Integrated cognitive behavioral therapy for comorbid cannabis use and anxiety disorders: A pilot randomized controlled trial

Abstract

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, M age = 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 * Correspondence may be sent to Julia D.

Integrated Cognitive Behavioral Therapy for Anxiety and Smoking Cessation

“…It is also notable that FSET skills have been integrated into MI-based CBT for cannabis use disorder (Steinberg et al, 2005) to treat co-occurring CUD and anxiety disorders (Buckner, Zvolensky, et al, 2014). That integrated treatment resulted in decreases in anxiety and cannabis use in case studies (Buckner, Ecker, et al, 2016) and a pilot RCT (Buckner et al, 2019). When considered in light of the current data, it appears that FSET is a transdiagnostic anxiety treatment that can be readily integrated into extant CBT manuals for substance use disorders to simultaneously treat substance use and anxiety disorders.…”

“…TASC may also increase confidence to change anxiety and quit smoking as patients learn alternative, more adaptive coping skills to help them cope with anxiety and other high-risk smoking situations. TASC was developed after FSET was successfully integrated with CBT for CUD to successfully treat comorbid anxiety and cannabis use disorders (Buckner et al, 2019; Buckner, Ecker, et al, 2016). To illustrate the utility of TASC for smoking cessation patients with a variety of co-occurring anxiety disorders, we first provide an overview of TASC sessions and then present two case examples.…”

Psychosocial and pharmacological treatments for cannabis use disorder and mental health comorbidities: a narrative review

“…A large multisite RCT in the USA (Buckner & Carroll, 2010) reported that nine sessions of CBT tailored to CUD ( n = 156) compared to two-session MET alone ( n = 146) reduced anxiety and that reduction was correlated with successful reduction in CUD (Table 4). Furthermore, a small pilot trial conducted in the USA combining cannabis-tailored MET–CBT with transdiagnostic anxiety treatment (ICART, n = 27) showed preliminary evidence of increased rates of abstinence at the end of treatment over MET–CBT alone as confirmed using urinalysis (Buckner et al, 2019). Targeted treatments for depression have also been investigated.…”

Marijuana: To Use or Not to Use

“…However, CBR1 blockers were not approved for therapy of obesity or metabolic syndrome due to serious neuropsychiatric and psychological untoward effects including severe depression leading to suicides and homicides as well as acute and chronic psychotic behavior. [19][20][21] In contrast, marijuana with 2 major active cannabinoids is legalized by individual state authorities as a supplement for medicinal usage for many disorders. it is apparent that marijuana use fits in with vitamin D supplementation.…”