Impact of Reduced Cannabis Use on Functional Outcomes
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, and increased rates of addiction,
      unemployment, and neuropsychological deficits. Studies by the lab and others suggest that
      cannabis use is also associated with increased mental health symptoms and suicidal and
      nonsuicidal self-injury. In addition, cannabis is the illicit drug most strongly associated
      with drugged driving and traffic accidents, including fatal accidents. There is evidence that
      sustained abstinence from cannabis can lead to improvements in the functional outcomes of
      former users. However, he degree to which reductions in cannabis use might be associated with
      positive changes in functional outcomes is currently unknown. The overall objective of the
      present research is to use ecological momentary assessment (EMA), a real-time, naturalistic
      data collection method, to 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. The investigators novel
      approach includes mobile technology to make CM more portable and feasible. The present
      research will use this technology in conjunction with state-of-the-art EMA methods to study
      the impact of reduced cannabis use on key functional outcomes. The investigators central
      hypothesis is that reductions in frequency and quantity of cannabis use will lead to positive
      changes in cannabis users' mental health, physical activity, working memory, health-related
      quality of life, and driving behavior.
    

Detailed description: 
      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, and increased rates of addiction,
      unemployment, and neuropsychological deficits. Studies by the lab and others suggest that
      cannabis use is also associated with increased mental health symptoms and suicidal and
      nonsuicidal self-injury. In addition, cannabis is the illicit drug most strongly associated
      with drugged driving and traffic accidents, including fatal accidents. While there is
      evidence that sustained abstinence can lead to improvements in the functional outcomes of
      former users, the degree to which reductions in cannabis use alone (i.e., in the absence of
      sustained abstinence) might be associated with positive changes in functional outcomes is
      currently unknown. This is a critical gap in the literature, as many clinical 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 overall 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. EMA addresses several limitations of traditional
      assessment techniques by enhancing ecological validity, minimizing memory bias, and enabling
      examination of the impact of context on participants' behavior. 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. Moreover, the investigators have recently developed a novel approach that
      leverages mobile technology and recent developments in cannabis testing to make CM for
      cannabis more portable and feasible. The investigators have pilot-tested this approach with
      heavy cannabis users and found that it is an acceptable and feasible method to reduce their
      cannabis use. The present research will use this technology in conjunction with
      state-of-the-art EMA methods to study the impact of reduced cannabis use on key functional
      outcomes. The investigators central hypothesis is that reductions in frequency and quantity
      of cannabis use will lead to positive changes in cannabis users' mental health, 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, active
Intervention type(s): Behavioral
Intervention description(s): Participants are provided monetary reinforcement for providing oral fluid test results that suggest they have reduced cannabis use.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Other