Disorders - Cannabis Use
Meisel, S. N., Treloar-Padovano, H., Miranda, R.
Background:
Theoretical models of behavior change argue that youth should decrease their time with cannabis-using friends and increase their time with non-using
friends during treatment. Informed by behavior-change models of recovery and socialization and selection peer-influence models, the current study
examined whether combining evidence-based psychosocial treatment with adjunctive pharmacotherapy helps youth decrease their affiliations with
cannabis-using friends and increase their affiliations with non-using friends during cannabis misuse treatment. Method(s): Youth ages 15-24 years (51
% male), participated in a double-blind randomized clinical trial that tested the effects of motivational enhancement and cognitive behavioral
therapy (MET-CBT) plus topiramate (N = 39) or placebo (N = 26) on cannabis craving and use. Ecological momentary assessment data, collected via
smartphones throughout the six-week intervention, assessed youths' time with cannabis-using and non-using friends, cannabis use, and craving in
daily life. Multiple group multilevel structural equation modeling tested study hypotheses. Result(s): Across the topiramate (48 % completion rate)
and placebo (77 % completion rate) conditions, greater time spent with cannabis-using friends promoted greater next day cannabis use and craving
(socialization effect). In turn, cannabis craving, but not use, promoted continued selection of cannabis-using friends. This indirect effect was only
supported in the placebo condition due to the selection piece of this cycle not being significant for youth who received topiramate. Neither cannabis
craving nor use were associated with time with non-using friends the next day. Conclusion(s): MET-CBT and adjunctive topiramate pharmacotherapy
interrupted youth selection processes. This finding suggests that changing peer affiliations could be one mechanism by which treatments can work.
Copyright © 2021 Elsevier B.V.
Drug and Alcohol Dependence, 225 (no
pagination) :
- Year: 2021
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions
(any), Medications used to treat substance abuse, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Motivational interviewing, includes Motivational Enhancing Therapy
Lile, J. A., Alcorn, J. L., Hays, L. R., Kelly, T. H., Stoops, W. W., Wesley, M.
J., Westgate, P. M.
No medications are approved for cannabis use disorder (CUD), though a small
clinical trial demonstrated that the voltage-dependent calcium channel (VDCC) ligand gabapentin reduced cannabis use in treatment seekers. VDCCs are
modulated by cannabinoid (CB) ligands, and there are shared effects between CB agonists and VDCC ligands. This overlapping neuropharmacology and the
initial clinical results supported the evaluation of pregabalin, a \"next-generation\" VDCC ligand, as a CUD medication. Two separate placebo-
controlled, double-blind, counterbalanced, within-subjects human laboratory studies tested placebo and 300 (N = 2 females, 11 males; Experiment [EXP]
1) or 450 (N = 3 females, 11 males; EXP 2) mg/day pregabalin in cannabis users who were not seeking treatment or trying to reduce/quit their cannabis
use. The protocol consisted of two outpatient maintenance phases (11 days in EXP 1 and 15 days in EXP 2) that concluded with four experimental
sessions within each phase. During experimental sessions, maintenance continued, and participants completed two 2-day blocks of sampling and self-
administration sessions to determine the reinforcing effects of smoked cannabis (0% and 5.9% delta9-tetrahydrocannabinol [THC]), as well as
subjective, attentional bias, performance, and physiological responses. In addition, naturalistic cannabis use, side effects, sleep quality, craving,
and other self-reported substance use were measured during pregabalin maintenance. Cannabis was self-administered and produced prototypical effects,
but pregabalin generally did not impact the effects of cannabis or alter naturalistic use. These human laboratory results in cannabis users not
trying to reduce/quit their use do not support the efficacy of pregabalin as a stand-alone pharmacotherapy for CUD. (PsycInfo Database Record (c)
2021 APA, all rights reserved) In this outpatient human laboratory study, non-treatment-seeking cannabis users were maintained on pregabalin to
determine its ability to reduce the reinforcing and other behavioral effects of cannabis in a controlled laboratory setting, as well as naturalistic
use. Pregabalin did not alter cannabis use and had minimal effects on the response to cannabis or outcomes thought to be related to continued
cannabis use (e.g., sleep or cannabis craving), which does not support the potential efficacy of pregabalin as a stand-alone pharmacotherapy for
cannabis use disorder. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Copyright © 2021 American Psychological Association
Experimental and
Clinical Psychopharmacology., :
- Year: 2021
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions
(any), Anticonvulsants/mood stabilisers (excl. lithium), Anxiolytics including benzodiazepines, Medications used to treat substance abuse
Davoudi,
M., Allame, Z., Foroughi, A., Taheri, A. A.
