Disorders - cannabis use
McRae-Clark, A. L., Baker, N. L., Gray, K. M., Killeen, T. K., Wagner, A. M., Brady, K. T., DeVane, C. L., Norton, J.
Background: The purpose of this study was to evaluate the efficacy of buspirone, a partial 5-HT1A agonist, for treatment of cannabis dependence. Methods: One hundred seventy-five cannabis-dependent adults were randomized to receive either up to 60. mg/day of buspirone ( n= 88) or placebo ( n= 87) for 12 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. Results: Participants in both groups reported reduced cannabis craving over the course of the study; however, buspirone provided no advantage over placebo in reducing cannabis use. Significant gender by treatment interactions were observed, with women randomized to buspirone having fewer negative urine cannabinoid tests than women randomized to placebo ( p= 0.007), and men randomized to buspirone having significantly lower creatinine adjusted cannabinoid levels as compared to those randomized to placebo ( p= 0.023). An evaluation of serotonin allelic variations did not find an association with buspirone treatment response. Conclusions: Buspirone was not more efficacious than placebo in reducing cannabis use. Important gender differences were noted, with women having worse cannabis use outcomes with buspirone treatment. Considerations for future medication trials in this challenging population are discussed.
Drug & Alcohol Dependence, 156 : 29-37
- Year: 2015
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Medications used to treat substance abuse
de-Oliveira-Christoff, A, Boerngen-Lacerda, R.
The prevalence of alcohol and other drug use is high among college students. Reducing their consumption will likely be beneficial for society as a whole. Computer and web-based interventions are promising for providing behaviorally based information. The present study compared the efficacy of three interventions (computerized screening and motivational intervention [ASSIST/MBIc], non-computerized screening and motivational intervention [ASSIST/MBIi], and screening only [control]) in college students in Curitiba, Brazil. A convenience sample of 458 students scored moderate and high risk on the ASSIST. They were then randomized into the three arms of the randomized controlled trial (ASSIST/MBIc, ASSIST/MBIi [interview], and assessment-only [control]) and assessed at baseline and 3months later. The ASSIST involvement scores decreased at follow-up compared with baseline in the three groups, suggesting that any intervention is better than no intervention. For alcohol, the specific involvement scores decreased to a low level of risk in the three groups and the MBIc group showed a positive outcome compared with control, and the scores for each question were reduced in the two intervention groups compared to baseline. For tobacco, involvement scores decreased in the three groups, but they maintained moderate risk. For marijuana, a small positive effect was observed in the ASSIST/MBIi and control groups. The ASSIST/MBIc may be a good alternative to interview interventions because it is easy to administer, students frequently use such computer-based technologies, and individually tailored content can be delivered in the absence of a counselor. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Addictive Behaviors, 45 : 164-171
- Year: 2015
- Problem: Alcohol Use, 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 Psychological Interventions, Technology, comparing delivery mode (e.g. online vs. face-to-face)
Yurasek, A. M., Dennhardt, A. A., Murphy, J. G.
Objective - A recent study demonstrated that a single 50-minute supplemental session that targeted the behavioral economic mechanisms of substance-free reinforcement and delayed reward discounting (Substance Free Activity Session: SFAS) enhanced the efficacy of a standard alcohol brief motivational intervention (BMI) for college drinkers. The purpose of the current study was to conduct a randomized controlled trial intended to replicate and extend the aforementioned study by focusing on both drug and alcohol misuse and reducing session length in order to enhance dissemination potential.
Method - Participants were 97 college students (58.8% women; 59.8% white/Caucasian & 30.9% African American; M age = 20.01, SD = 2.23) who reported at least one heavy drinking episode in the past month (M = 4.01 episodes). Most participants (62%) reported recent marijuana use (M = 12.22 days of past-month use). After completing a baseline assessment and an individual 30-minute alcohol-focused BMI, participants were randomized to either the 30-minute SFAS session or an education control session.
