Disorders - Cannabis Use
Baldus, C., Thomsen, M., Sack, P. M., Broning, S., Arnaud, N., Daubmann, A., Thomasius, R.
BACKGROUND: The purpose of this study is to evaluate the effects of a German adaptation of the Strengthening Families Programme 10-
14 (SFP 10-14; Familien Starken).\rMETHODS: A multi-centre randomised controlled trial comparing the German SFP version consisting of seven sessions
and four booster-sessions with a minimal intervention on parenting as control condition. Outcomes comprise measures of adolescent substance use
(initiation) and behaviour problems and are assessed at baseline, after programme delivery and at 6- and 18-month follow-ups. Primary outcomes were
lifetime tobacco, alcohol and cannabis use at 18 months. Data of n = 292 families were analysed using baseline adjusted logistic regressions and
mixed models.\rRESULTS: We observed reduced rates of lifetime tobacco use in analyses with follow-up respondents, but not in data using the complete
intention to treat sample with multiple imputation estimates for missing data. Parents reported fewer adolescent behaviour problems in analyses with
the total sample and multiple imputed data, but not in data with follow-up respondents only. There were no other significant effects of SFP 10-14.
\rCONCLUSION: Overall the medium size effects found in previous US trials could not be replicated in a German context.
European Journal of Public Health, 26(6) : 953-
959
- Year: 2016
- Problem: Alcohol
Use, Cannabis Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Family therapy, Other Psychological Interventions
Hoch, E., Preuss, U. W., Ferri, M., Simon, R.
[Correction Notice: An Erratum for this article was reported in Vol 22(5) of European Addiction
Research (see record 2016-40765-008). In the original article, in line 8 on p. 238 it should be Jonas et al. [24] instead of Tossmann et al. [25] and
in the second line of the third paragraph it should be [23] instead of [24]. In the third line of the fourth paragraph the [..] should be deleted.]
Background: Existing cannabis treatment programs reach only a very limited proportion of people with cannabis-related problems. The aim of this
systematic review and meta-analysis was to assess the effectiveness of digital interventions applied outside the health care system in reducing
problematic cannabis use. Methods: We systematically searched the Cochrane Central Register of Controlled Trials (2015), PubMed (2009-2015), Medline
(2009-2015), Google Scholar (2015) and article reference lists for potentially eligible studies. Randomized controlled trials examining the effects
of internet- or computer-based interventions were assessed. Study effects were estimated by calculating effect sizes (ESs) using Cohen's d and
Hedges' g bias-corrected ES. The primary outcome assessed was self-reported cannabis use, measured by a questionnaire. Results: Fifty-two studies
were identified. Four studies (including 1,928 participants) met inclusion criteria. They combined brief motivational interventions and cognitive
behavioral therapy delivered online. All studies were of good quality. The pooled mean difference (DELTA = 4.07) and overall ES (0.11) give evidence
of small effects at 3-month follow-up in favor of digital interventions. Conclusions: Digital interventions can help to successfully reduce
problematic cannabis use outside clinical settings. They have some potential to overcome treatment barriers and increase accessibility for at-risk
cannabis users. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
European Addiction
Research, 22(5) : 233-242
- Year: 2016
- Problem: Cannabis Use
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Motivational interviewing, includes Motivational Enhancing Therapy, Personalised feedback, normative feedback, Technology, interventions delivered using technology (e.g. online, SMS)
Blevins, C. E., Banes, K. E., Stephens, R. S., Walker, D. D., Roffman, R. A.
Background
Heavy cannabis use has been associated with negative outcomes, particularly among individuals who begin use in adolescence. Motives for cannabis use
can predict frequency of use and negative use-related problems. The purpose of the current study was to assess change in motives following a
motivational enhancement therapy (MET) and cognitive behavioral therapy (CBT) intervention for adolescent users and assess whether change in motives
was associated with change in use and self-reported problems negative consequences. Methods Participants (n = 252) were non-treatment seeking high
school student cannabis users. All participants received two sessions of MET and had check-ins scheduled at 4, 7, and 10 months. Participants were
randomized to either a motivational check-in condition or an assessment-only check-in. Participants in both conditions had the option of attending
additional CBT sessions. Cannabis use frequency, negative consequences, and motives were assessed at baseline and at 6, 9, 12, and 15 month follow-
ups. Results There were significant reductions in motives for use following the intervention and reductions in a subset of motives significantly and
uniquely predicted change in problematic outcomes beyond current cannabis use frequency. Change in motives was significantly higher among those who
utilized the optional CBT sessions. Conclusions This study demonstrates that motives can change over the course of treatment and that this change in
motives is associated with reductions in use and problematic outcomes. Targeting specific motives in future interventions may improve treatment
outcomes. Copyright © 2016 Elsevier Ireland Ltd
Drug & Alcohol Dependence, 167 : 175-181
- Year: 2016
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Motivational interviewing, includes Motivational Enhancing Therapy
Champion, K. E., Newton, N. C., Stapinski,
L., Slade, T., Barrett, E. L., Teesson, M.