Objective: To conduct a pilot RCT investigating the
feasibility, acceptability, and preliminary efficacy of\rdialectical behavioral therapy (DBT) for marijuana cessation and craving reduction. Methods:
Sixty-one patients with marijuana use disorder diagnoses were randomly assigned to a DBT group or a control group (psycho-education). Patients
completed measures at pre-intervention, postintervention, and at two-month follow-up. The Marijuana Craving Questionnaire (MCQ) and marijuana urine
test kits were used to assess craving and abstinence respectively. Results: The feasibility of DBT was significantly higher than control group
feasibility. In the DBT 29/30 participants completed all sessions (96% retention) and 24/31 control group participants completed all sessions (77%
retention) (
Trends in Psychiatry and Psychotherapy, 43(4) : 302-
310
- Year: 2021
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Dialectical behavioural therapy
(DBT), Psychoeducation
Wolff, J., Esposito-Smythers, C., Frazier, E., Stout, R., Gomez, J., Massing-Schaffer, M., Nestor, B., Cheek, S., Graves, H., Yen, S., Hunt, J., Spirito, A.
The current study conducted a preliminary test of whether community mental health clinic staff
could implement a multicomponent cognitive behavioral treatment, developed for adolescents with substance misuse (alcohol and/or marijuana) and
comorbid psychiatric symptoms. We randomized a total of 111 families, with an adolescent 12-18 years old, referred to a home-based services program
for youth with co-occurring substance use and mental health problems, to receive treatment from either masters-level therapists who received
intensive cognitive behavioral therapy (I-CBT) training or from masters-level therapists who took part in a typical brief continuing education-style
CBT workshop (treatment as usual, or TAU). Each family's therapist and insurance company determined the frequency and intensity of treatment. We
administered follow-up assessments at 3, 6, and 12 months. There was a small, but not statistically significant, reduction in the percent days of
heavy drinking and marijuana use over time for both conditions, with the overall effect across the three follow-up points favoring the I-CBT
condition. There were no differences on alcohol use days or other drug use. There was also a small, but nonsignificant, positive effect over time on
externalizing symptoms, depressed mood, and anxiety, favoring the I-CBT condition. Youth in the I-CBT condition relative to TAU had significantly
fewer juvenile justice contacts, while the pattern of costly service use varied, with higher rates at 6-month and lower rates at 12-month follow-ups.
If therapists pay greater attention to parent training and provide more parent-adolescent communication sessions, outcomes may improve above standard
community care. Training enhancements, to better meet the needs of community therapists and their clinic settings, may also produce better overall
results for parents and adolescents. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
Journal of Substance Abuse Treatment Vol 116 2020, ArtID
108055, 116 :
- Year: 2020
- Problem: Anxiety Disorders (any), Depressive Disorders, Alcohol
Use, Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder), At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other service delivery and improvement
interventions
Sharma, R. A., Kiani, I., Jain, A., Bronsther, R., Mufti, M., Malhi,
N.
