Approximately one in four daily cannabis users becomes dependent on the substance, according to a new report recently released by the World Health Organization (WHO). But is there any way to treat cannabis dependence? This is a summary of the preventive strategies considered to be effective at reducing the harm associated with marijuana use.
According to the WHO report, currently marijuana remains the most commonly used drug in the world (if you do not count alcohol or tobacco); cannabis is also widely used among youth, including persons under the age of 21. The UNODC estimates that there are more than 180 million cannabis users globally.
Despite the growing popularity of cannabis, there is very little systematically composed knowledge about the possible health consequences of marijuana use or potential negative effects of legalizing weed. Legalization of recreational cannabis presents novel policy challenges as governments are faced with the problem of coming up with a coherent marijuana policy and sets of regulations. Should marijuana be treated like alcohol? How to prevent marijuana abuse, especially among children and youth?
The new WHO report reviews the most significant evidence of the impact of nonmedical cannabis use based on the last 20 years of research. The report is titled “The health and social effects of non-medical cannabis use” and contains the overview of the key studies on the subject.
In this article, we review the key findings concerning preventive programs for different age groups in different settings, from stand-alone media campaigns to programs for families to various medications for acute cannabis intoxication.
According to the report, young people who use marijuana regularly are about twice as likely as adolescents who do not use the drug to leave school early and experience cognitive impairments.
In Europe, treatment for marijuana users employs a broad range of approaches including Internet-based measures, family therapy, cognitive-behavioral procedures, and some other structured psychological measures.
The authors of the 2013 European Drug Report called family prevention strategies “likely beneficial.” Such measures involve training for children, their parents, and other relatives how to effectively reduce marijuana use.
Another study of universal school-based prevention programs for drug misuse in adolescents found family-based prevention measures to be much more effective than youth-only programs. The researchers pointed to significant encouraging results of a meta-analysis on multidimensional family therapy: seven of eight family-based programs showed positive effects during a period of at least two years.
There is a huge number of the programs targeted at adolescents and parents with the particular needs. After being thoroughly tailored and tested, some of them were found to be highly effective and more friendly compared to universal-level prevention activities that targeted everyone. The multilevel parenting and family support strategies turned to be less stigmatizing and use flexible methods, including individual face-to-face, group, and telephone assistance and self-directed approaches.
A 2005 study, aimed to summarize the findings of the five Cochrane (British independent research organization) reviews on substitution maintenance treatment for cannabis dependence, found that life skills programs could potentially reduce marijuana use at a year-long follow-up and beyond. Such measures included both “a social competence curriculum and social influence approaches”—social skills lessons, various activities aimed at boosting self-esteem, skills in recognizing high-risk situations and avoiding them. This approach was found to discourage drug use, help cope with dependence, help young people to resist peer pressure while maintaining self-respect, and increase the quality of their life.
There are nearly 200 other studies in the field that found “a delay in onset of substance use and a reduction in youth cannabis use” while researching interactive drug curricula. The experts are confident that such approaches are far more effective than non-interactive, lecture-based drug curricula. For example, according to a 2014 Cochrane review, those programs that were based on a mix of social influence measures and social competence demonstrate better results in preventing marijuana use, as well as any other drug use.
The expert also pointed on an effective classroom management as a method that can create a positive school environment and prevent early onset of marijuana use.
Usually, teenagers start to consume marijuana at young ages. The long-term, heavy marijuana use was proven to cause enduring neuropsychological problems that persist beyond the period of acute intoxication. Numerous studies show that most of the chronic, frequent drug users performed worse on neuropsychological tests and had lower IQ.
Scientists found that people who sought to quit marijuana use and failed are most likely to have related disorders, but they are not the only persons who need therapeutic interventions or medical treatment.
Cognitive therapy was found to be a pretty effective marijuana addiction treatment program. Even very brief, 5-minutes psychological sessions can be enough to increase rates of cessation at three and twelve months. However, it works only if the student is highly motivated and fully trusts the therapist.
Otherwise, such single-session method is of limited value in the treatment of marijuana dependence.
A recent review by the WHO shows that evidence from clinical trials supports the use of several approaches, including combinations of methods to boost motivation, and family therapy.
Motivational enhanced therapy seemed to be more effective than a waiting list control. Cognitive-behavioral therapy and contingency management “produced a 50 percent reduction in continuous measures of cannabis use.” For teenagers dependent on cannabis, family therapy was more effective than individual interventions.
As for drug treatment, no medication—neither antidepressants nor psychotropics—has been found to be effective for treating marijuana dependence or stopping smoking cannabis side effects. As for acute cannabis intoxication (anxiety, arrhythmia, psychotic symptoms), use of medication seemed to show better results. For example, beta-blockers were found to be relatively effective in reducing tachycardia. Arrhythmias from marijuana intoxication could be normalized by using antiarrhythmic agents (flecainide, propafenone, and digoxin). However, the advisability of using these medications in the management of drug withdrawal is not yet well established.