Who responds best to text-delivered cannabis use disorder treatment? A randomized clinical trial with young adults.

Abstract

Young adults ages 18 to 25 have the highest percentage (5%) of cannabis use disorder (CUD) among all age groups, and are the least likely to receive treatment compared with other age groups. Because this population is in need of creative approaches for treatment engagement, we tested Peer Network Counseling-txt (PNC-txt), a 4-week, automated text-delivered cannabis treatment that focuses on close peer relations with 96 treatment seeking young adults. Participants meeting CUD criteria were randomized to PNC-txt, or assessment only control condition and followed for 3-months. At 3-months, the PNC-txt group reduced number of heavy cannabis-use days and relationship problems due to cannabis use compared with controls. Subgroup analyses were conducted with cases having more and fewer CUD symptoms than the full sample. For cases with fewer symptoms, but not for those with more, PNC-txt reduced past 30-day use, urges to use, memory problems, and relationship problems due to cannabis use compared with controls. Treatment satisfaction data from the full sample indicated that participants thought the intervention texts helped them reduce or manage their cannabis use and increased their understanding of the negative relational effects associated with ongoing cannabis use. Findings provide evidence of the efficacy of PNC-txt in treating CUD in young adults, support clinically targeting peer relations, and suggest that PNC-txt may be most helpful for those with mild to moderate CUD severity.

Online interventions for cannabis use among adolescents and young adults: Systematic review and meta‐analysis

“…Participants' mean age ranged from 16.3 to 29.8, and 47.6% were female. Twelve studies reported CU as the main outcome (Buckner et al, 2020;Elliott et al, 2014;Jacobus et al, 2018;Lee et al, 2010;Mason, Zaharakis, Russell, et al, 2018;Mason, Zaharakis, Moore, et al, 2018;Schaub et al, 2015;Shrier et al, 2018;Sinadinovic et al, 2020;Tossmann et al, 2011;Walton et al, 2013;Walukevich-Dienst et al, 2019) while the other five also include use of other drugs as an outcome. Becker as a secondary outcome (Buckner et al, 2020;Elliott et al, 2014;Jacobus et al, 2018;Schaub et al, 2015 andSinadinovic et al, 2020), and two studies (Shrier et al, 2018;Walton et al, 2013)…”

“…Interventions included 11 studies examining motivational interviewing (Becker et al, 2014;Buckner et al, 2020;Christoff & Boerngen-Lacerda, 2015;Gryczynski et al, 2020;Hernandez et al, 2019;Lee et al, 2010;Mason, Zaharakis, Moore, et al, 2018;Mason, Zaharakis, Russell, et al, 2018;Thompson Jr. et al, 2020;Walton et al, 2013;Walukevich-Dienst et al, 2019), one study evaluating counselling combined with MI (Shrier et al, 2018), one study evaluating counselling combined with MI and CBT (Schaub et al, 2015), another providing psychoeducation based on MI and CBT (Sinadinovic et al, 2020), and one study each using counselling (Tossmann et al, 2011), psychoeducation (Elliott et al, 2014), and cognitive training (Jacobus et al, 2018) as shown in Table 2. As depicted in Table 2, recruitment methods consisted of a national drug specialized website (Sinadinovic et al, 2020;Tossmann et al, 2011), local newspapers, radio and TV (Becker et al, 2014) (Gryczynski et al, 2020;Walton et al, 2013), inner crisis shelters (Thompson Jr. et al, 2020), and family court systems (Hernandez et al, 2019).…”

Adolescent Substance Use Disorder Treatment: an Update on Evidence-Based Strategies

“…In the last three years, there have been several studies examining the effectiveness of digitized interventions such as web-applications [77,78], text messaging [79], video games [80], and cognitive bias training [81]. Development of many of these promising interventions has been based on interventions such as MI [77, 82•,83], with the aim of effectively reducing substance use and substancerelated cravings and problems through the delivery of automated, personalized text messages [83][84][85].…”

“…Positive studies have found that texting and web-based interventions can effectively reduce risky drinking and drinking frequency as well as lessen existing substance use [76,82]. However, the effects of some of these technology-based interventions may be limited, as one study found that digital interventions are more effective among highly-educated adolescents compared to less-educated adolescents [86], as well as among youth with less severe substance use disorders [85].…”

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

“…Preliminary evidence from an RCT conducted in the USA showed that a 4-week text-delivered treatment reduced the proportion of the sample reporting cannabis-related relationship problems ( n = 51) significantly more than an assessment-only control ( n = 50). However, there was no reduction in frequency of cannabis use (Mason et al, 2018). Furthermore, retention was high with 96% of participants completing 3-month follow-up.…”