Development and Efficacy Test of Computerized Treatment for Marijuana Dependence
Condition: Marijuana Abuse and Dependence
MeSH terms: Marijuana Abuse
Study type: Interventional

Summary: 
      More US residents are dependent on marijuana than on any other illicit drug, and the number
      enrolled in treatment for marijuana continues to increase such that it is now comparable to
      that for cocaine and heroin. This application seeks to advance the overarching goal to
      develop and disseminate cost-effective treatments for marijuana dependence that can address
      this growing problem.

      The researchers' previous research suggests that an intervention comprising motivational
      enhancement, cognitive-behavioral, and contingency-management components (MET/CBT/CM)
      produces greater rates of successful and durable outcomes than has been demonstrated
      previously. However, three issues relevant to its efficacy and eventual dissemination must be
      confronted. First, the outcomes achieved can only be characterized as modest; many
      individuals do not respond to the treatment and relapse rates remain problematic. Second,
      access is limited by the availability of trained providers. Third, the cost of delivering the
      treatment is higher than more traditional outpatient interventions.

      To address these issues, Specific Aim 1 is to develop and test a computer-assisted version of
      MET/CBT/CM. Computerized treatments have the potential to increase overall effectiveness of
      treatment services by increasing availability of and access to potent treatments, and by
      applying innovative technology to enhance outcomes. During Year 1, the intervention will be
      developed and pilot tested. An interactive program that showed promise in a previous trial
      for opioid dependence will be modified and enhanced to deliver individualized MET/CBT/CM
      using effective computer learning technologies. These technologies and access to the
      MET/CBT/CM program made available via the Internet between treatment sessions and after
      treatment ends have the potential to promote better learning and more use of coping skills,
      which in turn can improve outcomes. During Years 2-4 a randomized trial will provide an
      initial efficacy test of cMET/CBT/CM by comparing it with a brief treatment (MET) and with
      therapist-delivered MET/CBT/CM. Specific Aim 2 is to learn more about how behavioral
      treatments like MET/CBT/CM work by focusing on two putative mechanisms of action examined in
      prior trials: self-efficacy/coping skills and impulsivity/delay discounting. The experimental
      design will provide a unique opportunity to explore such mechanisms in a novel context- where
      the therapist is vs. is not a prominent part of the treatment.

      The proposed project will address the objectives of NIDA's Behavioral and Integrative
      Treatment Development Program by providing research on technology-assisted treatment that
      attempts to make treatment delivery less complex, easier to access, and less costly - while
      retaining or improving its effectiveness. Findings will inform future studies designed to
      refine the technology and how it is applied; conduct more definitive effectiveness testing;
      test generality to other populations including adolescents; and to further advance
      translation to community settings.
    


Intervention name(s): Psychotherapy; Computerized Psychotherapy; Motivational enhancement therapy
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Nine session treatment; Nine session computer delivered treatment; Two session treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Marijuana; Treatment; Behavioral; Computer; Internet