Abstract
IntroductionCannabis 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. MethodThis 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). ResultsSince all but one of the eight identified studies had delayed treatment controls, results could only be summarised across 2–4months. Average weighted days of use in the previous 30days 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. ConclusionsWhile 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.
Highlights
Cannabis remains the most used illegal substance across the globe, and negative outcomes and disorders are common
Electronic searches were performed in January 2015, to find studies that included a control group that had explored the topic of cannabis use treatment
A final decision on inclusion was determined after reading the full paper, and any that raised potential questions on inclusion were reviewed by all authors, until consensus was reached
Summary
Cannabis remains the most used illegal substance across the globe, and negative outcomes and disorders are common. Current estimates of unassisted cessation or reduction in cannabis use rely on community surveys, and few studies focus on individuals with disorder. Method: 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. Australia has high rates of use, with 35% of adults reporting lifetime consumption, and 10% using it in the previous 12 months (Australian Institute of Health and Welfare, 2014). In common with other substances, most successful cessation occurs without treatment (Cunningham, 2000; Price, Risk, & Spitznagel, 2001) While these changes are typically greatest among infrequent or non-problematic users (Chen & Kandel, 1998), people with cannabis abuse or. An analysis of data from Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions (Agosti & Levin, 2007) found that 81% of people with lifetime cannabis dependence did not meet criteria over the previous year
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