Abstract
BackgroundRates of cannabis use are highest during emerging adulthood (age 18–25), with the prevalence of near daily and daily increasing among this age group. Emerging adults are clinically challenging in terms of harmful cannabis use due to perceptions of high rates of peer use, social acceptance, and low risk of harm. Brief interventions to increase awareness and promote motivation to change are therefore particularly important for this age group. There is existing evidence on the effectiveness of brief interventions for alcohol in emerging adults, but it is not clear if comparable evidence is present for cannabis. The objective of this systematic review is to summarize and critically appraise the existing literature of brief interventions for cannabis use both narratively, to describe the content and delivery of existing interventions, and meta-analytically, to determine the aggregated efficacy of these interventions on cannabis use and other outcomes (e.g., other substance use, mental health, help-seeking behaviors, and academic and occupational outcomes).MethodsA systematic search of randomized controlled trials, quasi-experimental trials, and pre-post designs will be conducted in the following electronic databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Allied and Complementary Medicine, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO. Ongoing trials will be identified using the World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov, and Current Controlled Trials. Unpublished trials will be identified using Proquest Dissertations, OpenGrey, Google Scholar, and brief interventions on the Substance Abuse and Mental Health Services Administration webpage. Two authors will independently screen and extract data from articles using a predetermined screening and extraction forms (which will include risk of bias assessments). Calibration exercises will be performed prior to full screening and extraction. Disagreements will be resolved through discussion or consultation with a third reviewer. All studies will be reported narratively, and if appropriate, we will perform random effects meta-analyses with subgroup analyses and meta-regression.DiscussionResults of this review are expected to provide guidance on the content, delivery methods, and effectiveness of brief interventions for cannabis use to assist post-secondary institutions in identifying brief intervention strategies to implement prior to or in response to legalization.Systematic review registrationCRD42018085412
Highlights
Rates of cannabis use are highest during emerging adulthood, with the prevalence of near daily and daily increasing among this age group
Emerging adults are neurodevelopmentally vulnerable to the effects of cannabis, as cannabis acts on areas of the brain integral to brain development
Regular cannabis use during adolescence has shown to negatively affect memory, attention, and psychomotor skills [10,11,12], potentially causing irreversible cognitive impairment [13] resulting in an increased likelihood of fatal car accidents [14], poor academic performance [15,16,17], and dropping out of school [17]
Summary
Rates of cannabis use are highest during emerging adulthood (age 18–25), with the prevalence of near daily and daily increasing among this age group. Brief interventions to increase awareness and promote motivation to change are important for this age group. Risks of cannabis-related harm are more pervasive for individuals who begin using cannabis during adolescence, with earlier age of first use potentially resulting in long lasting consequences [6]. Given the high prevalence of use and potential for significant impairment, efficacious interventions for high-risk individuals in this age group are a pressing clinical priority. Regular cannabis use during adolescence has shown to negatively affect memory, attention, and psychomotor skills [10,11,12], potentially causing irreversible cognitive impairment [13] resulting in an increased likelihood of fatal car accidents [14], poor academic performance [15,16,17], and dropping out of school [17]. Cannabis use during emerging adulthood is concerning due to its potential to disrupt neurological, social, emotional, and cognitive development
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