CANDIS treatment program for cannabis use disorders: findings from a randomized multi-site translational trial

E Hoch; G Bühringer; A Pixa; K Dittmer; J Henker; A Seifert; H U Wittchen

doi:10.1016/j.drugalcdep.2013.09.028

CANDIS treatment program for cannabis use disorders: findings from a randomized multi-site translational trial

Drug Alcohol Depend. 2014 Jan 1:134:185-193. doi: 10.1016/j.drugalcdep.2013.09.028. Epub 2013 Oct 8.

Authors

E Hoch¹, G Bühringer², A Pixa³, K Dittmer³, J Henker³, A Seifert³, H U Wittchen³

Affiliations

¹ Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Chemnitzer Strasse 46, Dresden 01187, Germany; Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Heidelberg University, Square J5, Mannheim 68159, Germany. Electronic address: Eva.Hoch@zi-mannheim.de.
² Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Chemnitzer Strasse 46, Dresden 01187, Germany; IFT Institut fuer Therapieforschung, Parzivalstrae 25, Munich 80804, Germany.
³ Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Chemnitzer Strasse 46, Dresden 01187, Germany.

PMID: 24176199
DOI: 10.1016/j.drugalcdep.2013.09.028

Abstract

Background: In a recent paper, we reported the efficacy of a modular cognitive-behavioral intervention for treating adolescents and adults with cannabis use disorders (CUD). In this study, we examine the outcome of this intervention after translating it into clinical practice.

Methods: A multi-site, randomized controlled trial of 279 treatment seekers with ICD-10 cannabis use disorders aged 16- 63 years was conducted in 11 outpatient addiction treatment centers in Germany. Patients were randomly assigned to an Active Treatment (AT, n=149) or Delayed Treatment Control (DTC, n=130). Treatment consisted of 10 sessions of fully manualized individual psychotherapy that combined Cognitive-Behavioral Therapy, Motivational EnhancementTherapy and problem-solving training. Assessments were conducted at baseline, during each therapy session, at post-treatment and at three and six month follow-ups.

Results: At post assessment 53.3% of AT patients reported abstinence (46.3% negative urine screenings) compared to 22% of DTC patients (17.7% negative drug screenings) (p<0.001, Intention-to-treat analysis). AT patients improved in the frequency of cannabis use, number of cannabis dependence criteria, severity of dependence, as well as number and severity of cannabis-related problems. Effect sizes were moderate to high. While abstinence rates in the AT group decreased over the 3-month (negative urine screenings: 32.4%) and 6-month (negative urine screenings: 35.7%) follow-up periods, the effects in secondary outcomes were maintained.

Conclusions: The intervention can successfully be translated to and applied in clinical practice. It has the potential to improve access to evidence-based care for chronic CUD patients.

Trial registration: ClinicalTrials.gov NCT00673647.

Keywords: CBT; Cannabis; MET; RCT; Translational research; Treatment.

Publication types

Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Ambulatory Care / methods*
Female
Follow-Up Studies
Humans
Male
Marijuana Abuse / diagnosis
Marijuana Abuse / epidemiology*
Marijuana Abuse / therapy*
Middle Aged
Registries
Single-Blind Method
Substance Abuse Treatment Centers / methods*
Translational Research, Biomedical / methods*
Treatment Outcome
Young Adult

Associated data

ClinicalTrials.gov/NCT00673647