Objectives: The objective was to conduct a meta-analysis from existing data to identify the impact of N-
acetylcysteine (NAC) and a nonpharmacological combination approach for cannabis use disorder in youth. The use of cannabis for recreational use has
risen dramatically among young adults and adolescents. In the United States, several states have legalized the use of cannabis. NIDA has reported
that the lifetime prevalence of cannabis use in 12th-grade adolescents was 35% in 2017, which rose to 43.6% in 2018. The active ingredient in
cannabis, tetrahydrocannabinol (THC), is implicated in both triggering and worsening mental health symptoms. Efforts were taken by the mental health
community to address this challenge, including making more inclusive diagnostic criteria in the DSM-5, studying underlying mechanisms of cannabis-
related change in brain homeostasis, researching novel pharmacological options such as NAC, and combining pharmacological and nonpharmacological
approaches (CBT, motivational intervention [MI], and contingency management [CM]) for optimum outcomes. Despite these efforts, the FDA has not yet
approved any drug for cannabis use disorder because of a lack of conclusive data. Method(s): We conducted a Medical Subject Headings (MeSH) search
using the search terms \"cannabis\" and \"N-acetylcysteine.\" A total of 20 results were available, which, after applying our exclusion criteria of
excluding literature reviews, were cut down to 7 results. Out of these 7 studies, 2 were RCTs and 1 was an open-label study. The remaining 4 articles
were related to detailed descriptions of these RCTs or their sub-analysis. We conducted a Wilson regression meta-analysis for subjects aged 15-21
years. Result(s): There are limited RCTs that look into NAC in cannabis use disorder. Both open-label and double-blind studies in individuals aged
15-21 years show promising results. Our meta-analysis of the data for this age group showed that a combination of NAC and CM for cannabis use
disorder has better outcomes. Our meta-analysis suggested that there was a statistically significant reduction of cannabis use in the NAC plus CM
group in individuals aged 12-21 years (OR = 1.89; 95% CI, 1.44-2.47; p < 0.01; Cochrane Q = 0.37, p = 0.54). Numerically, the odds were even better
for patients who were tobacco-free (OR = 3.78; p = 0.07). Conclusion(s): Further research with a bigger sample size should be considered, and
patients should be educated about higher chances of abstinence if there is no concurrent use of tobacco use. SUD, DAM, RF Copyright © 2020
Journal of the American Academy
of Child and Adolescent Psychiatry, 59 (10 Supplement) : S227
- Year: 2020
- Problem: Cannabis Use
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Medications used to treat substance abuse, Psychological Interventions
(any), Contingency
management
Newton, N. C., Chapman, C., Slade, T., Birrell, L., Healy, A., Mather, M., McBride, N., Hides, L., Allsop, S., Mewton,
L., Andrews, G., Teesson, M.
BACKGROUND: The burden of disease attributable to alcohol and other drug (AOD) use in young
people is considerable. Prevention can be effective, yet few programs have demonstrated replicable effects. This study aimed to replicate research
behind Climate Schools: Alcohol and Cannabis course among a large cohort of adolescents. METHOD(S): Seventy-one secondary schools across three States
participated in a cluster-randomised controlled trial. Year 8 students received either the web-based Climate Schools: Alcohol and Cannabis course
(Climate, n = 3236), or health education as usual (Control, n = 3150). Outcomes were measured via self-report and reported here for baseline, 6- and
12-months for alcohol and cannabis knowledge, alcohol, cannabis use and alcohol-related harms. RESULT(S): Compared to Controls, students in the
Climate group showed greater increases in alcohol- [standardised mean difference (SMD) 0.51, p < 0.001] and cannabis-related knowledge (SMD 0.49, p <
0.001), less increases in the odds of drinking a full standard drink[(odds ratio (OR) 0.62, p = 0.014], and heavy episodic drinking (OR 0.49, p =
0.022). There was no evidence for differences in change over time in the odds of cannabis use (OR 0.57, p = 0.22) or alcohol harms (OR 0.73, p =
0.17). CONCLUSION(S): The current study provides support for the effectiveness of the web-based Climate Schools: Alcohol and Cannabis course in
increasing knowledge and reducing the uptake of alcohol. It represents one of the first trials of a web-based AOD prevention program to replicate
alcohol effects in a large and diverse sample of students. Future research and/or adaptation of the program may be warranted with respect to
prevention of cannabis use and alcohol harms.
Psychological medicine, : 1-9
- Year: 2020
- Problem: Alcohol
Use, Cannabis Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Freeman, T. P., Hindocha, C., Baio, G., Shaban, N.
D. C., Thomas, E. M., Astbury, D., Freeman, A. M., Lees, R., Craft, S., Morrison, P. D., Bloomfield, M. A.
P., ORyan, D., Kinghorn,
J., Morgan, C. J. A., Mofeez, A., Curran, H. V.
Background A substantial and unmet clinical need exists for pharmacological treatment of cannabis use disorders.
