Cannabis Use Disorder: Is It Addiction or Dependency?

Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. One example is group psychoeducation, in which a therapist or facilitator will provide information about CUD and its consequences if you don’t stop using.

A longitudinal study of the effects of cannabis exposure on neuro-development in adolescents and young adults

Regular evaluations help professionals identify what works and what may require a change. By closely following each step, the plan stays flexible and responsive to individual progress. Clear documentation and honest feedback create a pathway that supports steady recovery while ensuring that every component of the treatment is given proper attention.

1.1. Abstinence

A first-in-class drug engineered to selectively inhibit the signaling pathway of the cannabinoid receptor shows promise as a safe and effective treatment for cannabis use disorder (CUD), a condition where a person is unable to control their cannabis use, even though it’s causing problems in their lives. Important technologically based interventions for CUD have been developed in recent years and is an emerging area. These computer and Internet-based treatments seek to improve service access, reduce training and delivery costs, ensure treatment fidelity, and enhance existing evidence-based approaches.77 Several studies have shown promising initial results. Cannabis Use Disorder (CUD) is a significant mental health condition recognized by the American Psychiatric Association.

Motivational enhancement therapy (MET) is based on motivational interviewing (MI) principles20 and seeks to enhance motivation to change by providing nonjudgmental feedback, exploring and resolving ambivalence, and collaborative goal setting. The therapist uses an empathic nonconfrontational approach to elicit “change talk” (e.g., “I really need to stop smoking pot before I get into trouble again”), which predicts subsequent behavior change. For those studies where age overlapped between different age groups, we classified them as “mixed age group”.

Treatment Approach

Yale Medicine psychiatrists treat patients for all addictions, including cannabis use disorder. Yale Medicine doctors are conducting exciting research in the fields of marijuana and other addiction treatments. Preliminary results for clinical trials testing a drug that increases the brain’s cannabis-like proteins are promising — especially in terms of reducing drug use and withdrawal symptoms. Behavioral interventions for substance use disorders are the mainstay of treatment and have evidence for efficacy in reducing use and facilitating abstinence.

Cognitive behavioral therapy, which helps to identify and modify damaging thinking and behavior, can also help people overcome addictions. Regular or heavy use of cannabis can result in the development of tolerance and dependence. It’s important to turn to healthy coping mechanisms during these times of change, such as exercising, meditating or learning a new hobby. Consider seeing a mental health professional if you’re having issues managing your stress. Over time, marijuana (THC) can change your brain chemistry, and you become desensitized to its effects. Marijuana is parts of or products from the Cannabis sativa plant that contain substantial amounts of tetrahydrocannabinol (THC) — the chemical that makes you feel “high.” Marijuana is cannabis, but not all cannabis is marijuana.

Baclofen, a derivative of GABA, did not improve withdrawal or cannabis use disorder relapse in a human laboratory study, although craving was reduced. In CBT, there’s an emphasis on learning how thoughts, feelings, and behaviors impact each other. CBT can help you identify and change maladaptive (unhealthy, unhelpful) thought patterns and behaviors linked to cannabis use, Dr. Muhrer says. If you struggle with cannabis use disorder (CUD), it’s important to understand how to achieve recovery. Dr. D’Souza and others at Yale Medicine are hard at work developing the most promising behavioral, pharmacological, and combined treatments for cannabis use disorder.

Pharmacotherapy for the Treatment of Cannabis Use Disorder: A Systematic Review

Such suggestions are empirically supported, for example, by the large multisite trials among cannabis smokers with CUD reported by Babor and colleagues (112) and Hoch et al. (120, 121). Combined motivational and CBT-based approaches have also been shown to reduce the quantity and frequency of cannabis use when delivered remotely (123, 124). The use of cannabinoids for recreational and therapeutic purposes has been described for centuries 44. Cannabis accounts for the third most commonly used substance worldwide, only after alcohol and tobacco 45.

• This involvement helps to build a supportive home environment that complements the strategies outlined in the sample treatment plan for cannabis use disorder.
• Of note, evidence demonstrates that treatments for SUDs are cost-effective and tend to have similar rates of recurrence/relapse compared to other chronic illnesses in the older adult population 52.

The utility of extended-release zolpidem in targeting cannabis abstinence–induced sleep disruptions has been evaluated.51 Zolpidem attenuated the effects of cannabis abstinence on sleep architecture and normalized sleep efficiency scores but did not affect sleep latency. No significant differences in withdrawal symptoms were observed between participants during placebo-abstinence and zolpidem-abstinence periods. Furthermore, there appears to be disproportionately less research conducted in older adult drug addiction treatment populations compared to adolescents and young adults. Only 6 of the 24 studies majorly focused specifically on those aged 26–65 years old.

Glutamatergic Agents

Moreover, the use of these medications for specific age groups, such as adolescents and older adults, remains unclear, since most studies tend to exclude these specific cohorts from trials. Behavioral and https://www.foxhoundband.com/is-addiction-genetic-about-addictive-personality/ psychosocial interventions remain the main stay treatment for CUD. However, limited access to these evidence-based interventions, engagement, and retention in treatment are often suboptimal, impacting clinical outcomes and overall prognosis. High-intensity treatment approaches, such as more than four sessions delivered over more than a month, were superior to lower intensity treatment. However, no particular intervention was consistently effective at nine-month follow-up or later.

Results suggest limited benefit of longer treatment duration as both active treatments did better than the control group on primary outcomes; however, results of subsequent studies, such as the Marijuana Treatment Project12 (discussed below) support the benefit of more extended interventions. However, some studies have shown that even though it reduces withdrawal, Dronabinol is not effective at reducing cannabis self-administration (Haney et al. and Hart et al.). Similarly, a clinical trial that combined dronabinol with behavioral therapies (motivational enhancement and relapse prevention therapy) also showed no benefit over placebo. However, the dronabinol group did have better treatment retention compared to the placebo group (77% vs 61%) and reported fewer withdrawal symptoms. Medical interventions complement behavioral therapies by addressing the physical aspects of dependency. These services may include medication management and wellness programs designed to reduce withdrawal symptoms and promote overall health.

Moving from oral to computerized delivery of interventions, Riggs et al. (2018) evaluated an eCHECKUP marijuana personal feedback program compared to an attention control condition providing general stress management tips. The eCHECKUP group received detailed personalized feedback on their cannabis use frequency, risks for cannabis use disorder, and tips to reduce use. Over 6 weeks, the eCHECKUP group significantly reduced multiple indicators of cannabis use frequency and severity compared to controls, including hours high per week, days high per week, weeks high per month, and weekly use episodes 28.