Disorders - Cannabis Use
Machielsen, M. W. J., Veltman, D. J., Van-Den-Brink, W., De Haan, L.
Cannabis use disorders (CUDs) are highly comorbid in patients with schizophrenia and are associated
with poor outcome. Clozapine has been put forward as the first choice antipsychotic in this comorbid group. However, little is known about the
mechanisms underlying the assumed superiority of clozapine. We compared the effects of clozapine and risperidone on attentional bias, subjective
craving and associated regional brain activity in patients with schizophrenia and CUD. Overall, 36 patients with schizophrenia and 19 healthy
controls were included. Patients were randomised to antipsychotic treatment with clozapine or risperidone. At baseline and after 4 weeks of
medication use, regional brain responses were measured during a classical Stroop and a cannabis word Stroop using functional magnetic resonance
imaging. Clozapine-treated CUD patients showed a larger reduction in craving and in activation of the insula during the cannabis word Stroop, while
risperidone-treated patients showed a larger decrease in activation of the right anterior cingulate cortex during the classical Stroop. A significant
association was found between decreases in subjective craving and decreases in insula activation during the cannabis word Stroop. These findings
strongly suggest that clozapine may be a better treatment choice in patients with schizophrenia and CUD than risperidone. © The Author(s) 2014.
Journal of Psychopharmacology, 28(7) : 633-642
- Year: 2014
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Atypical Antipsychotics (second
generation), Medications used to treat substance abuse
Palfai, T. P., Saitz, R., Winter, M., Brown, T. A., Kypri, K., Goodness, T. M., O'Brien, L. M., Lu, J.
This pilot study sought to test the feasibility of
procedures to screen students for marijuana use in Student Health Services (SHS) and test the efficacy of a web-based intervention designed to reduce
marijuana use and consequences. Students were asked to participate in voluntary screening of health behaviors upon arrival at SHS. One hundred and
twenty-three students who used marijuana at least monthly completed assessments and were randomized to one of four intervention conditions in a 2
(intervention: Marijuana eCHECKUP TO GO vs. control)×2 (site of intervention: on-site vs. off-site) between-groups design. Follow-up assessments were
conducted online at 3 and 6 months. Latent growth modeling was used to provide effect size estimates for the influence of intervention on outcomes.
One thousand and eighty undergraduate students completed screening. The intervention did not influence marijuana use frequency. However, there was
evidence of a small overall intervention effect on marijuana-related consequences and a medium effect in stratified analyses in the on-site
condition. Analyses of psychological variables showed that the intervention significantly reduced perceived norms regarding peer marijuana use. These
findings demonstrate that it is feasible to identify marijuana users in SHS and deliver an automated web-based intervention to these students in
different contexts. Effect size estimates suggest that the intervention has some promise as a means of correcting misperceptions of marijuana use
norms and reducing marijuana-related consequences. Future work should test the efficacy of this intervention in a full scale randomized controlled
trial.; Copyright © 2014 Elsevier Ltd. All rights reserved.
Addictive
Behaviors, 39(9) : 1346-1352
- Year: 2014
- 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)
Elliott, J. C., Carey, K. B., Vanable,
P. A.
Young adults in college have high rates of marijuana use, abuse, and dependence. Web-based interventions are
increasingly popular, but their dissemination exceeds empirical support. One popular but understudied program is The Marijuana eCHECKUP TO GO (e-
TOKE) for Universities & Colleges (San Diego State University Research Foundation, 2009). The aim of the present study was to evaluate its short-term
effectiveness in changing marijuana involvement and perceived norms in undergraduates. Participants were 317 undergraduates (52% female, 78% White)
who reported marijuana use within the month preceding baseline; each was randomly assigned to 1 of 4 conditions formed by crossing e-TOKE versus
assessment only, with brief versus extensive baseline assessment (to assess assessment reactivity). Thus, 161 (51%) received eTOKE (77 with extended
baseline, 84 with brief baseline), and 156 (49%) received assessment-only control (85 with extended baseline, 71 with brief baseline). 1 month later,
all participants reported on marijuana use, problems, abuse and dependence symptoms, and norms. Assessment reactivity analyses yielded no significant
differences by assessment condition. Individuals completing the e-TOKE program reported less extreme descriptive norms (ps < 0.01) but no decrease in
marijuana use frequency, problems, abuse or dependence symptoms, or changes in injunctive norms (ps > 0.10). Thus, e-TOKE reduces perceptions of
others' use, but this study did not provide evidence for its utility in changing personal use and problem indicators in the short-term. More
research with longer follow-ups is indicated, given the possibility that descriptive norms could mediate behavior change.;
Psychology of Addictive
Behaviors, 28(1) : 288-293
- Year: 2014
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Fernandez-Artamendi, S., Fernandez-Hermida, J. R., Godley, M.D., Secades-
Villa, R.