Results - A series of mixed model intent-to-treat analyses revealed that both groups reported drinking reductions and that participants in the BMI+SFAS group reported fewer days using marijuana at the 6-month follow-up.
Conclusions - These results do not support the incremental efficacy of the briefer SFAS for reducing drinking but suggest that it may improve marijuana outcomes. Future research is needed to identify the ideal length and timing of the SFAS supplement to BMIs.
Exp Clin Psychopharmacol., 23(5) : 332-338
- 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, Psychoeducation, Personalised feedback, normative feedback
deGee, E. A., Verdurmen, J. E., Bransen, E., deJonge, J. M., Schippers, G. M.
Evidence for negative effects of early-onset cannabis use has led to a need for effective interventions targeting adolescent cannabis users. A randomized controlled trial of an Australian two-session intervention based on motivational interviewing (the ACCU, or Weed-Check in Dutch) was replicated in a larger Dutch sample of 119 non-treatment-seeking adolescent cannabis users. Outcome measures at the 3-month follow-up were quantity and frequency of cannabis use, symptoms of dependence, stage of change, and psychosocial functioning. Changes in all measures were in the expected direction, yet not significant. In moderation analyses, heavier cannabis users at baseline receiving the Weed-Check had greater reductions in cannabis use than those in the control condition. These results suggest that the Weed-Check might be beneficial for heavier cannabis-using adolescents. Further research is needed to confirm these results in a sample of adolescent heavy cannabis users and to examine the relationship between MI skills of prevention workers and outcome. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Journal of Substance Abuse Treatment, 47(3) : 181-188
- Year: 2014
- 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
Asevedo, E., Mendes, A. C., Berk, M., Brietzke, E.
Objective: To conduct the first systematic literature review of clinical trials of N-acetylcysteine (NAC) for the treatment of substance abuse disorders and addictive behaviors.; Methods: A search of the MEDLINE, Embase and PsycINFO databases was conducted. The inclusion criteria for the review were clinical trials that used NAC in the treatment of a disorder related to substance use and/or addictive behaviors, limited to texts in English, Spanish, or French. The selected studies were evaluated with respect to type of trial, sample size, diagnostic input, intervention, length of follow-up, outcome variables, and results.; Results: Nine studies analyzing a total of 165 patients met the eligibility criteria and were included in qualitative analysis. These studies evaluated the role of NAC in cocaine dependence (three studies), cannabis dependence (two studies), nicotine dependence (two studies), methamphetamine addiction (one study), and pathological gambling (one study). Five of these trials were double-blind, randomized, and placebo-controlled.; Conclusions: The studies analyzed suggest a potential role for NAC in the treatment of addiction, especially of cocaine and cannabis dependence. These results are concordant with the hypothesis of the involvement of glutamatergic pathways in the pathophysiology of addiction.;
Revista Brasileira De Psiquiatria, 36(2) : 168-175
- Year: 2014
- Problem: Cannabis Use
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Other biological interventions
Machielsen, M. W. J., Veltman, D. J., Van-Den-Brink, W., De Haan, L.
Cannabis use disorders (CUDs) are highly comorbid in patients with schizophrenia and are associated with poor outcome. Clozapine has been put forward as the first choice antipsychotic in this comorbid group. However, little is known about the mechanisms underlying the assumed superiority of clozapine. We compared the effects of clozapine and risperidone on attentional bias, subjective craving and associated regional brain activity in patients with schizophrenia and CUD. Overall, 36 patients with schizophrenia and 19 healthy controls were included. Patients were randomised to antipsychotic treatment with clozapine or risperidone. At baseline and after 4 weeks of medication use, regional brain responses were measured during a classical Stroop and a cannabis word Stroop using functional magnetic resonance imaging. Clozapine-treated CUD patients showed a larger reduction in craving and in activation of the insula during the cannabis word Stroop, while risperidone-treated patients showed a larger decrease in activation of the right anterior cingulate cortex during the classical Stroop. A significant association was found between decreases in subjective craving and decreases in insula activation during the cannabis word Stroop. These findings strongly suggest that clozapine may be a better treatment choice in patients with schizophrenia and CUD than risperidone. © The Author(s) 2014.
