TY - JOUR
T1 - A contingency management method for 30-days abstinence in non-treatment seeking young adult cannabis users
AU - Schuster, Randi Melissa
AU - Hanly, Ailish
AU - Gilman, Jodi
AU - Budney, Alan
AU - Vandrey, Ryan
AU - Evins, A. Eden
N1 - Funding Information:
Dr. Schuster, Ms. Hanly, and Dr. Gilman and Dr. Budney declare no conflicts of interest. Dr. Evins has received research grant support to her institution from Pfizer Inc, Forum Pharmaceuticals and GSK and honoraria for advisory board work from Pfizer and Reckitt Benckiser for work unrelated to this project. Dr. Vandrey is a consultant for Zynerba Pharmaceuticals and CW Botanicals, and has received honoraria for advisory board work from Insys Therapeutics for work unrelated to this project.
Funding Information:
This publication was made possible by support from K24 DA030443 (Evins), K01DA034093 (Gilman), by the Harvard Medical School Norman E. Zinberg and Livingston Fellowships (Schuster) , and by a Louis V. Gerstner III Research Scholar Award (Schuster) .
Publisher Copyright:
© 2016 Elsevier Ireland Ltd
PY - 2016
Y1 - 2016
N2 - Background Rates of young adult cannabis use are rising, perceived harm is at its historical nadir, and most users do not want to quit. Most studies evaluating effects of cannabis use in young adults are cross-sectional, limiting causal inference. A method to reliably induce abstinence periods in cannabis users would allow assessment of the effects of abstinence and resumption of use on a variety of outcomes in a within-subjects, repeated measures design. Methods We examined the efficacy and feasibility of a voucher-based contingency management procedure for incentivizing one month of continuous cannabis abstinence among young adults who reported at least weekly cannabis use, volunteered to participate in a laboratory study, and did not express a desire to discontinue cannabis use long-term. Continuous cannabis abstinence was reinforced with an escalating incentive schedule, and self-report of abstinence was confirmed by frequent quantitative assays of urine cannabis metabolite (THCCOOH) concentration. New cannabis use during the abstinence period was determined using an established algorithm of change in creatinine-adjusted cannabis metabolite concentrations between study visits. Results Thirty-eight young adults, aged 18–25 years, enrolled and 34 (89.5%) attained biochemically confirmed 30-day abstinence. Among those who attained abstinence, 93.9% resumed regular use within two-weeks of incentive discontinuation. Conclusion Findings support the feasibility and efficacy of contingency management to elicit short-term, continuous cannabis abstinence among young adult, non-treatment seeking, regular cannabis users. Further work should test the effectiveness of this contingency management procedure for cannabis abstinence in periods longer than one month, which may be required to evaluate some effects of abstinence.
AB - Background Rates of young adult cannabis use are rising, perceived harm is at its historical nadir, and most users do not want to quit. Most studies evaluating effects of cannabis use in young adults are cross-sectional, limiting causal inference. A method to reliably induce abstinence periods in cannabis users would allow assessment of the effects of abstinence and resumption of use on a variety of outcomes in a within-subjects, repeated measures design. Methods We examined the efficacy and feasibility of a voucher-based contingency management procedure for incentivizing one month of continuous cannabis abstinence among young adults who reported at least weekly cannabis use, volunteered to participate in a laboratory study, and did not express a desire to discontinue cannabis use long-term. Continuous cannabis abstinence was reinforced with an escalating incentive schedule, and self-report of abstinence was confirmed by frequent quantitative assays of urine cannabis metabolite (THCCOOH) concentration. New cannabis use during the abstinence period was determined using an established algorithm of change in creatinine-adjusted cannabis metabolite concentrations between study visits. Results Thirty-eight young adults, aged 18–25 years, enrolled and 34 (89.5%) attained biochemically confirmed 30-day abstinence. Among those who attained abstinence, 93.9% resumed regular use within two-weeks of incentive discontinuation. Conclusion Findings support the feasibility and efficacy of contingency management to elicit short-term, continuous cannabis abstinence among young adult, non-treatment seeking, regular cannabis users. Further work should test the effectiveness of this contingency management procedure for cannabis abstinence in periods longer than one month, which may be required to evaluate some effects of abstinence.
KW - Abstinence
KW - Cannabis
KW - Contingency management
KW - Marijuana
KW - Methodology
KW - Young adults
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U2 - 10.1016/j.drugalcdep.2016.08.622
DO - 10.1016/j.drugalcdep.2016.08.622
M3 - Article
C2 - 27590742
AN - SCOPUS:85002831919
SN - 0376-8716
VL - 167
SP - 199
EP - 206
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
ER -