Disorders - cannabis use
Carroll, Kathleen M., Nich, Charla, LaPaglia, Donna M., Peters, Erica N., Easton, Caroline J., Petry, Nancy M.
Aims: To evaluate reciprocal enhancement (combining treatments to offset their relative weaknesses) as a strategy to improve cannabis treatment outcomes. Contingency management (CM) with reinforcement for homework completion and session attendance was used as a strategy to enhance cognitive - behavioral therapy (CBT) via greater exposure to skills training; CBT was used as a strategy to enhance durability of CM with rewards for abstinence. Setting: Community-based out-patient treatment program in New Haven, Connecticut, USA. Design: Twelve-week randomized clinical trial of four treatment conditions: CM for abstinence alone or combined with CBT, CBT alone or combined with CM with rewards for CBT session attendance and homework completion. Participants: A total of 127 treatment-seeking young adults (84.3% male, 81.1% minority, 93.7% referred by criminal justice system, average age 25.7 years). Measurements: Weekly urine specimens testing positive for cannabis, days of cannabis use via the time-line follow-back method. Findings: Within treatment, reinforcing homework and attendance did not significantly improve CBT outcomes, and the addition of CBT worsened outcomes when added to CM for abstinence (75.5 versus 57.1% cannabis-free urine specimens, F = 2.25, P = 0.02). The CM for abstinence condition had the lowest percentage of cannabis-negative urine specimens and the highest mean number of consecutive cannabis-free urine specimens (3.3, F = 2.33, P = 0.02). Attrition was higher in the CBT alone condition, but random effect regression analyses indicated this condition was associated with the greatest rate of change overall. Cannabis use during the 1-year follow-up increased most rapidly for the two enhanced groups. Conclusions: Combining contingency management and cognitive - behavioural therapy does not appear to improve success rates of treatment for cannabis dependence in clients involved with the criminal justice system. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)
Addiction, 107(9) : 1650-1659
- Year: 2012
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Contingency management
Lawlor, E., Madigan, K., Russell, V., O'Connor, J. J., Turner, N., Clarke, M., Waddington, J., O'Callaghan, E.
Background: A Cochrane review of 25 randomized controlled trials of psychosis and comorbid substance use found little evidence of effective strategies to improve outcome amongst this cohort. Few studies have evaluated a group based intervention and none have utilized a group based cognitive behavioural therapy approach combined with motivational interviewing. Aim: We adapted the Cannabis and Psychosis (CAP) individual programme to a group-based format for those with early phase psychosis and cannabis abuse. The final intervention consisted of 12 weekly sessions and was based upon motivational interviewing, cognitive behavioural therapy and psychoeducation. The six phases included: (i) entry: gaining commitment to treatment; (ii) commitment: building commitment to a goal of nonproblematic substance misuse; (iii) goal setting: reinforcing commitment to change and development of goal achievement strategies; (iv) challenges: withdrawal counseling; (v) relapse prevention and lifestyle: early warning signs, healthy living; (vi) maintenance: coping skills. Results: In total 230 individuals were referred to the trial. Of those referred, 72 (31%) did not meet inclusion criteria and 70 (30.4%) refused. Of the remainder, 88 were randomized on a 2 : 1 ratio, 59 (26%) to intervention and 29 (13%) to treatment as usual. However 32 (14%) individuals allocated to the intervention declined to participate in the group based programme. Conclusion: It is difficult to engage participants with early phase psychosis and comorbid cannabis use with a group psychological intervention aimed at improving outcome in psychosis. Innovative engagement strategies are needed with this cohort.
Early Intervention in Psychiatry, 6 : 28
- Year: 2012
- Problem: Psychosis Disorders, 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, Psychoeducation
Hoch, E., Noack, R., Henker, J., Pixa, A., Hofler, M., Behrendt, S., Buhringer, G., et-al
Aims: To examine the efficacy, 3- and 6-month follow-up effects of a psychological treatment for older adolescents and adults with DSM-IV cannabis use disorders. The program was tailored to the needs of this patient population.; Experimental Procedures: A randomized controlled clinical trial of 122 patients aged 16 to 44 years with DSM-IV cannabis dependence as the main substance use diagnosis was conducted. Patients were randomly assigned to either Active Treatment (AT, n = 90) or a Delayed Treatment Control group (DTC, n = 32). Treatment consisted of 10 sessions of therapy, detailed in a strictly enforced manual. Assessments were conducted at baseline, during each therapy session, at post treatment and at follow-up assessments at 3 and 6 months.; Results: The treatment retention rate was 88%. Abstinence was achieved in 49% of AT patients and in 13% of those in DTC (p < 0.001; intend-to-treat (ITT) analysis). Further, AT patients improved significantly (p < = 0.001) in the frequency of cannabis use per week, addiction severity, number of disability days, and overall level of psychopathology. Program effects were maintained over a 3-month- (abstinence rate: 51%) and 6-month follow-up (45%) period.; Conclusion: The treatment program is effective in obtaining abstinence as well as reducing cannabis use and improves the associated social and mental health burden.; Copyright © 2011 Elsevier B.V. and ECNP. All rights reserved.