OBJECTIVE: Replication is an important step in evaluating evidence-based preventive interventions and is crucial for establishing
the generalizability and wider impact of a program. Despite this, few replications have occurred in the prevention science field. This study aims to
fill this gap by conducting a cross-validation trial of the Climate Schools: Alcohol and Cannabis course, an Internet-based prevention program, among
a new cohort of Australian students.\rMETHOD: A cluster randomized controlled trial was conducted among 1103 students (Mage: 13.25 years) from 13
schools in Australia in 2012. Six schools received the Climate Schools course and 7 schools were randomized to a control group (health education as
usual). All students completed a self-report survey at baseline and immediately post-intervention. Mixed-effects regressions were conducted for all
outcome variables. Outcomes assessed included alcohol and cannabis use, knowledge and intentions to use these substances.\rRESULTS: Compared to the
control group, immediately post-intervention the intervention group reported significantly greater alcohol (d = 0.67) and cannabis knowledge (d =
0.72), were less likely to have consumed any alcohol (even a sip or taste) in the past 6 months (odds ratio = 0.69) and were less likely to intend on
using alcohol in the future (odds ratio = 0.62). However, there were no effects for binge drinking, cannabis use or intentions to use cannabis.
\rCONCLUSION: These preliminary results provide some support for the Internet-based Climate Schools: Alcohol and Cannabis course as a feasible way of
delivering alcohol and cannabis prevention. Intervention effects for alcohol and cannabis knowledge were consistent with results from the original
trial; however, analyses of longer-term follow-up data are needed to provide a clearer indication of the efficacy of the intervention, particularly
in relation to behavioral changes.\rCopyright © The Royal Australian and New Zealand College of Psychiatrists 2015.
Australian & New Zealand Journal of Psychiatry, 50(1) : 64-
73
- Year: 2016
- Problem: Alcohol
Use, Cannabis Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Dupont, Hans B., Candel, Math J., Kaplan, Charles D., van-de-Mheen, Dike, de-Vries, Nanne K.
The Moti-4 intervention, in which motivational interviewing, self-monitoring, and
strengthening behavioral control are used, was developed in the Netherlands in response to several rapid assessments of problematic use of cannabis
among vulnerable adolescents. The main goal of the study reported in this article was to determine whether the Moti-4 intervention was able to reduce
two outcome measures pertaining to the level of cannabis use; the amount of Euros spent a week on cannabis and the mean number of cannabis joints
(cigarettes) smoked in a week. In a randomized controlled trial (RCT) with a 6-month follow-up, 27 trained Dutch prevention workers recruited 71
Moti-4 participants and 60 controls assigned to usual care. Participants were Dutch youth aged 14-24 years who had used cannabis during the preceding
month. At baseline (T0), post-test (T1) and 6-month follow-up (T2), participants completed a questionnaire with 51 items. The 27 prevention workers
also completed a checklist to assess the fidelity of delivering each item to each participant in the Moti-4 protocol. Multilevel and binary logistic
regression was used to assess the impact of the prevention worker and 14 participant variables on the likelihood of drop-out. Mean scores for
cannabis use outcome measures by Moti-4 participants and controls at baseline, T1 and T2 were compared using paired sample t-tests. Top-down multiple
regression was used to assess relationships between Moti-4 and 13 other variables on the one hand and changes in weekly cannabis use at T1 and T2 on
the other. The Moti-4 experimental condition had a significant and positive influence in reducing the level of expenditure on cannabis (p < 0.05).
There was no significant difference in outcome, neither for the 4 participating institutes nor for the professionals implementing the intervention.
Baseline cannabis use was the strongest predictor (p < 0.001) of weekly cannabis expenditure at posttest and 6-month follow-up. This effect was still
present at T2. Being female, having two Dutch parents and perceived behavioral control also made significant positive contributions (p < 0.05).