The goal of the
present study is to describe the implementation of two Evidence-based treatments (EBT) for adolescent Cannabis Use Disorders (CUD) in the Spanish
Public Health System, and its main clinical outcomes. Adolescent Community Reinforcement Approach (A-CRA) and Contingency Management (CM) were chosen
as the most efficacious treatment programs for this population. A total of 26 adolescent cannabis users entered the study (91.7% male; age=16.50) at
two outpatient clinical facilities in Spain. A quasi-experimental design was utilized, with one group receiving A-CRA only and the other A-CRA+CM.
Implementation of both EBTs resulted feasible, with positive clinical outcomes. Results indicated that A-CRA has positive retention (81.3%) and
abstinence rates (68.8%). Results for the group receiving A-CRA+CM were not significantly better than A-CRA in retention (100%) or abstinence
(75.5%), although sample is too small to establish firm conclusions. Cannabis-related problems and depressive symptomatology also decreased during
treatment. Several limitations prevent us from determining the clinical efficacy of A-CRA in this study. The process of translating EBT's to
clinical contexts presented with many difficulties that need to be overcome. Recommendations are made for further attempts to implement EBTs in these
contexts.\rEl objetivo de este estudio era describir la implementación en el Sistema Público de Salud de dos programas basados en la evidencia (PBE)
para adolescentes con trastornos por consumo de cannabis, y sus principales resultados. La Aproximación de Reforzamiento Comunitario para
Adolescentes (A-CRA) y el Control de Contingencias (MC) fueron elegidos como los programas de intervención más eficaces para esta población. Un total
de 26 adolescentes participaron en el estudio (91.7% chicos; edad media=16.50 años) en dos centros de carácter ambulatorio en España. Se utilizó un
diseño cuasi-experimental, donde un grupo recibió A-CRA y el otro A-CRA+MC. La implementación de ambos programas resultó factible, con resultados
clínicos positivos. El A-CRA ofreció buenas tasas de retención (81.3%) y abstinencia (68.6%). Los resultados del grupo A-CRA+MC no fueron
significativamente mejores que los del A-CRA en retención (100%) o abstinencia (75.5%), aunque el limitado tamaño muestral no permite establecer
conclusiones firmes. Los problemas asociados al cannabis y la sintomatología depresiva se redujeron durante el tratamiento. Varias limitaciones nos
impiden determinar la eficacia clínica del A-CRA en este estudio. El proceso de traslación de los PBE al contexto clínico presentó múltiples
dificultades que deben ser abordadas. Se discuten recomendaciones para futuros intentos de implementación de PBE en estos contextos.
International
Journal of Clinical and Health Psychology, 14 : 186-
194
- Year: 2014
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Contingency
management, Other service delivery and improvement
interventions
Vogl, L.
E., Champion, K. E., Teesson, M.
BACKGROUND: Psychostimulants and cannabis are two of the three most commonly used illicit drugs by young Australians. As such, it is important to
deliver prevention for these substances to prevent their misuse and to reduce associated harms. The present study aims to evaluate the feasibility
and effectiveness of the universal computer-based Climate Schools: Psychostimulant and Cannabis Module.\rMETHODS: A cluster randomised controlled
trial was conducted with 1734 Year 10 students (mean age = 15.44 years; SD = 0.41) from 21 secondary schools in Australia. Schools were randomised to
receive either the six lesson computer-based Climate Schools program or their usual health classes, including drug education, over the year.
\rRESULTS: The Climate Schools program was shown to increase knowledge of cannabis and psychostimulants and decrease pro-drug attitudes. In the
short-term the program was effective in subduing the uptake and plateauing the frequency of ecstasy use, however there were no changes in
meth/amphetamine use. In addition, females who received the program used cannabis significantly less frequently than students who received drug
education as usual. Finally, the Climate Schools program was related to decreasing students' intentions to use meth/amphetamine and ecstasy in the
future, however these effects did not last over time.\rCONCLUSIONS: These findings provide support for the use of a harm-minimisation approach and
computer technology as an innovative platform for the delivery of prevention education for illicit drugs in schools. The current study indicated that
teachers and students enjoyed the program and that it is feasible to extend the successful Climate Schools model to the prevention of other drugs,
namely cannabis and psychostimulants.\rTRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry ACTRN12613000492752.