Cannabidiol could offer a novel treatment, but it is unclear which doses might be efficacious or safe. Therefore, we aimed to identify efficacious
doses and eliminate inefficacious doses in a phase 2a trial using an adaptive Bayesian design. Method(s): We did a phase 2a, double-blind, placebo-
controlled, randomised, adaptive Bayesian trial at the Clinical Psychopharmacology Unit (University College London, London, UK). We used an adaptive
Bayesian dose-finding design to identify efficacious or inefficacious doses at a-priori interim and final analysis stages. Participants meeting
cannabis use disorder criteria from DSM-5 were randomly assigned (1:1:1:1) in the first stage of the trial to 4-week treatment with three different
doses of oral cannabidiol (200 mg, 400 mg, or 800 mg) or with matched placebo during a cessation attempt by use of a double-blinded block
randomisation sequence. All participants received a brief psychological intervention of motivational interviewing. For the second stage of the trial,
new participants were randomly assigned to placebo or doses deemed efficacious in the interim analysis. The primary objective was to identify the
most efficacious dose of cannabidiol for reducing cannabis use. The primary endpoints were lower urinary 11-nor-9-carboxy-delta-9-
tetrahydrocannabinol (THC-COOH):creatinine ratio, increased days per week with abstinence from cannabis during treatment, or both, evidenced by
posterior probabilities that cannabidiol is better than placebo exceeding 0.9. All analyses were done on an intention-to-treat basis. This trial is
registered with ClinicalTrials.gov (NCT02044809) and the EU Clinical Trials Register (2013-000361-36). Finding(s): Between May 28, 2014, and Aug 12,
2015 (first stage), 48 participants were randomly assigned to placebo (n=12) and to cannabidiol 200 mg (n=12), 400 mg (n=12), and 800 mg (n=12). At
interim analysis, cannabidiol 200 mg was eliminated from the trial as an inefficacious dose. Between May 24, 2016, and Jan 12, 2017 (second stage),
randomisation continued and an additional 34 participants were allocated (1:1:1) to cannabidiol 400 mg (n=12), cannabidiol 800 mg (n=11), and placebo
(n=11). At final analysis, cannabidiol 400 mg and 800 mg exceeded primary endpoint criteria (0.9) for both primary outcomes. For urinary THC-
COOH:creatinine ratio, the probability of being the most efficacious dose compared with placebo given the observed data was 0.9995 for cannabidiol
400 mg and 0.9965 for cannabidiol 800 mg. For days with abstinence from cannabis, the probability of being the most efficacious dose compared with
placebo given the observed data was 0.9966 for cannabidiol 400 mg and 0.9247 for cannabidiol 800 mg. Compared with placebo, cannabidiol 400 mg
decreased THC-COOH:creatinine ratio by -94.21 ng/mL (95% interval estimate -161.83 to -35.56) and increased abstinence from cannabis by 0.48 days per
week (0.15 to 0.82). Compared with placebo, cannabidiol 800 mg decreased THC-COOH:creatinine ratio by -72.02 ng/mL (-135.47 to -19.52) and increased
abstinence from cannabis by 0.27 days per week (-0.09 to 0.64). Cannabidiol was well tolerated, with no severe adverse events recorded, and 77 (94%)
of 82 participants completed treatment. Interpretation(s): In the first randomised clinical trial of cannabidiol for cannabis use disorder,
cannabidiol 400 mg and 800 mg were safe and more efficacious than placebo at reducing cannabis use. Funding(s): Medical Research Council. Copyright ©
2020 Elsevier Ltd
The Lancet Psychiatry, 7(10) : 865-
874
- Year: 2020
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Other biological interventions
Exner-Cortens, D., Wolfe, D., Crooks, C. V., Chiodo, D.
Bullying and mental health problems are pressing concerns for
adolescents. Given their burden, we need to find efficacious ways to prevent these experiences. However, existing prevention programs tend to be
single-issue and may not focus on the universal capacities required to reduce these problems among youth. To this end, we evaluated the universal,
small groups Healthy Relationships Plus (HRP) program, which focuses on the promotion of positive mental health and the reduction of bullying and
substance misuse. A sample of 212 youth from Southwestern Ontario were randomly assigned to the HRP or an attention-control condition over an 8-day
period during summer 2014. Primary outcome measures (i.e., most important outcomes for this evaluation) were positive mental health, bullying
victimization/perpetration, and substance misuse (alcohol, marijuana). We also examined a mediator (help-seeking) and two moderators (sex, adverse
childhood experiences) of main effects. Participation in HRP was associated with reduced odds of physical bullying victimization at 1-year follow-up,
compared with adolescents in the attention-control condition. This finding was mediated by increased intention to seek help from a mental health
professional following HRP participation. We did not find main effects for positive mental health or substance misuse in this sample; however, there
was an interaction effect whereby youth with significant trauma experiences reported less marijuana use at 1-year follow-up compared with control
students. Findings reiterate the importance of help-seeking for bullying prevention and demonstrate the preliminary efficacy of the HRP as a
universal strategy for preventing bullying victimization among mid-adolescents within school and community settings. (PsycInfo Database Record (c)
2021 APA, all rights reserved)
Canadian Journal of School Psychology, 35(1) : 3-
22
- Year: 2020
- Problem: Alcohol
Use, Cannabis Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Skills training
Robbins, M. S., Waldron, H. B., Turner, C. W., Brody, J., Hops,
H., Ozechowski, T.