European Neuropsychopharmacology, 22(4) : 267-280
- Year: 2012
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
De Dios, M. A., Herman, D. S., Britton, W. B., Hagerty, C. E., Anderson, B. J., Stein, M. D.
This pilot study tested the efficacy of a brief intervention using motivational interviewing (MI) plus mindfulness meditation (MM) to reduce marijuana use among young adult females. Thirty-four female marijuana users between the ages of 18 and 29 were randomized to either the intervention group (n = 22), consisting of two sessions of MI-MM, or an assessment-only control group (n = 12). The participants' marijuana use was assessed at baseline and at 1, 2, and 3 months posttreatment. Fixed-effects regression modeling was used to analyze treatment effects. Participants randomized to the intervention group were found to use marijuana on 6.15 (z = -2.42, p = .015), 7.81 (z = -2.78, p = .005), and 6.83 (z = -2.23, p = .026) fewer days at Months 1, 2, and 3, respectively, than controls. Findings from this pilot study provide preliminary evidence for the feasibility and effectiveness of a brief MI-MM for young adult female marijuana users. (copyright) 2012 Elsevier Inc.
Journal of Substance Abuse Treatment, 42(1) : 56-64
- Year: 2012
- 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, Mindfulness based therapy
Killeen, T. K., McRae-Clark, A. L., Waldrop, A. E., Upadhyaya, H., Brady, K. T.
Adolescent substance abuse remains a public health problem, and more effective treatment approaches are needed. The study aims to determine the feasibility and preliminary effectiveness of implementing a cost-effective contingency management (CM) intervention in community substance abuse treatment for adolescents with marijuana use disorders. Thirty-one adolescents with primary marijuana use disorder enrolled in a community treatment were randomized into either a prize-based CM intervention contingent when submitting negative urine drug screens (UDS) or a noncontingent control group. There were no significant group differences in percent negative UDS, sustained negative UDS, or retention in treatment. CM was difficult to integrate into community treatment programs and did not seem to be an effective adjunct to standard community substance abuse treatment for adolescents with marijuana use disorders. Modifying the CM procedure for adolescents, changing staff attitudes toward CM, and/or combining CM with other evidence-based psychosocial treatment may improve outcomes. (copyright) 2012 Wiley Periodicals, Inc.
Journal of Child & Adolescent Psychiatric Nursing, 25(1) : 33-41
- Year: 2012
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Contingency management
Fischer, B., Jones, W., Shuper, P., Rehm, J.
One in three young people use cannabis in Canada. Cannabis use can be associated with a variety of health problems which occur primarily among intensive/frequent users. Availability and effectiveness of conventional treatment for cannabis use is limited. While Brief Interventions (BIs) have been shown to result in short-term reductions of cannabis use risks or problems, few studies have assessed their longer-term effects. The present study examined 12-month follow-up outcomes for BIs in a cohort of young Canadian high-frequency cannabis users where select short-term effects (3 months) had previously been assessed and demonstrated. N=134 frequent cannabis users were recruited from among university students in Toronto, randomized to either an oral or a written cannabis BI, or corresponding health controls, and assessed in-person at baseline, 3-months, and 12-months. N=72 (54%) of the original sample were retained for follow-up analyses at 12-months where reductions in 'deep inhalation/breathholding' (Q=13.1; p< .05) and 'driving after cannabis use' (Q=9.3; p< .05) were observed in the experimental groups. Reductions for these indicators had been shown at 3-months in the experimental groups; these reductions were maintained over the year. Other indicators assessed remained overall stable in both experimental and control groups. The results confirm findings from select other studies indicating the potential for longer-term and sustained risk reduction effects of BIs for cannabis use. While further research is needed on the long-term effects of BIs, these may be a valuable - and efficient - intervention tool in a public health approach to high-risk cannabis use.
