An adolescent with new-onset inattention

2021 ◽  
pp. 221-228
Author(s):  
Samantha M. Taylor ◽  
David L. Beckmann
Keyword(s):  
Behavioral Therapy ◽  
Contingency Management ◽  
Cannabis Use ◽  
Motivational Enhancement Therapy ◽  
Cannabis Use Disorder ◽  
Psychoactive Substance ◽  
Cognitive Domains ◽  
Problematic Use ◽  
High Concentrations ◽  
Family Based

Cannabis use disorder is defined as a pattern of use that includes at least two signs or symptoms of problematic use. Cannabis is the second most commonly used psychoactive substance by adolescents. Cannabis use is associated with significant impairments in multiple cognitive domains, although even one week of abstinence can result in improved cognitive functioning. Cannabis use, particularly of products containing high concentrations of tetrahydrocannabinol (THC), increases the likelihood of developing schizophrenia. N-acetylcysteine (NAC) may be helpful for decreasing cravings and the risk of relapse. The most effective therapy modalities for cannabis use disorder are motivational enhancement therapy, contingency management, cognitive behavioral therapy (CBT), and family-based therapy.

scholarly journals Psychosocial and pharmacological interventions for the treatment of cannabis use disorder

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 173 ◽  
Author(s):  
Pamela Sabioni ◽  
Bernard Le Foll
Keyword(s):  
Behavioral Therapy ◽  
Contingency Management ◽  
Psychosocial Interventions ◽  
Cannabis Use ◽  
Public Health Issue ◽  
Management Approach ◽  
Motivational Enhancement Therapy ◽  
Cannabis Use Disorder ◽  
Pharmacological Interventions ◽  
Positive Effects

Cannabis use has been continuously increasing, and cannabis use disorder (CUD) has become a public health issue. Some psychosocial interventions have demonstrated the ability to reduce cannabis use; however, there are no pharmacotherapies approved for the treatment of CUD. Some drugs have shown limited positive effects on use and withdrawal symptoms, but no controlled studies have been able to show strong and persistent effects on clinically meaningful outcomes. The aim of this review is to synthesize the evidence from the available literature regarding the effectiveness of psychosocial and pharmacological treatments for CUD among adults (that is, 18 years old or older). An analysis of the evidence shows that the current best psychosocial intervention to reduce cannabis use is the combination of motivational enhancement therapy and cognitive-behavioral therapy, preferably accompanied by a contingency management approach. In regard to pharmacological interventions, there are mostly unclear findings. Some drugs, such as CB1 agonists, gabapentin, and N-acetylcysteine, have been shown to produce improvements in some symptoms of CUD in single studies, but these have not been replicated. Other classes of medications, including antidepressants and antipsychotics, have been unsuccessful in producing such effects. There is an imminent need for more clinical trials to develop more effective treatments for CUD.

scholarly journals Computer-assisted behavioral therapy and contingency management for cannabis use disorder.

2015 ◽  
Vol 29 (3) ◽  
pp. 501-511 ◽  
Author(s):  
Alan J. Budney ◽  
Catherine Stanger ◽  
J. Mick Tilford ◽  
Emily B. Scherer ◽  
Pamela C. Brown ◽  
...  
Keyword(s):  
Behavioral Therapy ◽  
Contingency Management ◽  
Cannabis Use ◽  
Computer Assisted ◽  
Cannabis Use Disorder

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

2021 ◽  
pp. 1-12
Author(s):  
Rachel Lees ◽  
Lindsey A. Hines ◽  
Deepak Cyril D'Souza ◽  
George Stothart ◽  
Marta Di Forti ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Decision Making ◽  
Treatment Compliance ◽  
Narrative Review ◽  
Cannabis Use ◽  
Psychotic Symptoms ◽  
Motivational Enhancement Therapy ◽  
Cannabis Use Disorder ◽  
Pharmacological Treatments ◽  
Health Comorbidities

Abstract Cannabis is the most widely used illicit drug worldwide, and it is estimated that up to 30% of people who use cannabis will develop a cannabis use disorder (CUD). Demand for treatment of CUD is increasing in almost every region of the world and cannabis use is highly comorbid with mental disorders, where sustained use can reduce treatment compliance and increase risk of relapse. In this narrative review, we outline evidence for psychosocial and pharmacological treatment strategies for CUD, both alone and when comorbid with psychosis, anxiety or depression. Psychosocial treatments such as cognitive behavioural therapy, motivational enhancement therapy and contingency management are currently the most effective strategy for treating CUD but are of limited benefit when comorbid with psychosis. Pharmacological treatments targeting the endocannabinoid system have the potential to reduce cannabis withdrawal and cannabis use in CUD. Mental health comorbidities including anxiety, depression and psychosis hinder effective treatment and should be addressed in treatment provision and clinical decision making to reduce the global burden of CUDs. Antipsychotic medication may decrease cannabis use and cannabis craving as well as psychotic symptoms in patients with CUD and psychosis. Targeted treatments for anxiety and depression when comorbid with CUD are feasible.

