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TreatingMarijuanaUse
Marijuanaisnowthenumberonereasonkidsentertreatmentmorethanalcohol,cocaine,heroin,meth,ecstasy,andotherdrugscombined.i
DatafromtheNationalInstituteonDrugAbusefoundthatin1993marijuanacomprisedapproximately8%ofALLtreatmentadmissions,butby2009thatnumberhadincreasedto18%.ii
Manyresearchershavepointedtohigherpotencyasapossiblereasonfor
skyrocketingtreatmentadmissionsratesgloballyforcannabis.iiiTHC
concentrationintheNetherlands,hasincreasedfrom9%to15%inthepast
10years.TheincreaseinTHCcontentisattributedtoindoorcultivationand
improvedbreeding.iv
Treatment,sometimeswithenforceablesanctions:Decadesofresearchhave
shownthattreatmentreducescrimeandsavesmoney.Butnewer
interventions,likedrugcourtsorinterventionsthatcombinepositivedrug
testswithveryshortsanctions(like1-3daysinjail)cansignificantlyreducedruguseandhelppeopleliveabetterlife.Usingthejudicialsystemwiselyby
enforcingabstinencewithshortstintsinjailisanincentivedruguserssometimesneedindeedithasshowntoworkbetterthantraditional,
voluntarytreatmentalone.
Forthosewhohavenotprogressedtofullcannabisaddiction,screening,
briefinterventionsandreferraltotreatment(SBIRT)mechanismsmaybe
appropriate.SBIRTservicesincludeaninitialdrugscreensbygeneral
primarycarephysiciansorcounselorstoidentifyat-riskpersons,brief
advicesuchasaone-timeinterventionforshortconsultationandliterature,
briefinterventionssuchasonetotwelvesessionsofsubstanceuse
intervention,and,finally,(ifnecessary),referraltotreatmentfordependent
userstoreceivespecializedservices,casemanagement,andfollow-up
supportinthecommunity.v
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Amajormethodtotreatcannabisaddictionisthroughcognitive-behavioraltherapy(CBT).Cognitive-behavioraltherapycomprisesacombinationof
approachesmeanttoincreaseself-control.Acentralelementofthistreatmentisanticipatinglikelyproblemsandhelpingpatientsdevelop
effectivecopingstrategies.Inseveralstudies,mostpeoplereceivingacognitive-behavioralapproachmaintainedthegainstheymadeintreatment
throughoutthefollowingyearvivii
Motivationalapproaches,suchasmotivationalinterviewing,arebestusedto
producerapid,internallymotivatedchange.Interpersonal,family,and
couplestherapyareusedtotreatdruguseinthesysteminwhichwas
developedandmaintained.Includingfamilyisparticularlyusefulforhelping
patientsstayintreatment(thisisparticularlytrueforadolescents),andaddressingthereasonsforwhichdrugusebegan.viii
iCenterforBehavioralHealthStatisticsandQuality,SubstanceAbuseandMentalHealthServices
CenterforAdministration,TreatmentEpisodeDataSet(TEDS).Basedonadministrativedata
reportedbyStatestoTEDSthroughOctober15,2012.
http://wwwdasis.samhsa.gov/webt/quicklink/US10.htm
iiSubstanceAbuseandMentalHealthServicesAdministration.(2009).OfficeofAppliedStudies.
TreatmentEpisodeDataSet(TEDS):2009DischargesfromSubstanceAbuseTreatmentServices
,DASIS.
iiiSeeforexampleCompton,W.,Grant,B.,Colliver,J.,Glantz;M.,Stinson,F.(2004).Prevalenceof
CannabisUseDisordersintheUnitedStates:1991-1992and2001-2002
JournaloftheAmerican
MedicalAssociation.
.291:2114-2121.AndSabet,K.(2006).The(oftenunheard)caseagainst
cannabisleniency.InPotPolitics(Ed.M.Earleywine).OxfordUniversityPress,pp.325-355
.
ivTetrault,J.M.,etal.Effectsofcannabissmokingonpulmonaryfunctionandrespiratory
complications:asystematicreview.ArchInternMed167,221-228(2007).
vSubstanceAbuseandMentalHealthServicesAdministration
-BasedApproachestoDrugAbuse
Treatment(2011).Screening,BriefInterventionandReferraltoTreatment(SBIRT)inBehavioral
Healthcare.Availableat:http://www.samhsa.gov/prevention/sbirt/SBIRTwhitepaper.pdf
viSeeNationalInstituteonDrugAbuse,Evidence
-BasedApproachestoDrugAbuseTreatment.AccessedNovember2011athttp://www.nida.nih.gov/podat/Evidence2.html
viiCarroll,K.M.,etal.Theuseofcontingencymanagementandmotivational/skills
-buildingtherapy
totreatyoungadultswithcannabisdependence.JournalofConsultingandClinicalPsychology
74(5):955-966,2006
viiiCarroll,KM(2005).Recentadvancesinthepsychotherapyofaddictivedisorders.Current
PsychiatryReports,7:329 -336.