This
study examined the effects of observation-based supervision Building Outcomes with Observation-Based Supervision of Therapy (BOOST therapists = 26,
families = 105), versus supervision as usual (SAU therapists = 21, families = 59) on (a) youth externalizing behavior problems and (b) the moderating
effects of changes in family functioning on youth externalizing behaviors for adolescents receiving Functional Family Therapy (FFT). Exploratory
analyses examined the impact of supervision conditions on youth internalizing problems. In 8 community agencies, experienced FFT therapists (M = 1.4
years) received either BOOST or SAU supervision in a quasi-experimental design. Male (59%) or female (41%) adolescents were referred for the
treatment of behavior problems (e.g., delinquency, substance use). Clients were Hispanic (62%), African American (19%), Non-Hispanic White (12%), or
Other (7%) ethnic/racial origins. Therapists (female, 77%) were Hispanic 45%, African American (19%), White Non-Hispanic (30%), or other (4%)
ethnic/racial backgrounds. Analyses controlled for the presence or absence of clinically elevated symptoms on outcome variables. Clinical outcomes
were measured at baseline, 5 months, and 12 months after treatment initiation. Clients with externalizing behavior above clinical thresholds had
significantly greater reductions in problem behaviors in the BOOST versus the SAU conditions. Clients below thresholds did not respond differentially
to conditions. Supervisors in BOOST had more experience with the FFT model; as such, the observed results may be a result of supervisor experience.
The BOOST supervision was associated with improved outcomes on problem behaviors that were above clinical thresholds. The findings demonstrate the
importance of addressing client case mix in implementation studies in natural environments. Copyright © 2018 Family Process Institute.
Family process, 58(4) : 873-890
- Year: 2019
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Family therapy, Other service delivery and improvement
interventions
Buckner, J. D., Zvolensky, M. J., Ecker, A. H., Schmidt, N.
B., Lewis, E. M., Paulus, D. J., Lopez-Gamundi, P., Crapanzano, K. A., Bakhshaie, J.
Cannabis use disorder (CUD) is
the most common illicit substance use disorder and individuals with CUD have high rates of comorbid anxiety disorders. Comorbidity between CUD and
anxiety disorders is of public health relevance given that although motivation enhancement therapy (MET) combined with cognitive-behavioral therapy
(CBT) is an efficacious intervention for CUD, outcomes are worse for patients with elevated anxiety. The current study tested the acceptability and
efficacy of the integration of a transdiagnostic anxiety CBT (i.e., treatment of patients with any anxiety disorder) with MET-CBT (integrated
cannabis and anxiety reduction treatment, or ICART) for CUD compared to MET-CBT alone. Treatment-seeking cannabis users (56.4% male, Mage
= 23.2, 63.3% non-Hispanic White) with CUD and at least one comorbid anxiety disorder were randomly assigned to ICART (n = 27) or MET-CBT (n = 28).
Patients in the ICART condition attended significantly more treatment sessions than those in the MET-CBT condition. Patients in the ICART condition
were more likely to be abstinent post-treatment than those in MET-CBT. Further, treatment produced decreases in cannabis use and related problems.
Notably, therapy type did not moderate the impact of treatment on frequency of use and related problems. Together, these data suggest that ICART may
be at least as efficacious as a gold-standard psychosocial CUD treatment, MET-CBT, for a difficult-to-treat subpopulation of cannabis users.
