urine specimens. Participants assigned to MET/CBT continued to reduce the frequency of their marijuana use through a 6-month follow-up. Copyright 2006 APA, all rights reserved.
Journal of Consulting & Clinical Psychology, 74(5) : 955-66
- Year: 2006
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Motivational interviewing, includes Motivational Enhancing Therapy, Contingency management
Edwards, J., Elkins, K., Hinton, M., Harrigan, S. M., Donovan, K., Athanasopoulos, O., McGorry, P. D.
OBJECTIVE: To evaluate a cannabis-focused intervention (cannabis and psychosis therapy: CAP) for patients continuing to use cannabis following initial treatment for first-episode psychosis (FEP). METHOD: Consecutive admissions to an early psychosis program were screened and consenting individuals using cannabis in the 4 weeks prior to assessment participated. A single-blind randomized controlled trial compared CAP (n = 23) with a clinical control condition (psychoeducation, PE; n = 24). There were no significant differences between the CAP and PE groups on cannabis use at end of treatment and 6 months post-intervention. RESULTS: There were no significant group differences on psychopathology and functional ratings at follow-up. A significant reduction in cannabis use was observed for both groups over time. CONCLUSION: PE and specific cannabis-focused intervention are associated with similar reductions in cannabis use in an FEP cohort. Simple interventions may therefore be worth considering prior to intensive psychotherapeutic efforts with this population.
Acta Psychiatrica Scandinavica, 114(2) : 109-17
- Year: 2006
- Problem: Psychosis Disorders, Cannabis Use
- Type: Randomised controlled trials
-
Stage: First episode (psychosis only)
, At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Other Psychological Interventions
Longshore, Douglas, Ghosh-Dastidar, Bonnie, Ellickson, Phyllis L.
This analysis examined the possible synergistic effect of exposure to the National Youth Anti-Drug Media Campaign and a classroom-based drug prevention curriculum among 9th grade students participating in a randomized trial of ALERT Plus. A total of 45 South Dakota high schools and their middle-school feeder(s) were randomly assigned to an ALERT condition (basic prevention curriculum delivered in 7th and 8th grades), an ALERT Plus condition (basic curriculum with booster lessons added for 9th and 10th grades), or a control condition. Marijuana use in the past month was significantly less likely among ALERT Plus students reporting at least weekly exposure to anti-drug media messages. The National Youth Anti-Drug Media Campaign may have led to reductions in marijuana use among youth who simultaneously received school-based drug prevention.
Addictive Behaviors, 31(3) : 496-508
- Year: 2006
- Problem: Cannabis Use
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Skills training
Walker, Denise D., Roffman, Roger A., Stephens, Robert S., Wakana, Kim, Berghuis, James, Kim, Wakana
This study's aims were (a) to investigate the feasibility of a school-based motivational enhancement therapy (MET) intervention in voluntarily attracting adolescents who smoke marijuana regularly but who are not seeking formal treatment and (b) to evaluate the efficacy of the intervention in reducing marijuana use. Ninety-seven adolescents who had used marijuana at least 9 times in the past month were randomly assigned to either an immediate 2-session MET intervention or to a 3-month delay condition. Two thirds of the sample characterized themselves as in the precontemplation or contemplation stages of change regarding marijuana use. Participants' marijuana use and associated negative consequences were assessed at baseline and at a 3-month follow-up. Analyses revealed that both groups significantly reduced marijuana use at the 3-month follow-up ( p = .001); however, no between-group differences were observed. Despite the absence of a clear effect of MET, this study demonstrated that adolescents could be attracted to participate in a voluntary marijuana intervention that holds promise for reducing problematic levels of marijuana use. Copyright 2006 APA, all rights reserved.
Journal of Consulting & Clinical Psychology, 74(3) : 628-32
- Year: 2006
- 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