Substance Abuse Treatment, Prevention &
Policy, 9 : 24
- Year: 2014
- Problem: Cannabis Use, Stimulant Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Psychoeducation, Technology, interventions delivered using technology (e.g. online, SMS)
Malmberg, M., Kleinjan, M., Overbeek, G., Vermulst, A., Monshouwer,
K., Lammers, J., Vollebergh, W. A., Engels, Rutger C.
Aim: To evaluate the effectiveness of the
Healthy School and Drugs programme on alcohol, tobacco and marijuana use among Dutch early adolescents. Design: Randomized clustered trial with two
intervention conditions (i.e. e-learning and integral). Setting: General population of 11-15-year-old adolescents in the Netherlands. Participants A
total of 3784 students of 23 Dutch secondary schools. Measurements: Structured digital questionnaires were administered pre-intervention and at 32
months follow-up. The primary outcome measures were new incidences of alcohol (life-time and 1-month prevalence), tobacco (life-time and 1-month
prevalence) and marijuana use (life-time prevalence). Findings: Main effect analyses showed no programme effects on incidences of alcohol consumption
(life-time prevalence: e-learning condition: B = 0.102, P = 0.549; integral condition: B = -0.157, P = 0.351; 1-month prevalence: e-learning
condition: B = 0.191, P = 0.288; integral condition: B = -0.140, P = 0.445), tobacco consumption (life-time prevalence: e-learning condition: B =
0.164, P = 0.444; integral condition: B = 0.160, P = 0.119; 1-month prevalence: e-learning condition: B = 0.088, P = 0.746; integral condition: B =
0.261, P = 0.093), or marijuana consumption (life-time prevalence: e-learning condition: B = 0.070, P = 0.732; integral condition: B = 0.186, P =
0.214). Conclusion: The non-significant impact of the Healthy School and Drugs programme (a Dutch school-based prevention programme for early
adolescents) on incidences of alcohol, tobacco and marijuana use indicates that the programme is either ineffective or implemented inadequately.
(PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract).
Addiction, 109(6) : 1031-1040
- Year: 2014
- Problem: Alcohol
Use, Cannabis Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Skills training, Other Psychological Interventions
Walton, M. A., Resko, S., Barry, K. L., Chermack, S. T., Zucker, R.
A., Zimmerman, M. A., Booth, B. M., Blow, F.
C.
Abstract Aims To examine the efficacy of a brief intervention delivered by a therapist (TBI) or a computer (CBI) in preventing cannabis use
among adolescents in urban primary care clinics. Design A randomized controlled trial comparing: CBI and TBI versus control. Setting Urban primary
care clinics in the United States. Participants Research staff recruited 714 adolescents (aged 12-18 years) who reported no life-time cannabis use on
a screening survey for this study, which included a baseline survey, randomization (stratified by gender and grade) to conditions (control; CBI; TBI)
and 3-, 6- and 12-month assessments. Measurements Using an intent-to-treat approach, primary outcomes were cannabis use (any, frequency); secondary
outcomes included frequency of other drug use, severity of alcohol use and frequency of delinquency (among 85% completing follow-ups). Findings
Compared with controls, CBI participants had significantly lower rates of any cannabis use over 12 months (24.16%, 16.82%, respectively, P < 0.05),
frequency of cannabis use at 3 and 6 months (P < 0.05) and other drug use at 3 months (P < 0.01). Compared with controls, TBI participants did not
differ in cannabis use or frequency, but had significantly less other drug use at 3 months (P < 0.05), alcohol use at 6 months (P < 0.01) and
delinquency at 3 months (P < 0.01). Conclusions Among adolescents in urban primary care in the United States, a computer brief intervention appeared
to prevent and reduce cannabis use. Both computer and therapist delivered brief interventions appeared to have small effects in reducing other risk
behaviors, but these dissipated over time. (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract).
Addiction, 109(5) : 786-797
- Year: 2014
- Problem: Substance Use Disorders (any), Alcohol
Use, Cannabis Use
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Motivational interviewing, includes Motivational Enhancing Therapy, Personalised feedback, normative feedback, Technology, comparing delivery mode (e.g. online vs. face-to-face)
Schaub, M. P., Henderson, C. E., Pelc, I., Tossmann, P., Phan,
O., Hendriks, V., Rowe, C., Rigter, H.
