Disorders - Cannabis Use
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
Ginsburg, Harvey J., Czyzewska, Maria
The effectiveness of national media campaigns aimed at reducing the prevalence
of tobacco and marijuana use among youth was investigated. We hypothesized that since recent self-reported tobacco use has declined substantially
more than marijuana, anti-tobacco television ads would produce higher favorable to unfavorable ratios of immediate post-viewing written comments
about the ads or the targeted substance. A double-blind experiment comparing the effectiveness of four televised anti-marijuana and anti-tobacco ads
ANOVA revealed significant interactions between type of ads and type of written comments. Co-varied pre-test substance attitude measures of 123
participants produced similar ANCOVA results. Immediate viewer reactions to the ads may be one mechanism for Hornik et. al.'s (2003, 2004) boomerang
outcomes for latest national anti-marijuana ad campaign. Substance prevention ads may reflect more than cause public perceptions of tobacco and
marijuana. Results did not support ads' success claimed by Office of National Drug Control (ONDCP). (PsycINFO Database Record (c) 2007 APA, all
rights reserved) (journal abstract).
North American Journal of Psychology, 7(3) : 367-
377
- Year: 2005
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Brown, Eric C., Catalano, Richard F., Fleming, Charles B., Haggerty, Kevin P., Abbott, Robert D.
Raising Healthy Children (RHC) is a
preventive intervention designed to promote positive youth development by targeting developmentally appropriate risk and protective factors. In this
study, the authors tested the efficacy of the RHC intervention on reducing adolescent alcohol, marijuana, and cigarette use. Ten public schools,
which comprised 959 1st- and 2nd-grade students (54% male students, 18% minority, 28% low socioeconomic status), were matched and assigned randomly
to either intervention or control conditions. A 2-part latent growth modeling strategy was used to examine change in both use-versus-nonuse and
frequency-of-use outcomes while students were in Grades 6-10. Results indicated significant (p < .05) intervention effects in growth trajectories for
frequency of alcohol and marijuana use but not for use versus nonuse. These findings provide support for preventive interventions that take a social
development perspective in targeting empirically supported risk and protective factors and demonstrate the use of 2-part models in adolescent
substance use research. Copyright 2005 APA, all rights reserved.
Journal of Consulting & Clinical Psychology, 73(4) : 699-710
- Year: 2005
- Problem: Alcohol
Use, Cannabis Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Bond,
Lyndal, Thomas,
Lyndal, Coffey, Carolyn, Glover, Sara, Butler, Helen, Carlin, John B., Patton, George
This study examined the impact of a school-based preventive intervention on cannabis use in adolescence,
using a cluster-randomized trial of a multilevel intervention aimed at improving social relationships within schools by promoting change in school
environment. Four waves of data were collected at baseline (1997, Year 8: mean age 13 years) and six, 18, and 30 months later (1999, Year 10: mean
age 16 years). Self-reported substance use, school engagement, and sociodemographic data were collected using computer-administered questionnaires.
Some 2.678(74%) Year 8 students participated (wave 1) with minimal attrition (10% by wave 4). Adjusting for baseline use, weak evidence existed for
an intervention effect on the prevalence of any use at Year 10 (OR 0.75, 95% CI 0.54, 1.05) and incident weekly use (OR 0.72, 95% CI 0.39, 1.33).
These effects were reduced after adjusting for confounders. Moderate evidence suggested an interaction effect between intervention group and tobacco
use (p = 0.04), suggesting the intervention was more effective for non-smokers at baseline (Adj. OR 0.50, 95% CI 0.26, 0.98). This study indicates
that a multi-level school-based program may provide an innovative direction for sustainable school interventions with the potential to reduce
substance use.
Journal of School Health, 74(1) : 23-9
- Year: 2004
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Skills training
Sinha, Rajita, Easton, Caroline, Renee-Aubin, Lisa, Carroll, Kathleen M.
Young marijuana abusers rarely seek treatment themselves and are difficult to engage in
treatment when referred by social agencies. To evaluate treatment engagement strategies in this population, 65 young probation-referred marijuana
abusers were randomly assigned to either three-session motivational enhancement therapy (MET alone) or three-session MET plus contingency management
(MET/CM), with vouchers for treatment attendance. A significantly higher number of participants in the MET/CM condition completed the three-session
intervention as compared with MET alone. Participants in both conditions reported significant reductions in marijuana use and improvement in legal
problems. These findings suggest that young marijuana abusers benefit from scientifically validated treatments.
American Journal on Addictions, 12(4) : 314-23
- Year: 2003
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Motivational interviewing, includes Motivational Enhancing Therapy, Contingency
management
Cuijpers, P., Jonkers,
R., De-Weerdt, I., De Jong, A.
Aims: To examine the effects of the 'Healthy School and
Drugs' project, a Dutch school-based drug prevention project that was developed in the late 1980s and disseminated during the 1990s. This programme
is currently being used by 64-73% of Dutch secondary schools and it is estimated that at least 350 000 high school students receive this intervention
each year. Design, setting and participants: A quasi-experimental study in which students of nine experimental (N = 1156) schools were compared with
students of three control schools (N = 774). The groups were compared before the intervention, 1 year later, 2 years later and 3 years later.
Measurements: Self-report measures of tobacco, alcohol and marijuana use. attitudes towards substance use, knowledge about substances and self-
efficacy. Findings: Some effects on the use of tobacco, alcohol and cannabis were found. Two years after the intervention, significant effects could
still be shown on alcohol use. Effects of the intervention were also found on knowledge, but there was no clear evidence for any effects on attitude
towards substance use and on self-efficacy. Conclusions: This study shows the Healthy School and Drugs project as implemented in Holland may have
some effect on drug use in the children exposed to it.
Addiction, 97(1) : 67-73
- Year: 2002
- Problem: Alcohol
Use, Cannabis Use
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Skills training