Journal of Psychopharmacology, 28(7) : 633-642
- Year: 2014
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Atypical Antipsychotics (second generation)
, Medications used to treat substance abuse
Palfai, T. P., Saitz, R., Winter, M., Brown, T. A., Kypri, K., Goodness, T. M., O'Brien, L. M., Lu, J.
This pilot study sought to test the feasibility of procedures to screen students for marijuana use in Student Health Services (SHS) and test the efficacy of a web-based intervention designed to reduce marijuana use and consequences. Students were asked to participate in voluntary screening of health behaviors upon arrival at SHS. One hundred and twenty-three students who used marijuana at least monthly completed assessments and were randomized to one of four intervention conditions in a 2 (intervention: Marijuana eCHECKUP TO GO vs. control)×2 (site of intervention: on-site vs. off-site) between-groups design. Follow-up assessments were conducted online at 3 and 6 months. Latent growth modeling was used to provide effect size estimates for the influence of intervention on outcomes. One thousand and eighty undergraduate students completed screening. The intervention did not influence marijuana use frequency. However, there was evidence of a small overall intervention effect on marijuana-related consequences and a medium effect in stratified analyses in the on-site condition. Analyses of psychological variables showed that the intervention significantly reduced perceived norms regarding peer marijuana use. These findings demonstrate that it is feasible to identify marijuana users in SHS and deliver an automated web-based intervention to these students in different contexts. Effect size estimates suggest that the intervention has some promise as a means of correcting misperceptions of marijuana use norms and reducing marijuana-related consequences. Future work should test the efficacy of this intervention in a full scale randomized controlled trial.; Copyright © 2014 Elsevier Ltd. All rights reserved.
Addictive Behaviors, 39(9) : 1346-1352
- Year: 2014
- 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)
Elliott, J. C., Carey, K. B., Vanable, P. A.
Young adults in college have high rates of marijuana use, abuse, and dependence. Web-based interventions are increasingly popular, but their dissemination exceeds empirical support. One popular but understudied program is The Marijuana eCHECKUP TO GO (e-TOKE) for Universities & Colleges (San Diego State University Research Foundation, 2009). The aim of the present study was to evaluate its short-term effectiveness in changing marijuana involvement and perceived norms in undergraduates. Participants were 317 undergraduates (52% female, 78% White) who reported marijuana use within the month preceding baseline; each was randomly assigned to 1 of 4 conditions formed by crossing e-TOKE versus assessment only, with brief versus extensive baseline assessment (to assess assessment reactivity). Thus, 161 (51%) received eTOKE (77 with extended baseline, 84 with brief baseline), and 156 (49%) received assessment-only control (85 with extended baseline, 71 with brief baseline). 1 month later, all participants reported on marijuana use, problems, abuse and dependence symptoms, and norms. Assessment reactivity analyses yielded no significant differences by assessment condition. Individuals completing the e-TOKE program reported less extreme descriptive norms (ps < 0.01) but no decrease in marijuana use frequency, problems, abuse or dependence symptoms, or changes in injunctive norms (ps > 0.10). Thus, e-TOKE reduces perceptions of others' use, but this study did not provide evidence for its utility in changing personal use and problem indicators in the short-term. More research with longer follow-ups is indicated, given the possibility that descriptive norms could mediate behavior change.;
Psychology of Addictive Behaviors, 28(1) : 288-293
- Year: 2014
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Fernandez-Artamendi, S., Fernandez-Hermida, J. R., Godley, M.D., Secades-Villa, R.