Background: US-based trials have
shown that Multidimensional Family Therapy (MDFT) not only reduces substance abuse among adolescents, but also decreases mental and behavioural
disorder symptoms, most notably externalising symptoms. In the INCANT trial, MDFT decreased the rate of cannabis dependence among Western European
youth. We now focus on other INCANT outcomes, i.e., lessening of co-morbidity symptoms and improvement of family functioning.Methods: INCANT was a
randomised controlled trial comparing MDFT with individual therapy (IP) at and across sites in Berlin, Brussels, Geneva, The Hague, and Paris. We
recruited 450 boys and girls aged 13 up to 18 years with a cannabis use disorder, and their parent(s), and followed them for 12 months. Mental and
behavioural characteristics (classified as 'externalising' or 'internalising') and family conflict and cohesion were assessed.Results: From
intake through 12 months, MDFT and IP groups improved on all outcome measures. Models including treatment, site, and referral source showed that MDFT
outperformed IP in reducing externalising symptoms.Adolescents were either self-referred to treatment (mostly on the initiative from people close to
the teen) or referred under some measure of coercion by an external authority. These two groups reacted equally well to treatment.Conclusions: Both
MDFT and IP reduced the rate of externalising and internalising symptoms and improved family functioning among adolescents with a cannabis use
disorder. MDFT outperformed IP in decreasing the rate of externalising symptoms. Contrary to common beliefs among therapists in parts of Western
Europe, the 'coerced' adolescents did at least as well in treatment as the self-referred adolescents.MDFT shows promise as a treatment for both
substance use disorders and externalising symptoms. © 2014 Schaub et al.; licensee BioMed Central Ltd.
BMC
Psychiatry, 14(1) :
- Year: 2014
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Family therapy, Other Psychological Interventions
Walton, Maureen. A., Bohnert, Kipling., Resko, Stella., Barry, Kristen. L., Chermack, Stephen. T., Zucker, Robert. A., Zimmerman, Marc. A., Booth, Brenda. M., Blow, Frederic. C.
Aims: This paper describes outcomes from a randomized controlled trial examining the efficacy of brief interventions delivered by a computer (CBI)
or therapist (TBI) among adolescents in urban primary care clinics.; Methods: Patients (ages 12-18) self-administered a computer survey. Adolescents
reporting past year cannabis use completed a baseline survey and were randomized to control, CBI or TBI, with primary (cannabis use, cannabis related
consequences - CC) and secondary outcomes [alcohol use, other drug use (illicit and non-medical prescription drugs), and driving under the influence
of cannabis (DUI)] assessed at 3, 6, and 12 months.; Results: 1416 adolescents were surveyed; 328 reported past year cannabis use and were
randomized. Comparisons of the CBI relative to control showed that at 3 months the group by time interaction (G × T) was significant for other drug
use and CC, but not for cannabis use, alcohol use, or DUI; at 6 months, the G × T interaction was significant for other drug use but not for cannabis
use, alcohol use, or CC. For analyses comparing the TBI to control, at 3 months the G×T interaction was significant for DUI, but not significant for
cannabis use, alcohol use, or CC; at 6 months, the G×T interaction was not significant for any variable. No significant intervention effects were
observed at 12 months.; Conclusion: Among adolescent cannabis users presenting to primary care, a CBI decreased cannabis related problems and other
drug use and a TBI decreased cannabis DUI in the short-term. Additional boosters may be necessary to enhance these reductions over time.; Copyright ©
2013 Elsevier Ireland Ltd. All rights reserved.
Drug & Alcohol Dependence, 132(3) : 646-653
- Year: 2013
- 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, comparing delivery mode (e.g. online vs. face-to-face)
Rigter, Henk., Henderson, Craig. E., Pelc, Isidore., Tossmann, Peter., Phan, Olivier., Hendriks, Vincent., Schaub, Michael., Rowe, Cindy. L.
