Impact of Reduced Cannabis Use on Functional Outcomes (R33 Phase)
Condition: Cannabis; Cannabis Use
MeSH terms: Marijuana Abuse
Study type: Interventional

Summary: 
      Nearly 20 million Americans report use of cannabis in the past month, and heavy cannabis use
      has increased by nearly 60% in the U.S. since 2007. Heavy cannabis use is associated with
      lower educational attainment, reduced physical activity, increased rates of addiction and
      unemployment, and neuropsychological deficits. Studies suggest that cannabis use is also
      associated with increased mental health symptoms, drugged driving, and traffic accidents.
      While there is evidence that sustained abstinence can lead to improvements in the functional
      outcomes of former users, the degree to which reductions alone (i.e., not sustained
      abstinence) in cannabis use might be associated with positive changes in functional outcomes
      is unknown. This is a critical gap in the literature, as many interventions for cannabis and
      other drugs are associated with decreases in frequency and quantity of use, but fail to
      achieve an effect on overall abstinence rates. The objective of the present research is to
      use ecological momentary assessment (EMA), a real-time, naturalistic data collection method,
      to prospectively study the impact of reduced cannabis use on functional outcomes in heavy
      cannabis users. Contingency management (CM) will be used to promote reductions in frequency
      and quantity of cannabis use. CM is an intensive behavioral therapy that is highly effective
      at producing short-term reductions in illicit drug use. We have recently developed a novel
      approach that leverages mobile technology and recent developments in cannabis testing. We
      have pilot-tested this approach with heavy cannabis users and found that it is an acceptable
      and feasible method. The present research will use this technology in conjunction with EMA
      methods to study the impact of reduced cannabis use on key functional outcomes. Our central
      hypothesis is that reductions in frequency and quantity of cannabis use will lead to positive
      changes in cannabis users' mental health, self-efficacy, physical activity, working memory,
      health-related quality of life, and driving behavior. The rationale for this research is that
      it will provide the first and only real-time data concerning the potential impact of
      reductions in cannabis use on functional outcomes. As such, the findings from the present
      research will directly inform ongoing efforts to include reductions in illicit drug use as a
      valid, clinically-meaningful outcome measure in clinical trials of pharmacotherapies for the
      treatment of substance use disorders.
    


Intervention name(s): Mobile contingency management
Intervention type(s): Behavioral
Intervention description(s): Mobile contingency management is a mobile-phone based behavioral therapy that provides positive reinforcement (i.e., money) for abstinence that is highly effective at reducing substance use.
Other intervention name(s): mCM
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment