Disorders - Cannabis Use
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)
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.\r(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)