A Web-Based Program for Cannabis Use and Psychotic Experiences in Young People (Keep It Real): Protocol for a Randomized Controlled Trial

Hides, Leanne; Baker, Amanda; Norberg, Melissa M.; Copeland, Jan; Quinn, Catherine; Walter, Zoe; Leung, Janni; Stoyanov, Stoyan; Kavanagh, David J.

doi:10.2196/15803

Cited by 17 publications

(13 citation statements)

References 69 publications

(78 reference statements)

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“…As it stands, research on smartphone-based psychological interventions for young adults with psychosis is limited but increasing [39]. Research into the effects of internet-based interventions on decreasing cannabis consumption in young adults with psychosis is in its incipient stage [19] but is gaining momentum [42,43], with increasing demand for eHealth interventions and the number of jurisdictions that are legalizing the recreational use of cannabis. This qualitative study fills an important research gap related to patients' and clinicians' perceptions of psychological interventions and the use of technology to include these interventions in the clinical toolbox for patients with CUD and FEP.…”

Section: Discussionmentioning

confidence: 99%

Technology-Based Psychological Interventions for Young Adults With Early Psychosis and Cannabis Use Disorder: Qualitative Study of Patient and Clinician Perspectives

Tatar¹,

Abdel‐Baki²,

Tra³

et al. 2021

JMIR Form Res

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Background The persistence of cannabis use disorder (CUD) in young adults with first-episode psychosis (FEP) is associated with poor clinical and functional outcomes. Face-to-face psychological interventions are effective in treating CUD. However, their use in early intervention services (EISs) for psychosis is inconsistent because of barriers, including high workload and heterogeneity in training of clinicians and lack of motivation for treatment among patients. Tailoring new technology-based psychological interventions (TBPIs) to overcome these barriers is necessary to ensure their optimal acceptability. Objective The aim of this study is twofold: to explore psychological intervention practices and intervention targets that are relevant for treating CUD in individuals with early psychosis and to explore factors related to the development and implementation of a technology-assisted psychological intervention. Methods A total of 10 patients undergoing treatment for FEP and CUD in EISs participated in a focus group in June 2019. Semistructured individual interviews were conducted with 10 clinicians working in first-episode clinics in the province of Québec, Canada. A hybrid inductive-deductive approach was used to analyze data. For the deductive analysis, we used categories of promoting strategies found in the literature shown to increase adherence to web-based interventions for substance use (ie, tailoring, reminders, delivery strategies, social support, and incentives). For the inductive analysis, we identified new themes through an iterative process of reviewing the data multiple times by two independent reviewers. Results Data were synthesized into five categories of factors that emerged from data collection, and a narrative synthesis of commonalities and differences between patient and clinician perspectives was produced. The categories included attitudes and beliefs related to psychological interventions (eg, behavioral stage of change), strategies for psychological interventions (eg, motivational interviewing, cognitive behavioral therapy, psychoeducation, stress management), incentives (eg, contingency management), general interest in TBPIs (eg, facilitators and barriers of TBPIs), and tailoring of TBPIs (eg, application needs and preferences, outcome measures of interest for clinicians). Conclusions This study provides a comprehensive portrait of the multifaceted needs and preferences of patients and clinicians related to TBPIs. Our results can inform the development of smartphone- or web-based psychological interventions for CUD in young adults with early psychosis.

