Successful outcomes with low–threshold intervention for cannabis use disorders in Norway - an observational study

Background Youth mortality from drugs is worryingly increasing in Europe. Little is so far known about what substance use services are available to young people. An out-of-home care placement is often used but does not suffice alone as an intervention in problematic substance use among youth. Additional interventions are needed. Objective This narrative review investigated what has been done, what works, and what is needed in treating youth substance use in the Nordic countries from the viewpoint of social services. This study brought together previous Nordic studies on this topic and presented responses to youth substance use in Nordic social welfare system to the wider international audience. Methods A search of the ProQuest and EBSCOhost databases revealed seven interventions reported in 17 papers. Narrative synthesis was used. Results Interventions included the Cannabis Cessation Program (CCP), the Icelandic version of the Motivation to Change Inventory for Adolescents, the Norwegian multisystemic therapy program (MST), the Structured Interview Manual UngDOK implemented in the Swedish Maria clinics, the Finnish ADSUME-based intervention in school health care, and the Swedish Comet 12–18 and ParentStep 13–17 programs. Many interventions had originated in the US rather than in the Nordic countries and most of them were adapted from adult interventions when youth specificity was lacking. Parental involvement was deemed important, but ineffective without involving the adolescent themself. Interventions and ways for dealing with young offenders required reconsideration from the perspective of the best interests of the child. The current research focuses on universal prevention while more knowledge about selective and indicative prevention was called for. Conclusions Not enough is known about the cessation of problematic youth substance use and subsequent rehabilitation in social services. We would encourage further research on the multi-producer system, subscriber-provider-cooperation in youth substance use services, non-medical youth-specific substance use interventions in social services, and rehabilitative juvenile drug offense practices.

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Evaluating user perceptions of an e-Health intervention for cannabis use: Focus Group Study (Preprint)

Folch Sanchez,

Pellicer,

Sestelo

et al. 2024

Preprint

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BACKGROUND Cannabis is the most used illicit drug and admissions for cannabis use disorders (CUDs) are rising worldwide, posing a significant public health problem. Despite its negative consequences, an important number of problematic users do not access treatment. Digital health interventions (DHIs) have spread over the past two decades, as they are easily accessible and cost-effective solutions. CANreduce is one of the eHealth interventions that has proven effective in reducing cannabis use (CU), although it exhibited suboptimal adherence rates. OBJECTIVE This study aims to enhance the effectiveness, adherence, and user experience of the Spanish version of CANreduce 2.0, by using focus groups (FGs), in the context of a patient-centered design approach that engages both patients and clinicians. METHODS Separate FGs were conducted for users and clinicians with a total of 10 participants. Each session was facilitated by two interviewers and conducted remotely via Zoom using a semi-structured script that allowed to discuss user’s perspectives on specific topics related to the acceptability, usability and utility of the DHI. A qualitative analysis of the transcripts was conducted using MAXQDA software. Content analysis methodology was used to identify and define themes that captured essential topics of interest from the data gathered. RESULTS Codes identified in the qualitative analysis were categorized into 3 main themes: "motivation and awareness," "guidance and use," and "content and design". Strengths and deficiencies of the intervention, as well as outlines on how to address them, were identified for each theme. The main findings highlighted the suitability of CANreduce 2.0 as a complement to in-person therapy serving as an educational and monitoring tool. Additionally, the importance of notifications, gamification, and personalization to was emphasized to enhance motivation and adherence. CONCLUSIONS This study highlights the complexity of designing effective DHIs for CU. Personalization, robust motivational strategies, and an interactive design are crucial for the process' success. Collaboration between technology developers, healthcare professionals, and patients should be in the center of developing DHIs, with user perspectives being key to reaching practical and effective solutions.

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Successful outcomes with low–threshold intervention for cannabis use disorders in Norway - an observational study

Cited by 3 publications

References 22 publications

Cannabis use in youth: Consumption and health consequences

Cannabis use in youth: Consumption and health consequences

Treatment for problematic substance use in Nordic youth: a narrative review from the viewpoint of social services

Evaluating user perceptions of an e-Health intervention for cannabis use: Focus Group Study (Preprint)

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