Facilitators and barriers in treatment seeking for cannabis dependence

Abstract

Facilitators and barriers in treatment seeking for cannabis dependence van der Pol, P.; Liebregts, N.; de Graaf, R.; Korf, D.J.; van den Brink, W.; van Laar, M. General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: http://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. Download date: 13 May 2018Drug and Alcohol Dependence 133 (2013) t r a c tBackground: Relatively few cannabis dependent people seek treatment and little is known about determinants of treatment seeking. Methods: Treatment determinants were compared among 70 DSM-IV cannabis dependent patients and 241 non-treatment seeking DSM-IV cannabis dependent community subjects. In addition, perceived facilitators for treatment seeking were assessed in patients, whereas perceived barriers were assessed in 160/241 cannabis dependent community subjects not prepared to seek treatment (precluders), of whom 63/160 showed an objective treatment need, and 30/241 showed a subjective treatment need. Results: Compared to non-treatment seekers, patients reported more cannabis use (176.9 versus 82.8 joints monthly), more symptoms of dependence (5.6 versus 4.5), higher perceived lack of social support (70.0% versus 41.1%), more pressure to seek treatment (58.6% versus 21.6%), a more positive attitude to treatment, and more previous treatments. In addition, patients reported more mental health problems (internalising disorders 57.1% versus 24.5%; externalising disorders 52.9% versus 35.3%) and more functional impairments (8.4 versus 4.8 monthly days out of role). Cannabis dependent 'precluders' reported desire for self-reliance (50.0%), preference for informal help (22.5%), and absent treatment need (16.9%) as their main reasons not to seek treatment, whereas cannabis dependent community subjects with a subjective treatment need mainly expressed desire for self-reliance (36.7%), treatment ineffectiveness (16.7%), and avoiding stigma (13.3%). Conclusions: Functional impairment, mental health problems and social pressure are important reasons to seek treatment in people with cannabis dependence. Treatment participation might improve if desire for self-reliance and the preference for informal help are considered, and perceived ineffectiveness of treatment and stigmatisation are publicly addressed.

Three-Year Course of Cannabis Dependence and Prediction of Persistence

“…One may argue that this marks their increased risk for the following relapse. The importance of functional impairment is underlined by our recent finding that functional impairment was the strongest reason to seek treatment for patients in addiction care, while in the current sample, one of the main self-reported barriers to seek treatment was thinking that treatment was not needed [15], in line with a previous study among frequent cannabis users [56]. This may also explain the low treatment seeking rates between T0 and T2.…”

“…Currently, levels of cannabis use or related problems following a period of cannabis dependence have only been quantified among remitted patients from clinical samples [9,13,14] and results are thus influenced by the treatment itself and the selection of more severe cases typically seen in treatment [15,16]. It is therefore important to know more about cannabis use, cannabis use problems and functional impairment of cannabis-dependent individuals in the community who remit from dependence compared to persistent dependent users.…”

Treatment seeking in cannabis dependence: The role of social cognition

“…Lack of self-efficacy to resist cannabis when experiencing distress may motivate individuals to seek help because they believe they are unable to make effective changes on their own. Past research has shown that treatment seekers are likely to have had more prior quit attempts than nontreatment seekers (van der Pol et al, 2013). Treatment seekers' self-efficacy may therefore have been reduced as a result of failed past attempts (Bandura, 1997).…”

“…These studies have found several characteristics that differ between these groups. Treatment seekers are more likely to have comorbid mental health problems, experience greater impairment as a result of their cannabis use, and encounter more problems (e.g., withdrawal symptoms) when attempting to quit cannabis (Agosti and Levin, 2009;Pacek and Vandrey, 2014;van der Pol et al, 2013). They also differ in motivation.…”

“…Those who do not seek formal treatment are more likely to be concerned about the stigma associated with seeking treatment, and are more likely to believe that treatment is not required in order to reduce their cannabis use (Gates et al, 2012;van der Pol et al, 2013). Vendetti and colleagues (2002) found that self-perceived cannabis dependence was a more important predictor of treatment initiation than actual level of cannabis-related problems, which were similar between treatment seekers and non-seekers.…”