Moderne Behandlung der Cannabisabhängigkeit

Abstract

The prevalence of cannabis use is rising also in Germany. The number of treatment seeking adolescents and adults increases simultaneously. Cannabis-related psychosocial sequels have driven controlled clinical trials of principally psychotherapeutic interventions in USA and Australia. Considering these trials brief interventions using motivational and cognitive behavioural techniques have been shown to be effective in cannabis dependent adults, adjunct to individual counselling. Regarding the specific treatment of young people, besides motivational and cognitive-behavioural also milieu and family therapeutic interventions were efficacious The only available controlled pharmacological study did not reveal any superiority of valproate. Meanwhile, also in Germany the first public studies have been started: “Realize-it (Sudbaden), “CANDIS” (Dresden), “INCA” (Bonn/Essen). Against the background of the high vulnerability of adolescents the “INCANT” project addresses the efficacy of multidimensional family therapy in the treatment of cannabis dependent adolescents and young adults. Unfortunately, no trial to date has taken account of relevant psychiatric co-morbidity. Nearly 70% of cannabis dependent adults suffer from concomittant anxiety or affective disorders, addictive diseases, personality disorders or schizophrenia. Therapeutical recommendations of these dual disorders still lean on the opinion of experts, such as collected in the AWMF-guideline: “cannabis-related disorders” ( http//www.uni-duesseldorf.de/www/AWMF/II/076-005.htm ).