Treating adult marijuana dependence: a test of the relapse prevention model.

Men (n = 161) and women (n = 51) seeking treatment for marijuana use were randomly assigned to either a relapse prevention (RP; G.A. Marlatt & J.R. Gordon, 1985) or a social support (SSP) group discussion intervention. Data collected for 12 months posttreatment revealed substantial reductions in frequency of marijuana use and associated problems. There were no significant differences between the cognitive-behavioral RP intervention and the SSP group discussion conditions on measures of days of marijuana use, related problems, or abstinence rates. Men in the RP condition were more likely than men in the SSP condition to report reduced use without problems at 3-month follow-up. Posttreatment increases in problems associated with alcohol did not appear to relate to reduced marijuana use. Results are discussed in terms of the need for further research with marijuana-dependent adults and the efficacy of RP.

Testing the abstinence violation effect construct with marijuana cessation.

It has been proposed that internal, stable, and global attributions for the cause of a lapse following a period of abstinence and concomitant feelings of guilt and loss of control increased the probability of a return to regular substance use. The Abstinence Violation Effect (AVE) hypotheses were tested in a sample of 75 adult marijuana users who reported a lapse into marijuana use following completion of either a relapse prevention (RP) or social support group treatment aimed at abstinence. Results showed that more internal, stable, and global attributions for the cause of the lapse and perceived loss of control were related significantly to concurrently reported relapse. Further, internal and global attributions predicted marijuana use during the subsequent 6 months. Results are discussed in terms of support for the AVE construct, treatment implications, and the failure of the RP treatment to modify reactions to a lapse.

Adult marijuana users seeking treatment.

In an effort to study the efficacy of attracting and intervening with adult marijuana users, 290 men and 92 women were screened for participation in a treatment-outcome study focused on marijuana cessation. The well-educated, self-referred sample reported using marijuana on 79 of the past 90 days before testing. Indices of the severity of marijuana abuse and general psychopathology were in the clinical range for a majority of Ss. Ss who did not report evidence of alcohol or other drug abuse (n = 144) reported less severe consequences of marijuana use and experienced less general psychological distress than Ss who also reported lifetime (n = 165) or current abuse (n = 73) of other substances in addition to marijuana. The findings indicate the need for clinical research targeting adults who are dependent on marijuana.

Predictors of marijuana treatment outcomes: the role of self-efficacy.

This study tested the ability of sets of demographic, socioeconomic, marijuana use/abuse, psychological distress, and self-efficacy variables to predict posttreatment indices of marijuana intake and problems related to use. Subjects were 167 adults who participated in one of two outpatient treatments for marijuana dependence and completed the 3-, 6-, and 12-month posttreatment follow-ups. Only pretreatment marijuana quantity-frequency of intake and self-efficacy variables made significant and consistent contributions to the regression equations predicting posttreatment frequency of use. In contrast, socioeconomic and severity of abuse indicators predicted posttreatment marijuana-related problems. Contrary to social cognitive theory (Bandura, 1986), there was no evidence that self-efficacy mediated the effects of other predictors. Results are discussed in terms of the specificity of predictor-outcome relationships and the need for improvements in self-efficacy measurement.

Assessing need for marijuana dependence treatment through an anonymous telephone interview.

In response to public service announcements directed at adult chronic marijuana users who were concerned about their smoking, 225 individuals were interviewed anonymously by telephone. This study was conducted to determine if a population of chronic dysfunctional marijuana users existed who were both interested in being treated and not concurrently abusing alcohol and/or other psychoactive drugs. Most of the callers (73.8%) were experiencing adverse consequences associated only with marijuana use rather than in combination with other substances. Most (92%) expressed interest in being treated, while very few (18%) had ever been seen in a drug or alcohol treatment program.

Stress inoculation training in the control of THC toxicities.

Fifty-four marijuana-naive cancer patients undergoing chemotherapy and about to use THC (delta-9-tetrahydrocannabinol) as an antiemetic for the first time were randomly assigned to one of two conditions: stress inoculation or placebo/information training. It was hypothesized that subjects exposed to stress inoculation training would experience fewer adverse subjective effects of THC, experience less stressful nausea and vomiting, and be less likely to voluntarily withdraw from subsequent THC trials. None of the hypotheses was confirmed.

The Controlled Substances Therapeutic Research Act in the state of Washington.

In March 1979, the Governor of the State of Washington signed legislation establishing a THC/marihuana research program within the Washington State Board of Pharmacy. By November 1980, approximately 80 physicians had enrolled more than 400 patients on the chemotherapy protocol which randomly assigned subjects to receive either THC and prochlorperazine or THC and placebo. This report describes the process of implementing the legislation, the administrative and clinical roles of project personnel, and the design of three currently operating protocols.