Combination of Therapy & Incentives For Marijuana Treatment

By The National Institute on Drug Abuse

Combination of Cognitive-Behavioral Therapy and Motivational Incentives Enhance Treatment for Marijuana addiction

New research supported by the National Institute on Drug Abuse (NIDA), National Institutes of Health, indicates that people who are trying to end their addiction to marijuana can benefit from a treatment program that combines motivational incentives with cognitive-behavioral therapy.

The study is published in the April 2006 issue of the Journal of Consulting and Clinical Psychology.

"Demand for effective treatments for marijuana addiction increased significantly in the United States during the 1990s," says NIDA Director Dr. Nora D. Volkow.

"Marijuana remains one of the most widely used drugs of abuse. Heavy use of the drug impairs a person's ability to form memories, recall events, and shift attention from one thing to another.

"Someone who smokes marijuana regularly may have many of the same respiratory problems that tobacco smokers do, such as daily cough and phlegm production, more frequent acute chest illnesses, and a heightened risk of lung infections. Thus, treatments to reduce and eliminate marijuana abuse will offer substantial public health benefits."

Dr. Alan Budney, of the University of Arkansas, and his colleagues at the University of Vermont followed 90 adult men and women diagnosed with marijuana dependence during the 14-week study. Participants were randomly assigned to one of three groups: (1) individuals who received vouchers as incentives to remain drug-free; (2) participants who received cognitive-behavioral therapy only (CBT); and (3) those who received both cognitive-behavioral therapy and vouchers (CBT+V).

Vouchers were awarded for having marijuana-free urine samples. In cognitive-behavioral therapy people are taught to recognize unhelpful patterns of thinking and reacting, and modify or replace these with more realistic or helpful ones.

At the end of 3 months of treatment, 43 percent of the CBT+V group was no longer using marijuana, compared with 40 percent of the voucher group and 30 percent of the CBT group. But at the end of the 12-month follow-up, 37 percent of the CBT+V group was abstinent, compared with17 percent of the voucher group and 23 percent of the CBT group.

"We found that vouchers generated greater rates of marijuana abstinence during treatment compared with CBT alone, but that CBT enhanced the maintenance of the voucher effect during treatment," says Dr. Budney. "Together, the combination of vouchers and CBT resulted in higher abstinence rates during the year following treatment than vouchers alone. This suggests that CBT helps maintain the initial positive effect of using vouchers to initiate abstinence during treatment."

The maximum amount of earnings for patients receiving vouchers for abstinence was $570, (i.e., the amount earned if they were abstinent throughout the entire 14 weeks of treatment). Earnings could be redeemed for retail goods and services (movie passes, sports/hobby equipment, and work materials), but not for purchases that might encourage substance use. CBT alone consisted of 50-minute sessions each week, with fixed-value voucher payments to encourage participation.

In CBT+V, participants reviewed their voucher earnings with their therapists at each visit and discussed how they might be used to support treatment goals of positive lifestyle changes and increased drug-free activities.

The scientists point out that the demographics of the study population - primarily white and male - may limit the ability to generalize their findings to other settings or populations.

"In addition," says Dr. Volkow, "although the study results are largely positive in that they show techniques that can lead marijuana-addicted patients to choose a more healthful lifestyle, there should be continued efforts to develop and evaluate effective treatments for marijuana addiction."


The Emotional Key to Overcoming Marijuana "Addiction"

by The Sedona Method staff

Marijuana is the most commonly used illegal drug in the United States. In 2006, nearly 15 million Americans 12 and older used the drug in the month prior to the survey, according to the National Survey on Drug Use and Health. Meanwhile, nearly 40 percent of the U.S. population over 12 has tried marijuana in their lifetime.

While some believe that marijuana is not an addictive drug, the National Institute on Drug Abuse (NIDA) states that long-term marijuana abuse can lead to addiction. And according to the Office of National Drug Control Policy (ONDCP), a 2002 survey found that over 4 million people were classified with dependence on or abuse of marijuana.

You may also be surprised to learn that more teens enter treatment centers because of marijuana dependence than they do for all other illegal drugs combined, according to ONDCP.

In all, 62 percent of teens in drug treatment centers are dependent on marijuana.

There is also a misconception that marijuana is a relatively harmless drug that just makes you "mellow."

In reality, those who use the drug have:

Increased rates of anxiety, depression, suicidal ideation, and schizophrenia

    * Impaired immune systems

    * Increased risk of lung cancer (marijuana smoke actually contains 50 percent to 70 percent more carcinogenic hydrocarbons than tobacco smoke)

    * Respiratory problems similar to those of tobacco smokers

Heavy marijuana use has also been proven to hinder life achievement in areas such as physical and mental health, cognitive abilities, social life and career status, NIDA states.

How to Overcome a Marijuana Addiction

Every addiction has a strong emotional component that drives you to continue the behavior. What makes it an addiction is that you continue to use marijuana even though it is interfering with your family, school, work or social life. Often, getting to the bottom of the emotional drive will allow you to break free from the physical dependence.

"All addictions have an emotional content," says Hale Dwoskin, CEO and director of training of Sedona Training Associates. "If you are willing to face and let go of the feeling that you need a substance in order to be comfortable with who or what you are, you can break any addiction."

Letting go is easy once you get the hang of it, but many people find using The Sedona Method helps them get a hold on the principle of releasing.

"As you let go of the feelings of incompleteness or whatever other feeling is motivating you to feel like you must do the addictive behavior, you will find it easier and easier to simply let it go and not be bound by the addiction anymore," Dwoskin says.

Keep in mind that people trying to quit marijuana often report feeling irritable and anxious, and having trouble sleeping. You can use The Sedona Method to release on these feelings and symptoms as well, and it will help you get through the transition.

National Institute on Drug Abuse: Marijuana
Office of National Drug Control Policy

Also see the Sedona Method site.