Psychological and psychosocial interventions for cannabis cessation in adults: A systematic review

Abstract

Objective: Many psychological and psychosocial interventions have been developed to treat regular users of cannabis, but it is unclear which intervention(s) are the most effective. This article aims to assess the effectiveness of psychological and psychosocial interventions for cannabis cessation, and to outline priorities for future research. Methods: A systematic review of the scientific literature. Eleven databases were searched in February 2014. Results: Twenty-six RCTs were identified; the majority were considered to be at a high risk of bias. Cognitive behavioural therapy (CBT) significantly improved outcomes compared with wait-list in five studies post-treatment, maintained at 9 months in the one study with later follow-up. Studies of motivational interviewing (MI) or motivational enhancement therapy (MET) gave mixed results, with some improvements over waitlist while some comparisons were not significant. Four studies comparing CBT against MI/MET gave mixed results; longer courses of CBT provided some improvements over shorter MI. Courses of other types of therapy (social support groups and case management) gave similar improvements to CBT. Vouchers for abstinence (contingency management) gave promising results in the short-term and at follow-up. Conclusion: Studies were heterogeneous, covering a range of interventions, comparators, populations and outcomes. CBT improved short-term outcomes in a clinically dependent self-selected population of cannabis users. Brief MI improved short-term outcomes at post-treatment in a younger non-clinically dependent population. There is some evidence that CBT may be more effective than briefer MI interventions although results were mixed. Contingency management may enhance long-term outcomes in combination with CBT in clinically dependent individuals.

Effectiveness of Motivational Interviewing on adult behaviour change in health and social care settings: A systematic review of reviews

“…Further details of the interventions using the ‘Template for Intervention Description and Replication (TIDieR) [ 14 ] are reported in S1 Table . Of the 104 reviews 40 were judged by two authors (PC and HF) as overall low risk of bias [ 7 , 11 , 12 , 20 , 21 , 25 – 27 , 30 , 35 , 38 , 41 , 44 , 47 – 49 , 51 , 53 , 54 , 56 , 57 , 59 , 65 , 71 , 81 , 83 , 84 , 89 , 91 – 94 , 97 , 98 , 100 , 102 , 111 , 113 – 115 ]. Fig 3 summaries the risk of bias across all reviews.…”

“…In total 20 narrative reviews were judged as low risk of bias graded using the ROBIS tool [ 15 ] [ 11 , 20 , 25 , 35 , 42 , 44 , 47 , 51 , 53 , 54 , 59 , 65 , 83 , 89 , 92 , 97 , 98 , 113 – 115 ]. Five of these reviews report positive effects of Motivational Interviewing.…”

“…Kay et al (2016) suggest that Motivational Interviewing has potential for use in oral care [ 65 ]. Chatters et al (2016) report short term benefits for reducing cannabis use in younger adults [ 47 ]. However, most were unable to make firm conclusions about effectiveness of Motivational Interviewing [ 20 , 44 , 59 , 89 ].…”

Relación entre las motivaciones para consumir y el consumo problemático de cannabis

“…También en el ámbito clínico, el abordaje motivacional muestra evidencia científica consistente en el tratamiento del trastorno por consumo de sustancias (TUS), incluido el cannabis (Chatters et al, 2016;K. Cooper, Chatters, Kaltenthaler, y Wong, 2015).…”

Is Recovery from Cannabis Dependence Possible? Factors that Help or Hinder Recovery in a National Sample of Canadians with a History of Cannabis Dependence

“…Unfortunately, the CCHS-MH did not contain information on what interventions, if any, the respondents with a history of cannabis dependence had accessed to assist them with quitting cannabis. A recent systematic review of randomized controlled trials of psychosocial interventions for cannabis cessation suggests that clinicians have several promising interventions to draw upon in order to effectively treat their patients with cannabis abuse and/or dependence in order to promote remission and recovery [36]. Efficacious treatment options include cognitive behavioural therapy and motivational interviewing [36].…”