Copyright © 2018 Elsevier Ltd
Behaviour Research and
Therapy, 115 : 38-45
- Year: 2019
- Problem: Anxiety Disorders (any), 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
Sherman, B. J., Caruso, M. A., McRae-Clark, A. L.
Background: Sex differences in cannabis use disorder (CUD) and its
treatment have been identified. Women report more severe withdrawal and have shown worse treatment outcomes. Ovarian hormones are implicated in these
differences and research suggests that exogenous progesterone may be an effective pharmacotherapy. Method(s): The current randomized, placebo-
controlled, feasibility trial tested a novel multimodal methodology for administering exogenous progesterone during acute cannabis withdrawal. Eight
heavy cannabis using women received micronized progesterone (200 mg bid) (n = 3) or matching placebo (n = 5) during the early follicular phase of
their menstrual cycle over a 5-day study period while abstaining from cannabis. Laboratory visits (days 1 and 5) included biological and self-report
assessments, while home-based procedures (days 2-4) included ambulatory assessments, video data capture and tele-drug testing, and biological
assessments. Primary outcomes were medication adherence and salivary hormone levels, and the exploratory outcome was cannabis withdrawal severity.
Result(s): Medication adherence rates were high as assessed via self-report (100.0%) and video data capture (98.0%). Salivary progesterone levels
differed between groups over time (p < 0.027) and the progesterone group achieved levels within the normal range during the luteal phase in healthy
adults. All tele-drug tests were negative confirming cannabis abstinence and there was an indication (p = 0.07) of reduced cannabis craving among
participants receiving progesterone. Conclusion(s): More effective and sex-based treatments for cannabis use disorder are needed. The current study
provides a novel multimodal methodology with low participant burden for investigating new medications for cannabis withdrawal. Clinical trials of
progesterone for cannabis withdrawal may be warranted. Copyright © 2019 Elsevier Inc.
Pharmacology Biochemistry and Behavior, 179 : 22-
26
- Year: 2019
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Other biological interventions
D'Amico, E. J., Parast,
L., Shadel, W. G., Meredith, L. S., Seelam, R., Stein, B. D., Osilla, K. C.
Purpose: Alcohol and other drug (AOD) use during adolescence is associated with numerous
problems. Primary care (PC) settings provide a unique opportunity to address AOD use through screening and brief intervention. Methods/Data: Every
adolescent age 12 through 18 that came for an appointment to four PC clinics (one in Los Angeles; three in Pittsburgh) during the 2.5-year study
period was asked to be in the study. Teens completed a screening; those at-risk completed a baseline survey and were randomized to either CHAT, a
brief 15-minmotivational interviewing intervention, or enhanced usual care (UC), a brochure on AOD use. Teens were followed at 3-, 6- and 12-months.
The sample (n = 294) was 58% female, 66% Hispanic, 17% Black, 12% white, 5%multiethnic or other, with an average age of 16 years. Result(s): We
worked closely with staff at the PC clinics to determine the best way to approach teens and parents. We faced several recruitment challenges
including construction and staffing changes. Retention was also initially lower in Pittsburgh due to challenges, including gift card vendors and cell
phones being disconnected. For example, the Target in Pittsburgh was too far for many teens, so we changed the gift card to a local shopping place
and retention rates increased. Compared to UC adolescents, CHAT adolescents reported less perceived peer use of alcohol andmarijuana at 3 (p's<.05)
and 6 months (p's<.05). CHAT adolescents also reported marginally fewer negative alcohol consequences experienced at 6 months (p = .08). At 12
months, compared to UC, CHAT adolescents reported less perceived peer alcohol (p < .05) andmarijuana (p < .01) use and fewer negative consequences
from alcohol (p < .05) andmarijuana use (p < .05). After controlling for baseline outcomes, CHAT teens who reported more alcohol consequences or had
an alcohol use disorder at baseline reported less alcohol use, heavy drinking, and consequences one year later compared to UC teens. CHAT teens who
reported more marijuana consequences at baseline reported fewer marijuana consequences one year later compared to UC teens. Conclusion(s): It is
crucial to determine the best ways to engage and retain at-risk adolescents. Findings emphasize that teens can benefit from PC interventions that
briefly and effectively address both alcohol and marijuana use.
Alcoholism: Clinical and Experimental Research, 43 (Supplement
1) : 281A
- Year: 2019
- 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, Psychoeducation, Other service delivery and improvement
interventions