Substance Abuse Treatment, Prevention & Policy, 7 : 15
- Year: 2012
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Psychoeducation
Gray, Kevin M., Carpenter, Matthew J., Baker, Nathaniel L., DeSantis, Stacia M., Kryway, Elisabeth, Hartwell, Karen J., McRae-Clark, Aimee L., et-al
[Correction Notice: An Erratum for this article was reported in Vol 169(8) of The American Journal of Psychiatry (see record 2012-28893-017). In the original article, Figure 3 was originally published online (in "AJP in Advance") with an incorrect scale for the y-axis. The figure appears as intended for the article's appearance in the August 2012 issue and in the online version posted as part of that issue.] Objective: Preclinical findings suggest that the over-the-counter supplement N-acetylcysteine (NAC), via glutamate modulation in the nucleus accumbens, holds promise as a pharmacotherapy for substance dependence. The authors investigated NAC as a novel cannabis cessation treatment in adolescents, a vulnerable group for whom existing treatments have shown limited efficacy. Method: In an 8-week double-blind randomized placebo-controlled trial, treatment-seeking cannabis-dependent adolescents (ages 15-21 years, N=116) received NAC (1200 mg) or placebo twice daily as well as a contingency management intervention and brief (<10 minutes) weekly cessation counseling. The primary efficacy measure was the odds of negative weekly urine cannabinoid test results during treatment among participants receiving NAC compared with those receiving placebo, in an intent-to-treat analysis The primary tolerability measure was frequency of adverse events, compared by treatment group. Results: Participants receiving NAC had more than twice the odds, compared with those receiving placebo, of having negative urine cannabinoid test results during treatment (odds ratio=2.4, 95% Cl=1.1 - 5.2). Exploratory secondary abstinence outcomes favored NAC but were not statistically significant. NAC was well tolerated, with minimal adverse events. Conclusions: This is the first randomized controlled trial of pharmacotherapy for cannabis dependence in any age group to yield a positive primary cessation outcome in an intent-to-treat analysis. Findings support NAC as a pharmacotherapy to complement psychosocial treatment for cannabis dependence in adolescents. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)
The American Journal of Psychiatry, 169(8) : 805-812
- Year: 2012
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Vitamins and supplements
Teesson, Maree, Newton, Nicola C., Barrett, Emma L.
Issues: To reduce the occurrence and costs related to substance use and associated harms it is important to intervene early. Although a number of international school-based prevention programs exist, the majority show minimal effects in reducing drug use and related harms. Given the emphasis on early intervention and prevention in Australia, it is timely to review the programs currently trialled in Australian schools. This paper reports the type and efficacy of Australian school-based prevention programs for alcohol and other drugs.; Approach: Cochrane, PsychInfo and PubMed databases were searched. Additional materials were obtained from authors, websites and reference lists. Studies were selected if they described programs developed and trialled in Australia that address prevention of alcohol and other drug use in schools.; Key Findings: Eight trials of seven intervention programs were identified. The programs targeted alcohol, cannabis and tobacco and most were based on social learning principles. All were universal. Five of the seven intervention programs achieved reductions in alcohol, cannabis and tobacco use at follow up.; Conclusion: Existing school-based prevention programs have shown to be efficacious in the Australian context. However, there are only a few programs available, and these require further evaluative research. This is critical, given that substance use is such a significant public health problem. The findings challenge the commonly held view that school-based prevention programs are not effective.; © 2012 Australasian Professional Society on Alcohol and other Drugs.
Drug & Alcohol Review, 31(6) : 731-736
- Year: 2012
- Problem: Substance Use Disorders (any), Alcohol Use, Cannabis Use
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions
Walker, D. D., Stephens, R., Roffman, R., DeMarce, J., Lozano, B., Towe, S., Berg, B.
Cannabis use adversely affects adolescents and interventions that are attractive to adolescents are needed. This trial compared the effects of a brief motivational intervention for cannabis use with a brief educational feedback control and a no-assessment control. Participants were randomized into one of three treatment conditions: Motivational Enhancement Therapy (MET), Educational Feedback Control (EFC), or Delayed Feedback Control (DFC). Those who were assigned to MET and EFC were administered a computerized baseline assessment immediately following randomization and completed assessments at the 3- and 12-month follow-up periods. Participants in the DFC condition were not assessed until the 3-month follow-up. Following the completion of treatment sessions, all participants were offered up to four optional individual treatment sessions aimed at cessation of cannabis use. The research was conducted in high schools in Seattle, Washington. The participant s included 310 self-referred adolescents who smoked cannabis regularly. The main outcome measures included days of cannabis use, associated negative consequences, and engagement in additional treatment. At the 3-month follow-up, participants in both the MET and EFC conditions reported significantly fewer days of cannabis use and negative consequences compared to those in the DFC. The frequency of cannabis use was less in MET relative to EFC at 3 months, but it did not translate to differences in negative consequences. Reductions in use and problems were sustained at 12 months, but there were no differences between MET and EFC interventions. Engagement in additional treatment was minimal and did not differ by condition. Brief interventions can attract adolescent cannabis users and have positive impacts on them, but the mechanisms of the effects are yet to be identified. (copyright) 2011 American Psychological Association.
