Guided web-based treatment program for reducing cannabis use: a randomized controlled trial

Kristina Sinadinovic,Philip Lindner,Thomas Lundqvist,Magnus Johansson,Ulric Hermansson,Ann-Sofie Johansson

doi:10.1186/s13722-020-00185-8

Abstract

BackgroundThe aim of this study was to investigate the effects of a web-based treatment program with therapist guidance for adults and adolescents with regular cannabis use from the general population.MethodsA double blinded randomized controlled trial with a parallel group design was conducted (intervention group n = 151, wait-list control group n = 152). Follow-up 12 weeks from treatment commencement of a 13-module intervention. The primary outcome was frequency of cannabis use. Time by group interaction effects were modeled using generalized estimated equations and the instrumental variable approach was used to estimate the effect of intervention adherence.ResultsAt follow-up, the intention to treat (ITT) analyses did not show any significant time by group effects. A significant association between intervention adherence and scores on the cannabis abuse screening test (CAST) was found. Secondary analysis excluding participants who had received other professional help revealed time by group effects for secondary outcomes gram cannabis consumed past week, number of dependency criteria and CAST score. Due to methodological limitations, these latter results should be interpreted with caution.ConclusionsIn this study we did not find a web-based treatment program with therapist guidance to be more effective than a waiting-list in reducing frequency of cannabis use.Trial registration The trial was pre-registered at ClinicalTrials.gov (NCT02408640) April 3, 2015

Highlights

The aim of this study was to investigate the effects of a web-based treatment program with therapist guidance for adults and adolescents with regular cannabis use from the general population
The main finding from this study is that access to a webbased treatment program with therapist guidance did not lead to significant additional decreases in cannabis use, associated symptoms or increase in help-seeking compared to a waiting list, which showed improvement over time
Our findings suggest that adherence to the program is associated with lower cannabis use disorder symptoms at follow-up, in analyses that correct for baseline confounding on both adherence and outcomes

Summary

Introduction

The aim of this study was to investigate the effects of a web-based treatment program with therapist guidance for adults and adolescents with regular cannabis use from the general population. Increasing interest in internet-based interventions designed to help individuals reduce or end cannabis use likely indicates efforts to meet the wide range of needs related to treatment of cannabis use. According to WHO, internet-based interventions for cannabis-use disorders is an area of priority for future research [1]. Internet-based interventions, in the context of substance use, represents supportive interventions with the aim of helping users reduce or end their consumption of the particular substance [6]. Compared to a regular informational website, an internet-based intervention is more structured and provides a variety of interactive support, e.g., for self-monitoring. Mechanisms for support can be preprogrammed text and/or direct communication, with, e.g., a therapist, via e-mail, chat or bulletin boards [7]

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