The goal of the present study is to describe the implementation of two Evidence-based treatments (EBT) for adolescent Cannabis Use Disorders (CUD) in the Spanish Public Health System, and its main clinical outcomes. Adolescent Community Reinforcement Approach (A-CRA) and Contingency Management (CM) were chosen as the most efficacious treatment programs for this population. A total of 26 adolescent cannabis users entered the study (91.7% male; age=16.50) at two outpatient clinical facilities in Spain. A quasi-experimental design was utilized, with one group receiving A-CRA only and the other A-CRA+CM. Implementation of both EBTs resulted feasible, with positive clinical outcomes. Results indicated that A-CRA has positive retention (81.3%) and abstinence rates (68.8%). Results for the group receiving A-CRA+CM were not significantly better than A-CRA in retention (100%) or abstinence (75.5%), although sample is too small to establish firm conclusions. Cannabis-related problems and depressive symptomatology also decreased during treatment. Several limitations prevent us from determining the clinical efficacy of A-CRA in this study. The process of translating EBT's to clinical contexts presented with many difficulties that need to be overcome. Recommendations are made for further attempts to implement EBTs in these contexts.
El objetivo de este estudio era describir la implementación en el Sistema Público de Salud de dos programas basados en la evidencia (PBE) para adolescentes con trastornos por consumo de cannabis, y sus principales resultados. La Aproximación de Reforzamiento Comunitario para Adolescentes (A-CRA) y el Control de Contingencias (MC) fueron elegidos como los programas de intervención más eficaces para esta población. Un total de 26 adolescentes participaron en el estudio (91.7% chicos; edad media=16.50 años) en dos centros de carácter ambulatorio en España. Se utilizó un diseño cuasi-experimental, donde un grupo recibió A-CRA y el otro A-CRA+MC. La implementación de ambos programas resultó factible, con resultados clínicos positivos. El A-CRA ofreció buenas tasas de retención (81.3%) y abstinencia (68.6%). Los resultados del grupo A-CRA+MC no fueron significativamente mejores que los del A-CRA en retención (100%) o abstinencia (75.5%), aunque el limitado tamaño muestral no permite establecer conclusiones firmes. Los problemas asociados al cannabis y la sintomatología depresiva se redujeron durante el tratamiento. Varias limitaciones nos impiden determinar la eficacia clínica del A-CRA en este estudio. El proceso de traslación de los PBE al contexto clínico presentó múltiples dificultades que deben ser abordadas. Se discuten recomendaciones para futuros intentos de implementación de PBE en estos contextos.
International Journal of Clinical and Health Psychology, 14 : 186-194
- Year: 2014
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Contingency management
, Other service delivery and improvement interventions
Vogl, L. E., Champion, K. E., Teesson, M.
BACKGROUND: Psychostimulants and cannabis are two of the three most commonly used illicit drugs by young Australians. As such, it is important to deliver prevention for these substances to prevent their misuse and to reduce associated harms. The present study aims to evaluate the feasibility and effectiveness of the universal computer-based Climate Schools: Psychostimulant and Cannabis Module.
METHODS: A cluster randomised controlled trial was conducted with 1734 Year 10 students (mean age = 15.44 years; SD = 0.41) from 21 secondary schools in Australia. Schools were randomised to receive either the six lesson computer-based Climate Schools program or their usual health classes, including drug education, over the year.
RESULTS: The Climate Schools program was shown to increase knowledge of cannabis and psychostimulants and decrease pro-drug attitudes. In the short-term the program was effective in subduing the uptake and plateauing the frequency of ecstasy use, however there were no changes in meth/amphetamine use. In addition, females who received the program used cannabis significantly less frequently than students who received drug education as usual. Finally, the Climate Schools program was related to decreasing students' intentions to use meth/amphetamine and ecstasy in the future, however these effects did not last over time.
CONCLUSIONS: These findings provide support for the use of a harm-minimisation approach and computer technology as an innovative platform for the delivery of prevention education for illicit drugs in schools. The current study indicated that teachers and students enjoyed the program and that it is feasible to extend the successful Climate Schools model to the prevention of other drugs, namely cannabis and psychostimulants.
TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry ACTRN12613000492752.
