Attempts to stop or reduce marijuana use in non-treatment seekers

Abstract

Daily marijuana smokers (n=19) who intended to quit or reduce in the next month on their own called a phone each night for 28 nights to report marijuana use and reported intentions to change at the end of each week. Outcomes did not differ between those who initially planned to reduce vs. quit in the next month. Participants averaged three attempts to reduce and one attempt to quit during the 28 days. Participants reduced on 11% and abstained on 14% of days. Most participants were successful in reducing or abstaining on half or more of the days they attempted; however, only four participants (21%) reduced ≥ 50% for ≥ 7 consecutive days and only two (10%) abstained for that long. Abstinence or reduction did not appear to change alcohol or caffeine use. We conclude a) initial intentions are poor predictors of outcomes, b) most users make multiple, short-lived attempts to change, c) reduction was as common as abstinence, d) many attempts to change are initially successful but few persist, and e) other drug use does not appear to worsen with marijuana reduction or abstinence.

Recovery from cannabis use disorders: Abstinence versus moderation and treatment-assisted recovery versus natural recovery.

“…The lack of differences found between the abstinence-and moderation-oriented participants are particularly interesting, as they suggest that while the decision to overcome a cannabis problem might be a conscious decision, goal choice at the time of change might be unrelated to the actual recovery orientation pathway that is eventually adopted. In other words, these results suggest that goal choice at the time of change might be a weak predictor of actual recovery orientation, a finding of which is consistent with literature suggesting that goal selection is fluid (Hodgins et al, 1997;Hughes et al, 2008;Ladouceur et al, 2009;Lozano et al, 2006;Ojehagen & Berglund, 1989), and that initial goal selection might be a poor predictor of outcome ).…”

“…Specifically, as alluded to previously in this manuscript, Hughes et al (2008) reported that among 19 non-treatment seeking daily cannabis users who intended to quit or reduce on their own in the next month, initial goal selection was a poor predictor of outcome, most users made multiple and short-lived attempts to change, reduced use was as common as abstinence, many attempts to change were initially successful but few persisted, and other drug use did not appear to worsen with reduced use or abstinence. Stephens et al (1994a) tested the abstinence violation effect (AVE; Marlatt & Gordon, 1980) among a sample of 75 adult cannabis users who reported a lapse into cannabis use following completion of either a relapse prevention treatment or social support group treatment.…”

“…Another interesting study reported that among 19 non-treatment seeking daily cannabis users who intended to quit or reduce on their own in the next month (participants were required to call a phone each night for 28 nights to report cannabis use and reported intentions to change at the end of each week), initial goal selection was a poor predictor of outcome, most users made multiple and short-lived attempts to change, reduced use was as common as abstinence, many attempts to change were initially successful but few persisted, and other drug use (including alcohol, tobacco, caffeine, and use of other illicit drugs) did not appear to worsen with cannabis moderation or abstinence (Hughes, Peters, Callas, Budney, & Livingston, 2008).…”

“…To date, only a handful of empirical studies might be considered to have touched upon this topic (Agosti & Levin, 2007;Degenhardt et al, 2010;Hughes et al, 2008;Stephens, Curtin, Simpson, & Roffman, 1994a;Swift et al, 2009), only one small study has evaluated a moderation-focused treatment program (Sobell, Sobell, Wagner, Agrawal, & Ellingstad, 2006), and only one study has specifically examined this topic in-depth and in the context of abstinence-oriented treatment (Lozano et al, 2006).…”

“…The items were adapted from checklists and categorizations of open-ended responses for reasons for resolution from previous studies in the natural recovery literature (Cunningham, Sobell, Sobell, & Kapur, 1995;Cunningham, Sobell, Sobell, & Gaskin, 1994;Ellingstad et al, 2006;Hodgins & el-Guebaly, 2000;Hughes et al, 2008;Toneatto et al, 2008). …”