Assessing the Efficacy of MOTI-4 for Reducing the Use of Cannabis Among Youth in the Netherlands: A Randomized Controlled Trial

Abstract

The Moti-4 intervention, in which motivational interviewing, self-monitoring, and strengthening behavioral control are used, was developed in the Netherlands in response to several rapid assessments of problematic use of cannabis among vulnerable adolescents. The main goal of the study reported in this article was to determine whether the Moti-4 intervention was able to reduce two outcome measures pertaining to the level of cannabis use; the amount of Euros spent a week on cannabis and the mean number of cannabis joints (cigarettes) smoked in a week. In a randomized controlled trial (RCT) with a 6-month follow-up, 27 trained Dutch prevention workers recruited 71 Moti-4 participants and 60 controls assigned to usual care. Participants were Dutch youth aged 14-24 years who had used cannabis during the preceding month. At baseline (T0), post-test (T1) and 6-month follow-up (T2), participants completed a questionnaire with 51 items. The 27 prevention workers also completed a checklist to assess the fidelity of delivering each item to each participant in the Moti-4 protocol. Multilevel and binary logistic regression was used to assess the impact of the prevention worker and 14 participant variables on the likelihood of drop-out. Mean scores for cannabis use outcome measures by Moti-4 participants and controls at baseline, T1 and T2 were compared using paired sample t-tests. Top-down multiple regression was used to assess relationships between Moti-4 and 13 other variables on the one hand and changes in weekly cannabis use at T1 and T2 on the other. The Moti-4 experimental condition had a significant and positive influence in reducing the level of expenditure on cannabis (p<0.05). There was no significant difference in outcome, neither for the 4 participating institutes nor for the professionals implementing the intervention. Baseline cannabis use was the strongest predictor (p<0.001) of weekly cannabis expenditure at posttest and 6-month follow-up. This effect was still present at T2. Being female, having two Dutch parents and perceived behavioral control also made significant positive contributions (p<0.05). Attitude at baseline was only related to cannabis expenditure after 6months (p=0.005). At T2 Moti-4 participants were found to have a significant reduction in the number of joints smoked weekly compared to T0 (on the average 4 joints). The study demonstrated that Moti-4 is an effective intervention to reduce cannabis use in youth.

A Narrative Review of Psychological Cannabis Use Treatments with And Without Pharmaceutical Adjunct

“…A total of 11 included studies investigated the efficacy of an MET-based intervention for cannabis use among adolescents (117)(118)(119)(120)(121)(122)(123)(124)(125)(126)(127). Participant groups receiving these interventions ranged in sample size from 20 (121) to 136 (127) across studies.…”

“…Participant groups receiving these interventions ranged in sample size from 20 (121) to 136 (127) across studies. Intervention sessions ranged from a single session (117,118,122,123) up to four sessions (120,124). Follow-up ranged from approximately three months up to 12 months.…”

“…Follow-up ranged from approximately three months up to 12 months. In these trials MET was compared with DC (119,120,125), CBT and family therapy (127), as well as MET with an abstinence-based CM adjunct (124). There was mixed evidence that MET was superior to DC.…”

A developmental‐based motivational intervention to reduce alcohol and marijuana use among non‐treatment‐seeking young adults: a randomized controlled trial

“…Of the 2645 individuals screened by phone, 2002 were ineligible. The most common reasons for ineligibility were not using both substances at the study threshold levels (976), having suicidal ideation (234), being outside the age range (148), cocaine or opioid use , and living at a distance . The remaining individuals were ineligible for other or multiple reasons.…”

“…In emerging adults , recent meta‐analyses have found small effects when examining the utility of BMI for alcohol use. Brief interventions have also addressed marijuana use among non‐treatment‐seekers in randomized trials, demonstrating efficacy among adolescents , men (Stephens et al . , young persons opportunistically approached during primary care visits , and community‐recruited, non‐treatment‐seeking, young adult women .…”