Substance Abuse Treatment, Prevention & Policy, 9 : 24
- Year: 2014
- Problem: Cannabis Use, Stimulant Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Psychoeducation, Technology, interventions delivered using technology (e.g. online, SMS)
Malmberg, M., Kleinjan, M., Overbeek, G., Vermulst, A., Monshouwer, K., Lammers, J., Vollebergh, W. A., Engels, Rutger C.
Aim: To evaluate the effectiveness of the Healthy School and Drugs programme on alcohol, tobacco and marijuana use among Dutch early adolescents. Design: Randomized clustered trial with two intervention conditions (i.e. e-learning and integral). Setting: General population of 11-15-year-old 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 32 months follow-up. The primary outcome measures were new incidences of alcohol (life-time and 1-month prevalence), tobacco (life-time and 1-month prevalence) and marijuana use (life-time prevalence). Findings: Main effect analyses showed no programme effects on incidences of alcohol consumption (life-time prevalence: e-learning condition: B = 0.102, P = 0.549; integral condition: B = -0.157, P = 0.351; 1-month prevalence: e-learning condition: B = 0.191, P = 0.288; integral condition: B = -0.140, P = 0.445), tobacco consumption (life-time prevalence: e-learning condition: B = 0.164, P = 0.444; integral condition: B = 0.160, P = 0.119; 1-month prevalence: e-learning condition: B = 0.088, P = 0.746; integral condition: B = 0.261, P = 0.093), or marijuana consumption (life-time prevalence: e-learning condition: B = 0.070, P = 0.732; integral condition: B = 0.186, P = 0.214). Conclusion: The non-significant impact of the Healthy School and Drugs programme (a Dutch school-based prevention programme for early adolescents) on incidences of alcohol, tobacco and marijuana use indicates that the programme is either ineffective or implemented inadequately. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract).
Addiction, 109(6) : 1031-1040
- Year: 2014
- Problem: Alcohol Use, Cannabis Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Skills training, Other Psychological Interventions
Walton, M. A., Resko, S., Barry, K. L., Chermack, S. T., Zucker, R. A., Zimmerman, M. A., Booth, B. M., Blow, F. C.
Abstract Aims To examine the efficacy of a brief intervention delivered by a therapist (TBI) or a computer (CBI) in preventing cannabis use among adolescents in urban primary care clinics. Design A randomized controlled trial comparing: CBI and TBI versus control. Setting Urban primary care clinics in the United States. Participants Research staff recruited 714 adolescents (aged 12-18 years) who reported no life-time cannabis use on a screening survey for this study, which included a baseline survey, randomization (stratified by gender and grade) to conditions (control; CBI; TBI) and 3-, 6- and 12-month assessments. Measurements Using an intent-to-treat approach, primary outcomes were cannabis use (any, frequency); secondary outcomes included frequency of other drug use, severity of alcohol use and frequency of delinquency (among 85% completing follow-ups). Findings Compared with controls, CBI participants had significantly lower rates of any cannabis use over 12 months (24.16%, 16.82%, respectively, P < 0.05), frequency of cannabis use at 3 and 6 months (P < 0.05) and other drug use at 3 months (P < 0.01). Compared with controls, TBI participants did not differ in cannabis use or frequency, but had significantly less other drug use at 3 months (P < 0.05), alcohol use at 6 months (P < 0.01) and delinquency at 3 months (P < 0.01). Conclusions Among adolescents in urban primary care in the United States, a computer brief intervention appeared to prevent and reduce cannabis use. Both computer and therapist delivered brief interventions appeared to have small effects in reducing other risk behaviors, but these dissipated over time. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract).
Addiction, 109(5) : 786-797
- Year: 2014
- Problem: Substance Use Disorders (any), Alcohol Use, Cannabis Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Motivational interviewing, includes Motivational Enhancing Therapy, Personalised feedback, normative feedback
, Technology, comparing delivery mode (e.g. online vs. face-to-face)