Psychotherapeutic interventions for cannabis abuse and/or dependence in outpatient settings.

Cecile Denis, Estelle Lavie, Melina Fatseas, Marc Auriacombe
Cochrane Database of Systematic Reviews. 2006-07-19; :
DOI: 10.1002/14651858.cd005336.pub2

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Denis C(1), Lavie E, Fatséas M, Auriacombe M.

Author information:
(1)Universite Victor Segalen Bordeaux – Centre Carreire du CHCP, Laboratoire de
Psychiatrie, 121 rue de la Bechade, Bordeaux Cedex, European Union 33076.

Update in
Cochrane Database Syst Rev. 2013;6:CD005336.

BACKGROUND: Cannabis use disorder is the most common illicit substance use
disorder in general population. Despite that, only a minority seek assistance
from a health professional, but the demand for treatment is now increasing
internationally. Trials of treatment have been published but to our knowledge,
there is no published systematic review .
OBJECTIVES: To evaluate the efficacy of psychosocial interventions for cannabis
abuse or dependence.
SEARCH STRATEGY: We searched the Cochrane Central Register of Trials (CENTRAL)
The Cochrane Library Issue 3, 2004; MEDLINE (January 1966 to August 2004),
PsycInfo (1985 to October 2004), CINAHL (1982 to October 2004), Toxibase (until
September 2004) and reference lists of articles. We also contacted researchers in
the field.
SELECTION CRITERIA: All randomized controlled studies examining a
psychotherapeutic intervention for cannabis dependence or abuse in comparison
with a delayed-treatment control group or combinations of psychotherapeutic
DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial quality
and extracted data
MAIN RESULTS: Six trials involving 1297 people were included. Five studies took
place in the United States, one in Australia. Studies were not pooled in
meta-analysis because of heterogeneity. The six included studies suggested that
counseling approaches might have beneficial effects for the treatment of cannabis
dependence. Group and individual sessions of cognitive behavioral therapy (CBT)
had both efficacy for the treatment of cannabis dependence and associated
problems, CBT produced better outcomes than a brief intervention when CBT was
delivered in individual sessions. Two studies suggested that adding voucher-based
incentives may enhance treatment when used in combination with other effective
psychotherapeutic interventions. Abstinence rates were relatively small overall
but favored the individual CBT 9-session (or more) condition. All included trials
reported a statistically significant reductions in frequency of cannabis use and
dependence symptoms. But other measures of problems related to cannabis use were
not consistently different.
AUTHORS’ CONCLUSIONS: The included studies were too heterogenous and could not
allow to draw up a clear conclusion. The studies comparing different therapeutic
modalities raise important questions about the duration, intensity and type of
treatment. The generalizability of findings is also unknown because the studies
have been conducted in a limited number of localities with fairly homogenous
samples of treatment seekers. However, the low abstinence rate indicated that
cannabis dependence is not easily treated by psychotherapies in outpatient


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