Psychology of Addictive Behaviors, 25(3) : 474-484
- Year: 2011
- 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
Hendriks, V., van der Schee, E., Blanken, P.
Background: To meet the treatment needs of the growing number of adolescents who seek help for cannabis use problems, new or supplementary types of treatment are needed. We investigated whether multidimensional family therapy (MDFT) was more effective than cognitive behavioral therapy (CBT) in treatment-seeking adolescents with a DSM-IV cannabis use disorder in The Netherlands. Methods: One hundred and nine adolescents participated in a randomized controlled trial, with study assessments at baseline and at 3, 6, 9 and 12 months following baseline. They were randomly assigned to receive either outpatient MDFT or CBT, both with a planned treatment duration of 5-6 months. Main outcome measures were cannabis use, delinquent behavior, treatment response and recovery at one-year follow-up, and treatment intensity and retention. Results: MDFT was not found to be superior to CBT on any of the outcome measures. Adolescents in both treatments did show significant and clinically meaningful reductions in cannabis use and delinquency from baseline to one-year follow-up, with treatment effects in the moderate range. A substantial percentage of adolescents in both groups met the criteria for treatment response at month 12. Treatment intensity and retention was significantly higher in MDFT than in CBT. Post hoc subgroup analyses suggested that high problem severity subgroups at baseline may benefit more from MDFT than from CBT. Conclusions: The current study indicates that MDFT and CBT are equally effective in reducing cannabis use and delinquent behavior in adolescents with a cannabis use disorder in The Netherlands. (copyright) 2011 Elsevier Ireland Ltd.
Drug & Alcohol Dependence, 119(1-2) : 64-71
- Year: 2011
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Family therapy
Stein, M. D., Hagerty, C. E., Herman, D. S., Phipps, M. G., Anderson, B. J.
We randomized 332 women, 18-24 years old, who were not explicitly seeking treatment for their marijuana use to either a two-session motivationally focused intervention or an assessment-only condition. Assessed by timeline follow-back methodology, participants reported using marijuana 57% of days in the 3 months prior to study entry. Intervention effects on the likelihood of marijuana use were not statistically significant at 1 month (odds ratio [OR] = 0.77, p = 17), significant at 3 months (OR = 0.53, p = 01), and no longer significant at 6 months (OR = 0.74, p = 20). Among the 61% of participants endorsing any desire to quit using marijuana at baseline, significant intervention effects on the likelihood of marijuana use days were observed at 1 month (OR = 0.42, p = 03), 3 months (OR = 0.31, p = 02), and 6 months (OR = 0.35, p = 03). A two-session brief motivational intervention reduced marijuana use among young women not seeking treatment. Women with a desire to quit showed a greater and more durable response. (copyright) 2011 Elsevier Inc.
Journal of Substance Abuse Treatment, 40(2) : 189-198
- Year: 2011
- 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
Tossmann, Hans-Peter, Jonas, Benjamin, Tensil, Marc-Dennan, Lang, Peter, Struber, Evelin
In the last decade, several programs for the treatment of cannabis-related disorders were developed. Until now, no information is available on the efficacy of Internet-based counseling approaches for this target group. This article describes the evaluation of "quit the shit," a web-based intervention developed to help young people to quit or reduce their cannabis use significantly. Cannabis users seeking web-based treatment were included in a two-arm controlled trial conducted on a website for drug-related information and prevention. After the baseline assessment, members of the treatment condition were randomized to a 50-day intervention program. Other trial participants were put on a waiting list. A post-test was conducted 3months after randomization. Of all 1,292 subjects included in the trial, a total of 206 participants took part at the post-test. Per-protocol- and intention-to-treat analyses were conducted. Members of the treatment condition showed a significantly stronger reduction in cannabis use (primary outcome) than the control group. In the per-protocol analyses, moderate-to-strong effects were found for the reduction of the frequency and the reduction of the quantity of consumed cannabis. Small-to-moderate effects were observed on the secondary outcomes (use-related self-efficacy, anxiety, depression, and life satisfaction). Despite limitations concerning the interpretation of the results, the intervention seems to offer an effective treatment option for persons with cannabis-related problems. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Cyberpsychology, Behavior & Social Networking, 14(11) : 673-679
- Year: 2011
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
, Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)