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Section: Discussionmentioning

confidence: 99%

Technology-Based Psychological Interventions for Young Adults With Early Psychosis and Cannabis Use Disorder: Qualitative Study of Patient and Clinician Perspectives

Tatar¹,

Abdel‐Baki²,

Tra³

et al. 2021

JMIR Form Res

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“…The current study was a cross-sectional design to investigate the following continuous variables at a single time point: cannabis use, PLEs, self-reported pain, childhood trauma, anxiety, and depression. The data formed part of a larger randomised controlled trial looking at high risk cannabis users with PLEs ('Keep It Real') [29].…”

Section: Methods 21 Participants and Designmentioning

confidence: 99%

Pain and Psychotic-like Experiences in Young People Using Cannabis

Wilson

Constable

Mason

et al. 2022

The 3rd International Electronic Conference on Environmental Research and Public Health—Public Health Issues in the C

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Research has demonstrated that cannabis use is linked with a greater risk of psychoticlike experiences (PLEs), particularly in young people. As many use cannabis for the alleviation of pain, it is important to examine the impact that PLEs have on pain. This is because current literature finds that psychotic and schizophrenic disorders impact pain experience, and PLEs are subclinical positive symptoms of psychosis. There is limited research on the impact of PLEs on pain experience, particularly in cannabis users, and thus the current study aims to address this gap in the literature. The study also examines whether childhood trauma and mental health problems contribute to the heightened risk of pain in cannabis users, and whether these relationships are moderated by PLEs. The current study was a cross-sectional design in young cannabis users aged 18-25 (N = 2630). Participants completed questionnaire measures of cannabis use, PLEs, self-reported pain, childhood trauma, anxiety, and depression. Logistic regression analyses revealed that young cannabis users experiencing more PLEs reported significantly higher pain. Additionally, experiencing a history of childhood trauma and depression were also found to result in higher pain in these cannabis users. Moderation analyses revealed that PLEs moderated the relationship between depression and pain; however, in contrast to our predictions, PLEs did not moderate the relationship between childhood trauma and pain. Anxiety did not significantly predict higher pain. The results of the current study have important implications for the use and legalisation of THC medically and the social, emotional, and cognitive aspects of pain and cannabis use. We propose recommendations for mitigating the risk of PLEs associated with cannabis use in chronic pain patients medically prescribed THC for its analgesic effects and suggestions for future research.

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“…However, involvement of the family in treatment appears successful in some patients and is a possible strategy for future research. In addition to psychosocial treatments, the effects of digital interventions are currently unclear, but a targeted, self-guided web-based programme is currently being trialled for young people with psychotic experiences and cannabis use in Australia (Hides et al, 2020).…”

Section: Psychosismentioning

confidence: 99%

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

et al. 2021

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Cannabis is the most widely used illicit drug worldwide, and it is estimated that up to 30% of people who use cannabis will develop a cannabis use disorder (CUD). Demand for treatment of CUD is increasing in almost every region of the world and cannabis use is highly comorbid with mental disorders, where sustained use can reduce treatment compliance and increase risk of relapse. In this narrative review, we outline evidence for psychosocial and pharmacological treatment strategies for CUD, both alone and when comorbid with psychosis, anxiety or depression. Psychosocial treatments such as cognitive behavioural therapy, motivational enhancement therapy and contingency management are currently the most effective strategy for treating CUD but are of limited benefit when comorbid with psychosis. Pharmacological treatments targeting the endocannabinoid system have the potential to reduce cannabis withdrawal and cannabis use in CUD. Mental health comorbidities including anxiety, depression and psychosis hinder effective treatment and should be addressed in treatment provision and clinical decision making to reduce the global burden of CUDs. Antipsychotic medication may decrease cannabis use and cannabis craving as well as psychotic symptoms in patients with CUD and psychosis. Targeted treatments for anxiety and depression when comorbid with CUD are feasible.

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A Web-Based Program for Cannabis Use and Psychotic Experiences in Young People (Keep It Real): Protocol for a Randomized Controlled Trial

Cited by 17 publications

References 69 publications

Technology-Based Psychological Interventions for Young Adults With Early Psychosis and Cannabis Use Disorder: Qualitative Study of Patient and Clinician Perspectives

Technology-Based Psychological Interventions for Young Adults With Early Psychosis and Cannabis Use Disorder: Qualitative Study of Patient and Clinician Perspectives

Pain and Psychotic-like Experiences in Young People Using Cannabis

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

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