Non-Pharmacological Therapies for Substance Use Disorders (DRAFT)

2018 ◽  
Author(s):  
Michael F. Weaver
Keyword(s):  
Primary Care ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Behavioral Therapy ◽  
Contingency Management ◽  
Motivational Enhancement Therapy ◽  
Present Level ◽  
Duration Of Treatment ◽  
Motivational Enhancement ◽  
Level Of Understanding

In conjunction with chapters 16 and 17, which described non-pharmacological approaches to pain management, this chapter reviews the available non-pharmacological approaches to substance use disorders (SUD). Specific subtopics include 12-Step programs and facilitation, motivational enhancement therapy, cognitive behavioral therapy, individual and group psychotherapies, contingency management, community reinforcement, family therapy, relapse management, and the terminal consideration of all therapies, termination (what is the duration of treatment)? Each subtopic is addressed in abstract rather than in comprehensive format, to allow the primary care provider to identify her level of interest and present level of understanding, and to inform further reading. The chapter concludes with a text box providing additional resources.

scholarly journals Mobile contingency management as an adjunctive treatment for co-morbid cannabis use disorder and cigarette smoking

2018 ◽  
Vol 79 ◽  
pp. 86-92 ◽  
Author(s):  
Jean C. Beckham ◽  
Kelsie A. Adkisson ◽  
Jeffrey Hertzberg ◽  
Nathan A. Kimbrel ◽  
Alan J. Budney ◽  
...  
Keyword(s):  
Cigarette Smoking ◽  
Contingency Management ◽  
Cannabis Use ◽  
Adjunctive Treatment ◽  
Cannabis Use Disorder

scholarly journals Retention and Treatment Outcome of Youth with Cannabis Use Disorder Referred By the Legal System

2019 ◽  
Vol 9 (1) ◽  
pp. 4-10 ◽  
Author(s):  
Yifrah Kaminer ◽  
Christine Ohannessian ◽  
Rebecca Burke
Keyword(s):  
Phase I ◽  
Juvenile Justice System ◽  
Behavioral Therapy ◽  
Cannabis Use ◽  
Retention Rates ◽  
Poor Responders ◽  
Second Phase ◽  
Cannabis Use Disorder ◽  
Community Reinforcement Approach ◽  
Treatment Onset

<P>Background: Youth with Substance Use Disorders (SUDs) referred to treatment from the Juvenile Justice System (JJS) account for approximately half of the treatment admissions nationwide. The objective of this paper is to report a comparison of retention and outcomes for JJS referrals to those from the general community. Methods: A total of 172 adolescents, 13-18 years of age, 83% males, 70% JJS referrals, diagnosed with DSM-IV Cannabis Use Disorder (CUD), enrolled in this outpatient, randomized, continued care study. Following a 7-session weekly motivational enhancement and cognitive behavioral therapy intervention (MET/CBT-7), only poor responders were randomized into a 10-week second phase of either an individualized enhanced CBT or an Adolescent Community Reinforcement Approach (ACRA) intervention. Results: JJS referrals’ retention rates were significantly higher than those of non-JJS referrals (X2(1) = 11.21, p < .01) at the end of Phase I (i.e. week 7). However, there was no difference in abstinence rates between the groups at the end of phase I or II and any of the quarterly additional follow-up assessments up to one year from treatment onset. </P><P> Conclusions: Additional research examining how to capitalize on improved retention rates among youth JJS referrals is necessary in order to advance abstinence.</P>

scholarly journals Assessing Cannabis Use Disorder in Medical Cannabis Patients: Interim Analyses from an Observational, Longitudinal Study

Cannabis ◽  
2021 ◽  
Vol 4 (2) ◽  
pp. 47-59
Author(s):  
Kelly Sagar ◽  
M. Kathryn Dahlgren ◽  
Rosemary Smith ◽  
Ashley Lambros ◽  
Staci Gruber
Keyword(s):  
Longitudinal Study ◽  
Cannabis Use ◽  
Screening Tools ◽  
Cannabis Use Disorder ◽  
Medical Cannabis ◽  
Problematic Use ◽  
Treatment Information ◽  
Frequent Use ◽  
Frequency Of Use ◽  
Disorder Identification

Background: To date, no studies have directly assessed potential cannabis use disorder (CUD) in medical cannabis (MC) patients pre- vs post-MC treatment. Given that MC patients use cannabis for symptom alleviation rather than intoxication, we hypothesized that MC patients would exhibit few symptoms of CUD after initiating MC treatment. Methods: As part of an ongoing observational, longitudinal study, 54 MC patients completed baseline assessments prior to initiating MC use and returned for at least one follow-up assessment after three, six, and/or twelve months of a self-selected MC treatment regimen; detailed MC treatment information was collected and quantified. All patients completed the Cannabis Use Disorder Identification Test - Revised (CUDIT-R) at each visit. Changes in individual items scores and total scores were assessed over time, and we examined whether total CUDIT-R scores correlated with frequency of MC use, delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) exposure. Further, Cronbach’s alpha analyses were conducted to provide preliminary data regarding the psychometric properties of the CUDIT-R when used among MC patients. Results: Although total CUDIT-R scores increased relative to baseline, on average, ratings fell below the ‘hazardous use’ threshold at each visit. Analyses of individual items revealed that increases in total scores were primarily attributable to increases in frequency of use and not necessarily other aspects of problematic use. Total CUDIT-R scores were not associated with number of MC uses or CBD exposure, but a significant relationship was detected between increased THC exposure and higher CUDIT-R scores. Importantly however, analyses revealed that the CUDIT-R does not appear to be an appropriate tool for identifying CUD in MC patients. Conclusions: Screening tools specifically designed to assess CUD in MC patients are needed and should distinguish between frequent use and problematic use; exposure to individual cannabinoids must also be considered.

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