Abstinence rates following behavioral treatments for marijuana dependence

Abstract

Previous studies have noted particular difficulty in achieving abstinence among those who are marijuana dependent. The present study employed a dismantling design to determine whether adding contingency management (ContM) to motivational enhancement therapy plus cognitive behavioral therapy (MET+CBT), an intervention used in prior studies of treatment for marijuana dependence, would enhance abstinence outcomes. 240 marijuana dependent participants were recruited via advertisements and assigned to either MET+CBT, ContM only, MET+CBT+ContM, or to a casemanagement control condition. All interventions involved 9 weekly 1-hour sessions, except for the ContM-only condition whose sessions lasted about 15 minutes. ContM provided reinforcement for marijuana-free urine specimens, in the form of vouchers redeemable for goods or services. Followup data were collected at posttreatment and at 3-month intervals for 1 year. The two ContM conditions had superior abstinence outcomes: ContM-only had the highest abstinence rates at posttreatment, and the MET+CBT+ContM combination had the highest rates at later follow-ups. The roles of contingency management and coping skills training in the treatment of marijuana dependence are discussed.

Psychological and psychosocial interventions for cannabis cessation in adults: A systematic review

“…One study only included participants who met the DSM criteria (Kadden et al, 2007), while two included participants who consumed cannabis at a certain frequency (Jungerman et al, 2007;Stephens et al, 1994) and one study included individuals without ''severe dependence'' (Sobell et al, 2009). All four studies showed no significant between group differences at posttreatment for cannabis usage outcomes, but showed mixed results for cannabis problems and severity of dependence outcomes, with the same study (Jungerman et al, 2007) showing significant results for each.…”

“…The same study also identified significant differences for dependence symptoms outcomes. Two studies reported average number of sessions attended across both study groups, reporting 76% (Stephens et al, 1994) and 58% (Kadden et al, 2007) attendance, with no significant differences between groups. At later follow-up points, no significant differences were identified for any key outcomes at 14 or 15 months.…”

“…Four studies (Jungerman et al, 2007;Kadden, Litt, Kabela-Cormier, & Petry, 2007;Sobell, Sobell, & Agrawal, 2009;Stephens, Roffman, & Simpson, 1994) compared CBT (4-10 sessions) against another intervention, comprising a social support group (Stephens et al, 1994), case management sessions (Kadden et al, 2007) or compared individual versus group CBT (Sobell et al, 2009) or CBT over different durations (Jungerman et al, 2007). One study only included participants who met the DSM criteria (Kadden et al, 2007), while two included participants who consumed cannabis at a certain frequency (Jungerman et al, 2007;Stephens et al, 1994) and one study included individuals without ''severe dependence'' (Sobell et al, 2009).…”

“…Five studies (Budney, Moore, Rocha, & Higgins, 2006;Budney et al, 2000Budney et al, , 2011Kadden et al, 2007;Litt, Kadden, & Petry, 2013) compared contingency management (vouchers for abstinence assessed via urine tests), alone or in combination with CBT, versus other interventions. One study also assessed computer-based CBT plus contingency management (Budney et al, 2011).…”

Naltrexone Maintenance Decreases Cannabis Self-Administration and Subjective Effects in Daily Cannabis Smokers

“…Currently, ∼ 24% of patients entering treatment for substance abuse have a diagnosis of cannabis use disorder (CUD;SAMHSA, 2012), yet few patients are able to achieve continued abstinence (Marijuana Treatment Project Research Group, 2004;Budney et al, 2006;Kadden et al, 2007;Levin et al, 2011;Weinstein et al, 2014). There is thus a clear and pressing need to improve treatment outcomes for cannabis use disorder, and pharmacological options are one important strategy needing development.…”