Treatment for Adolescent Marijuana Abuse
Condition: Marijuana Abuse
MeSH terms: Marijuana Abuse
Study type: Interventional

Summary: 
      Marijuana remains the most prevalent illicit substance used by adolescents and the number of
      adolescents receiving treatment for marijuana abuse more than tripled during the last decade.
      A small number of clinical trials suggest that family-based and individual interventions have
      efficacy for treating adolescent substance abuse. However, even with these interventions most
      adolescents fail to reduce their substance use substantially, thus, there remains much room
      for improvement of treatment services. The overarching goal of this project is to develop and
      test novel behavioral treatments to enhance treatment outcome in this important treatment
      population, and in so doing, learn more about mechanisms of change that have broader
      implications for addiction science. In our initial Stage IB project "Behavioral Treatment for
      Adolescent Marijuana Abuse", we created, manualized, and pilot tested a unique
      contingency-management (CM) intervention that combined abstinence-based voucher incentives
      with contingency management training for parents. A small randomized, clinical trial provided
      encouraging results. When added to a commonly used cognitive-behavior therapy, CM improved
      rates of sustained abstinence during treatment. Adolescents receiving this intervention were
      less likely to relapse over the 9-month follow-up period, however this finding was not as
      robust as the observed during treatment effects, most likely due to the small sample size and
      associated low power to detect effects. Despite strong indicators of the efficacy of this CM
      intervention, there remained room for improvement in increasing rates of treatment response
      and reducing rates of relapse. Hypothesized mediators and moderators of change indicated that
      changes in parenting had direct effects on post-treatment marijuana abstinence outcomes, and
      that abstinence early in treatment was a robust predictor of the CM treatment effect. This
      proposal will systematically replicate and extend these findings. A Stage II trial will
      compare three treatment conditions: (1) cognitive behavior therapy (CBT only); (2) CBT plus
      CM; and (3) CBT plus an enhanced CM model targeting increased early abstinence rates,
      parenting skills, and maintenance of effects. Replicating the initial demonstration of the
      positive effects of CM will extend the scientific evidence for use of CM to increase
      treatment efficacy for substance-abusing adolescents. Testing an enhanced CM model will
      determine if modifications that are consistent with the underlying behavioral principles and
      empiricism supporting CM interventions can result in improved outcomes. Last, assessment of
      potential mechanisms of action, particularly parenting, adolescent psychopathology and
      impulsivity, will provide scientific information directly relevant to future development of
      more effective intervention and prevention models of adolescent substance abuse, and will
      inform us about fundamental mechanisms operating in drug-dependence.
    


Intervention name(s): MET/CBT; CM; BPT
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Weekly Individual Counseling Sessions; Abstinence-based incentives delivered contingent on drug-negative urine test results.; Behavioral parent training involve 14 weekly counseling curriculum to improve parenting skills.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Adolescent Marijuana Abuse