Attitude at baseline was only related to cannabis expenditure after 6months (p = 0.005). At T2 Moti-4 participants were found to have a significant
reduction in the number of joints smoked weekly compared to T0 (on the average 4 joints). The study demonstrated that Moti-4 is an effective
intervention to reduce cannabis use in youth. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
Journal of Substance Abuse Treatment, 65 : 6-
12
- Year: 2016
- 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, Psychoeducation, Other Psychological Interventions, Personalised feedback, normative feedback
Georgie, J. M., Sean, H., Deborah, M. C., Matthew, H., Rona, C.
BACKGROUND AND AIMS: Peer-led interventions may offer a beneficial approach in preventing substance
use, but their impact has not yet been quantified. We conducted a systematic review to investigate and quantify the effect of peer-led interventions
that sought to prevent tobacco, alcohol and/or drug use among young people aged 11-21 years.\rMETHODS: Medline, EMBASE, PsycINFO, CINAHL, ERIC and
the Cochrane Library were searched from inception to July 2015 without language restriction. We included randomized controlled trials only. Screening
and data extraction were conducted in duplicate and data from eligible studies were pooled in a random effects meta-analysis.\rRESULTS: We identified
17 eligible studies, approximately half of which were school-based studies targeting tobacco use among adolescents. Ten studies targeting tobacco use
could be pooled, representing 13,706 young people in 220 schools. Meta-analysis demonstrated that the odds of smoking were lower among those
receiving the peer-led intervention compared with control [odds ratio (OR) = 0.78, 95% confidence interval (CI) = 0.62-0.99, P = 0.040]. There was
evidence of heterogeneity (I(2) = 41%, chi(2) 15.17, P = 0.086). Pooling of six studies representing 1699 individuals in 66 schools demonstrated that
peer-led interventions were also associated with benefit in relation to alcohol use (OR = 0.80, 95% CI = 0.65-0.99, P = 0.036), while three studies
(n = 976 students in 38 schools) suggested an association with lower odds of cannabis use (OR = 0.70, 0.50-0.97, P = 0.034). No studies were found
that targeted other illicit drug use.\rCONCLUSIONS: Peer interventions may be effective in preventing tobacco, alcohol and possibly cannabis use
among adolescents, although the evidence base is limited overall, and is characterized mainly by small studies of low quality.\rCopyright © 2015
Society for the Study of Addiction.
Addiction, 111(3) : 391-
407
- Year: 2016
- Problem: Alcohol
Use, Cannabis Use
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Other service delivery and improvement
interventions
Koning, Ina M., Vollebergh, Wilma A.
The secondary effects of an alcohol prevention program (PAS) on onset of weekly
smoking and monthly cannabis use are examined among >3000 Dutch early adolescents (M age = 12.64) randomized over four conditions: 1) parent
intervention (PI), 2) student intervention (SI), 3) combined intervention (CI) and 4) control condition (CC). Rules about alcohol, alcohol use, and
adolescents' self-control were investigated as possible mediators. PI had a marginal aversive effect, slightly increasing the risk of beginning to
smoke at T1, and increased the likelihood of beginning to use cannabis use at T1 and T2. SI delayed the onset of monthly cannabis use at T3. CI
increased the risk to use cannabis at T3. No mediational processes were found. In conclusion, though this study show mixed results, negative side
effects of the PI were found, particularly at earlier ages. Moreover, these results indicate the need for multi-target interventions. (PsycINFO
Database Record (c) 2016 APA, all rights reserved)
Journal of Substance Abuse Treatment, 67 : 55-
60
- Year: 2016
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Skills training, Other Psychological Interventions
McRae-Clark, A. L., Baker, N. L., Gray, K. M., Killeen,
T., Hartwell, K. J., Simonian, S. J.
