"Several clinical trials indicate that familybased , cognitive behavioral, and possibly adjunct pharmacological interventions hold promise for treating adolescent substance abuse (Cornelius et al., 2005; Randall and Cunningham, 2003; Riggs et al., 2004; Waldron and Turner, 2008). Although efficacious, the low abstinence rates and the relatively low magnitude of reduction in substance use indicate much room for additional enhancement, suggesting that adolescent substance abuse treatments need to be improved and alternative treatment models explored (Compton and Pringle, 2004). Further, the adolescent treatment literature has generally focused on reductions in the frequency of use or on reductions in problem use, with fewer demonstrations of differences across treatment conditions in rates of documented abstinence. "
[Show abstract][Hide abstract] ABSTRACT: An initial efficacy test of an innovative behavioral outpatient treatment model for adolescents with problematic use of marijuana enrolled 69 adolescents, aged 14–18, and randomly assigned them to one of two treatment conditions. Both conditions received individualized Motivational Enhancement and Cognitive Behavioral Therapy (MET/CBT) and a twice-weekly drug-testing program. The experimental contingency management condition involved a clinic-delivered, abstinence-based incentive program, and weekly behavioral parent training sessions that included a parent-delivered, abstinence-based, substance monitoring contract. The comparison condition included an attendance-based incentive program, and weekly psychoeducational parent sessions. Follow-up assessments were performed at 3, 6, and 9 months post-treatment. The experimental condition showed greater marijuana abstinence during treatment, e.g., 7.6 vs. 5.1 continuous weeks and 50% vs. 18% achieved ≥10 weeks of abstinence. Improvements were found in parenting and youth psychopathology across treatment conditions, and improvements in negative parenting uniquely predicted post-treatment abstinence. The outcomes observed in the experimental condition are consistent with adult substance-dependence treatment literature, and suggest that integrating CM abstinence-based approaches with other empirically based outpatient interventions provides an alternative and efficacious treatment model for adolescent substance abuse/dependence. Replication and continued development of more potent interventions remain needed to further advance the development of effective substance abuse treatments for adolescents.
Drug and alcohol dependence 12/2009; 105(3-105):240-247. DOI:10.1016/j.drugalcdep.2009.07.009 · 3.42 Impact Factor
"Among adults, marijuana use disorders increased despite stabilization of rates of use. An increased prevalence of disorders among young adult African-American and Hispanic men and African-American women appears to account for the overall rise among youth (Compton, 2004). The reasons for the upward trend in disorders among minority young people are not clear. "
[Show abstract][Hide abstract] ABSTRACT: The prevalence of marijuana abuse and dependence disorders has been increasing among adults and adolescents in the United States. This paper reviews the problems associated with marijuana use, including unique characteristics of marijuana dependence, and the results of laboratory research and treatment trials to date. It also discusses limitations of current knowledge and potential areas for advancing research and clinical intervention.
Addiction science & clinical practice 01/2008; 4(1):4-16. DOI:10.1151/ASCP07414
[Show abstract][Hide abstract] ABSTRACT: The present study investigated the efficacy of nefazodone and bupropion-sustained release for treating cannabis dependence. A double-blind, placebo-controlled, piggy back design was employed to assess if nefazodone and bupropion-sustained release increased the probability of abstinence from cannabis and reduced the severity of cannabis dependence and cannabis withdrawal symptoms during a 13-week outpatient treatment program. One-hundred and six participants (Mean = 32 years; females n = 25) were randomized to one of three medication conditions (nefazodone, bupropion-sustained release, or placebo) and participated in a weekly, individually based coping skills therapy program. Results indicated an increased probability of achieving abstinence over the course of treatment and a decrease in the severity of cannabis dependence and the withdrawal symptom of irritability. There were no significant effects demonstrated for nefazodone and bupropion-sustained release on cannabis use or cannabis withdrawal symptoms. The results indicate nefazodone and bupropion-sustained release may have limited efficacy in treating cannabis dependence.
American Journal on Addictions 01/2009; 18(1):53-64. DOI:10.1080/10550490802408936 · 1.74 Impact Factor
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