What are the recommended treatments for cannabis use disorder?

From the Guidelines

The most effective treatment approach for cannabis use disorder involves a combination of motivational treatment, family-based services, and behavior therapies, including cognitive-behavioral therapy and contingency management, as these have shown efficacy in promoting abstinence and reducing cannabis use 1. When considering treatment options, it's essential to prioritize approaches that have demonstrated effectiveness in real-life clinical settings. The principles and practices outlined in recent narrative reviews and empirical research studies support the use of:

• Motivational treatment to enhance motivation for change
• Family-based services to address the ecological context of substance use
• Behavior therapies, such as cognitive-behavioral therapy and contingency management, to promote abstinence and reduce cannabis use These approaches have been shown to be effective in reducing cannabis use and promoting recovery, particularly when paired with ongoing recovery monitoring and support 1. Key considerations in treatment include:
• Having a continuing care plan with ongoing recovery monitoring and support
• Using brief interventions, such as motivational interviewing and decisional balance exercises, to address problematic cannabis use
• Addressing co-occurring mental health conditions and providing strong social support systems to enhance treatment outcomes
• Considering the use of technology-delivered assessment and direct-to-consumer marketing strategies to reduce the gap in treatment access By prioritizing these evidence-based approaches, clinicians can provide effective treatment for cannabis use disorder and improve patient outcomes.

From the Research

Recommended Treatments for Cannabis Use Disorder

The following are some of the recommended treatments for cannabis use disorder:

• Motivational enhancement therapy (MET) and cognitive behavioral therapy (CBT) are considered effective interventions for adults with cannabis use disorder (CUD) 2, 3
• A combination of MET and CBT has been shown to produce abstinence and reductions in cannabis use greater than delayed treatment controls 2
• Pharmacotherapy trials have been conducted as adjunctive interventions to psychosocial treatment, with N-acetylcysteine and gabapentin being two of the most promising medications 4
• Contingency management is also a useful psychosocial intervention for the management of CUD 4, 5

Treatment Models

Different treatment models have been explored, including:

• A fixed-dose model, which provides a set number of treatment sessions 2
• A treatment "as needed" (PRN) model, which allows repeated access to treatment for a specified period 2
• A 12-week combined CBT and MET group treatment, which has shown promise in improving cannabis use outcomes 3

Challenges and Future Directions

Despite the availability of these treatments, challenges remain, including:

• High attrition rates and heterogeneity of concurrent interventions and outcomes assessment 6
• The need for more research to identify effective pharmacologic treatments 6, 4
• The importance of addressing cannabis-specific barriers to treatment 4