Background and Objectives: The purpose of this study was to evaluate the efficacy of vilazodone, a selective
serotonin receptor inhibitor and partial 5-HT1A agonist, for treatment of cannabis dependence. Methods: Seventy-six cannabis-dependent adults were
randomized to receive either up to 40 mg/day of vilazodone (n=41) or placebo (n=35) for 8 weeks combined with a brief motivational enhancement
therapy intervention and contingency management to encourage study retention. Cannabis use outcomes were assessed via weekly urine cannabinoid tests;
secondary outcomes included cannabis use self-report and cannabis craving. Results: Participants in both groups reported reduced self-reported
cannabis use over the course of the study; however, vilazodone provided no advantage over placebo in reducing cannabis use. Men had significantly
lower creatinine-adjusted cannabinoid levels and a trend for increased negative urine cannabinoid tests than women. Discussion and Conclusions:
Vilazodone was not more efficacious than placebo in reducing cannabis use. Important gender differences were noted, with women having worse cannabis
use outcomes than men. Scientific Significance: Further medication development efforts for cannabis use disorders are needed, and gender should be
considered as an important variable in future trials. Copyright © American Academy of Addiction Psychiatry.
American Journal on Addictions, 25(1) : 69-75
- Year: 2016
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Antidepressants
(any), Medications used to treat substance abuse, Psychological Interventions
(any), Motivational interviewing, includes Motivational Enhancing Therapy, Contingency
management
Squeglia, L. M., Baker, N. L., McClure, E. A., Tomko, R. L, Adisetiyo,
V., Gray, K. M.
Aims Current adolescent alcohol
treatments have modest effects and high relapse rates. Evaluation of novel pharmacotherapy treatment is warranted. N-acetylcysteine (NAC), an over-
the-counter antioxidant supplement with glutamatergic properties, is a promising treatment for marijuana cessation in adolescents; however, its
effects on adolescent drinking have not been examined. To that end, this secondary analysis evaluated: (1) the effect of NAC vs. placebo on alcohol
use over an eight-week adolescent marijuana cessation trial and (2) the role of marijuana cessation and reduction on subsequent alcohol use. Methods
Marijuana-dependent adolescents (ages 15-21; N = 116) interested in treatment were randomized to NAC 1200 mg or matched placebo twice daily for eight
weeks. Participants were not required to be alcohol users or interested in alcohol cessation to qualify. Results There were no demographic or
baseline alcohol use differences between participants randomized to NAC vs. placebo (ps > 0.05). Of the 89 participants returning for > one visit
following randomization, 77 reported > one alcoholic drink in the 30 days prior to study entry and averaged 1.3 (SD = 1.4) binge drinking days per
week. During treatment, less marijuana use (measured via urine cannabinoid levels) was associated with less alcohol use in the NAC-treated group but
not in the placebo-treated group (p = 0.016). Conclusions There was no evidence of compensatory alcohol use during marijuana treatment. In fact, in
the NAC group, lower levels of marijuana use were associated with less alcohol use, suggesting NAC effects may generalize to other substances and
could be useful in decreasing adolescent alcohol use. NAC trials specifically focused on alcohol-using adolescents are warranted. Copyright © 2016
Elsevier Ltd
Addictive Behaviors, 63 : 172-177
- Year: 2016
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Other biological interventions, Complementary & Alternative
Interventions (CAM), Vitamins and supplements
Yurasek, A., Fernandez, A., Miller, M. B., Metrik, J., Borsari, B.
Aims: Marijuana use among college students is highly prevalent and associated with poorer academic outcomes. Although brief
motivational interventions (BMIs) have been shown to be efficacious with reducing alcohol use in college students, little is known about the utility
of alcohol BMIs in reducing other addictive behaviors, such as marijuana use, that often co-occur with drinking. The purpose of the current study was
to examine the impact of alcohol-focused BMIs implemented within a stepped care approach in reducing marijuana use. Methods: Participants were 530
college students who violated campus alcohol policy and were mandated to receive an alcoholfocused brief advice (BA) session. Of the 530
participants, 39% (N= 208) reported baseline marijuana use and were included in the current analyses. Participants who reported continued risky
alcohol use (4 or more heavy drinking episodes and/or 5 or more alcohol-related problems in the past month) six weeks following the BA session were
randomized to BMI (n = 92) or assessment only (n = 90). Follow-up assessments were conducted 3, 6, and 9 months post-intervention. Results: Repeated
measures ANOVA revealed that students did not reduce their frequency of marijuana use following a BA session, nor did the BMI significantly reduce
marijuana use compared to the assessment-only group. Conclusions: Despite reductions in alcohol use, marijuana use did not change following alcohol-
focused intervention efforts. This suggests that marijuana users can still benefit from alcohol-related interventions yet may need a more intense and
targeted marijuana focused intervention to induce changes in marijuana use.