Background: Noticing a lack of evidence-based programmes for treating adolescents heavily using
cannabis in Europe, government representatives from Belgium, France, Germany, The Netherlands, and Switzerland decided to have U.S.-developed
multidimensional family therapy (MDFT) tested in their countries in a trans-national trial, called the International Need for Cannabis Treatment
(INCANT) study.; Methods: INCANT was a 2 (treatment condition)×5 (time) repeated measures intent-to-treat randomised effectiveness trial comparing
MDFT to Individual Psychotherapy (IP). Data were gathered at baseline and 3, 6, 9 and 12 months thereafter. Study participants were recruited at
outpatient secondary level addiction, youth, and forensic care clinics in Brussels, Berlin, Paris, The Hague, and Geneva. Participants were
adolescents from 13 through 18 years of age with a recent cannabis use disorder. 85% were boys; 40% were of foreign descent. One-third had been
arrested for a criminal offence in the past 3 months. Three primary outcomes were assessed: (1) treatment retention, (2) prevalence of cannabis use
disorder and (3) 90-day frequency of cannabis consumption.; Results: Positive outcomes were found in both the MDFT and IP conditions. MDFT
outperformed IP on the measures of treatment retention (p<0.001) and prevalence of cannabis dependence (p=0.015). MDFT reduced the number of cannabis
consumption days more than IP in a subgroup of adolescents reporting more frequent cannabis use (p=0.002).; Conclusions: Cannabis use disorder was
responsive to treatment. MDFT exceeded IP in decreasing the prevalence of cannabis dependence. MDFT is applicable in Western European outpatient
settings, and may show moderately greater benefits than IP in youth with more severe substance use.; Copyright © 2012 Elsevier Ireland Ltd. All
rights reserved.
Drug &
Alcohol Dependence, 130(1-3) : 85-93
- Year: 2013
- Problem: Cannabis Use
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Family therapy
Tait, Robert J., Spijkerman, Renske, Riper,
Heleen
Background: Worldwide, cannabis is the most
prevalently used illegal drug and creates demand for prevention and treatment services that cannot be fulfilled using conventional approaches.
Computer and Internet-based interventions may have the potential to meet this need. Therefore, we systematically reviewed the literature and
conducted a meta-analysis on the effectiveness of this approach in reducing the frequency of cannabis use.; Methods: We systematically searched
online databases (Medline, PubMed, PsychINFO, Embase) for eligible studies and conducted a meta-analysis. Studies had to use a randomized design, be
delivered either via the Internet or computer and report separate outcomes for cannabis use. The principal outcome measure was the frequency of
cannabis use.; Results: Data were extracted from 10 studies and the meta-analysis involved 10 comparisons with 4,125 participants. The overall effect
size was small but significant, g=0.16 (95% confidence interval (CI) 0.09-0.22, P<0.001) at post-treatment. Subgroup analyses did not reveal
significant subgroup differences for key factors including type of analysis (intention-to-treat, completers only), type of control (active,
waitlist), age group (11-16, 17+ years), gender composition (female only, mixed), type of intervention (prevention, 'treatment'), guided versus
unguided programs, mode of delivery (Internet, computer), individual versus family dyad and venue (home, research setting). Also, no significant
moderation effects were found for number of sessions and time to follow-up. Finally, there was no evidence of publication bias.; Conclusions:
Internet and computer interventions appear to be effective in reducing cannabis use in the short-term albeit based on data from few studies and
across diverse samples.; Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Drug & Alcohol Dependence, 133(2) : 295-
304
- Year: 2013
- Problem: Cannabis Use
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Technology, interventions delivered using technology (e.g. online, SMS)
Norberg, M. M., Kezelman, S., Lim-Howe, N.
A systematic review of primary prevention was conducted for cannabis use outcomes in youth and young adults. The aim of
the review was to develop a comprehensive understanding of prevention programming by assessing universal, targeted, uni-modal, and multi-modal
approaches as well as individual program characteristics. Twenty-eight articles, representing 25 unique studies, identified from eight electronic
databases (EMBASE, MEDLINE, CINAHL, ERIC, PsycINFO, DRUG, EBM Reviews, and Project CORK), were eligible for inclusion. Results indicated that primary
prevention programs can be effective in reducing cannabis use in youth populations, with statistically significant effect sizes ranging from trivial
(0.07) to extremely large (5.26), with the majority of significant effect sizes being trivial to small. Given that the preponderance of significant
effect sizes were trivial to small and that percentages of statistically significant and non-statistically significant findings were often equivalent
across program type and individual components, the effectiveness of primary prevention for cannabis use should be interpreted with caution. Universal
multi-modal programs appeared to outperform other program types (i.e, universal uni-modal, targeted multi-modal, targeted unimodal). Specifically,
universal multi-modal programs that targeted early adolescents (10-13 year olds), utilised non-teacher or multiple facilitators, were short in
duration (10 sessions or less), and implemented boosters sessions were associated with large median effect sizes. While there were studies in these
areas that contradicted these results, the results highlight the importance of assessing the interdependent relationship of program components and
program types. Finally, results indicated that the overall quality of included studies was poor, with an average quality rating of 4.64 out of 9.
Thus, further quality research and reporting and the development of new innovative programs are required.;
PLoS ONE, 8(1) : e53187-
e53187
- Year: 2013
- Problem: Cannabis Use
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any)