Abstract

Cannabis remains the most used illegal substance across the globe, and negative outcomes and disorders are common. A spotlight therefore falls on reductions in cannabis use in people with cannabis use disorder. Current estimates of unassisted cessation or reduction in cannabis use rely on community surveys, and few studies focus on individuals with disorder. A key interest of services and researchers is to estimate effect size of reductions in consumption among treatment seekers who do not obtain treatment. Effects within waiting list or information-only control conditions of randomised controlled trials offer an opportunity to study this question. This paper examines the extent of reductions in days of cannabis use in the control groups of randomised controlled trials on treatment of cannabis use disorders. A systematic literature search was performed to identify trials that reported days of cannabis use in the previous 30 (or equivalent). Since all but one of the eight identified studies had delayed treatment controls, results could only be summarised across 2–4 months. Average weighted days of use in the previous 30 days fell from 24.5 to 19.9, and a meta-analysis using a random effects model showed an average reduction of 0.442 SD. However, every study had at least one significant methodological issue. While further high-quality data is needed to confirm the observed effects, these results provide a baseline from which researchers and practitioners can estimate the extent of change required to detect effects of cannabis treatments in services or treatment trials.

Abstract

Cannabis is now the most widely used illicit substance in the world. Previous research demonstrates that cannabis use is associated with dysfunctional affect regulation and anxiety. Anxiety is characterised by attentional biases in the presence of emotional information. This novel study therefore examined the attentional bias of cannabis users when presented with anxiety-related stimuli. The aim was to establish whether cannabis users respond to anxiety-related stimuli differently to control participants. A dot-probe paradigm was utilised using undergraduate students. Trials contained anxiety-related stimuli and neutral control stimuli. Eye-tracking was used to measure attention for the stimuli. Results indicated that cannabis users demonstrated attentional-avoidance behaviour when presented with anxiety-related stimuli. The findings suggest a difference in processing of emotional information in relation to neutral information between groups. It would appear that cannabis users avoid anxiety provoking stimuli. Such behaviour could potentially have motivational properties that could lead to exacerbating anxiety disorder-type behaviour.