Drug & Alcohol Dependence, 156 : e243-
e244
- Year: 2015
- Problem: Alcohol
Use, Cannabis Use
- Type: Randomised controlled trials
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Motivational interviewing, includes Motivational Enhancing Therapy
Secades-Villa, R., Garcia-Rodriguez, O., Fernandez-Hermida, J. R.
Objective: We provide a narrative review of published studies
evaluating voucher-based contingency management (CM) treatment for cocaine, nicotine and cannabis use disorders in Spain and discuss the concerns and
future challenges. Method: Published studies between 2008 and 2015 that evaluated the impact of incentives for SUD in Spain and included an
appropriate control or comparison condition were identified and reviewed. Results: Adding voucher-based CM to standard treatments obtained better
treatment retention and cocaine abstinence than standard care alone. CM also improved psychosocial functioning. Economic status or depressive
symptoms did not affect the results of CM treatment for cocaine dependence. The addition of a CM protocol to cognitive behavioral treatment (CBT)
also improved treatment effectiveness for smoking cessation. Available data on the effect of CM on cannabis use disorders (CUD) with young people did
not allow confirmation of its superiority to date. Conclusion: The research conducted to date in Spain confirms and expands the findings of studies
conducted in the US supporting the effectiveness of CM in the context of community settings with cocaine- and nicotine-dependents. However, CM has
not yet been readily adopted into general clinical practice in Spain or the rest of Europe. The limited effectiveness of CM for CUD is likely due to
the scarcity of data and may change with more studies, taking into account recent research on this topic in the US. Continued efforts are warranted
to further develop and disseminate incentive-based treatments for SUD across clinical settings and populations in Spain.
Preventive Medicine, 80 : 82-
88
- Year: 2015
- Problem: Cannabis Use
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Contingency
management
Treloar,
H., Blanchard, A., Justus, A., Monti, P., Chun, T., Swift, R., Tidey, J., Gwaltney, C., Miranda, R.
Topiramate (TPM) reduced alcohol use among heavy-drinking and dependent
adults in several clinical trials. Based on TPM's facilitation of GABA and antagonism of glutamate, which suppresses dopaminergic activity in the
nucleus accumbens, the present, proof-of-concept study examined the potential of TPM to reduce cannabis use among youth and explored possible
mechanisms of TPM's effects. We hypothesized that TPM would reduce cannabis use and dampen subjective responses following cannabis use. Youth ages
15-24 (M = 19.71, SD = 2.16; 56.1% White; 25.8% Black; 51.5% female) were randomized to TPMor placebo for 6 weeks in addition to a 3-session,
manual-driven, behavioral intervention. Given TPM's adverse neurocognitive profile, side effects were assessed throughout the trial and participants
completed a neuropsychological test battery at baseline, week 3, and week 6. Subjective responses to cannabis were captured in real time using
ecological momentary assessment (EMA), whereby participants completed random assessments throughout the day and self-initiated reports before and
after cannabis use. Analyses focused on weeks 5 and 6 when youths randomized to TPM were stabilized at 200 mg/day. Thirty-nine youth completed the
trial (placebo = 20; TPM = 19). Baseline characteristics did not differ between youth who completed the trial and those who attrited. Multilevel
models with EMA reports nested within persons were estimated in SAS 9.3 PROCMIXED and indirect-effect tests of multilevel mediation were implemented
with Mplus 7.0. Multilevel analyses tested the effect of TPM on frequency and quantity of cannabis use. Analyses of subjective responses compared
youth's reports of craving, \"high,\" stimulation, and sedation before and after cannabis use. TPM reduced the amount (grams) of cannabis youth
smoked on days they used. Across conditions, youth reported reduced craving following cannabis use, increased \"high,\" and increased sedation.
Reports of subjective \"high\" were attenuated in the TPM group. TPM did not affect craving, stimulation, or sedation. Multilevel structural equation
modeling showed that TPM's effects on cannabis use were potentiallymediated by its effects on \"high.\" This initial study suggests that TPM may
reduce cannabis use by altering subjective responses to smoking, which is similar to how it appears to reduce drinking. Findings support the need for
additional trials implemented in larger samples and with longer stabilization at target dose.
Alcoholism: Clinical & Experimental
Research, 39 : 265A
- Year: 2015
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Anticonvulsants/mood stabilisers (excl. lithium), Medications used to treat substance abuse, Service Delivery & Improvement, Other service delivery and improvement
interventions