Brief Interventions for Cannabis Problems in the Postsecondary Setting: a Systematic Review
- 12 Downloads
Cannabis use is common among postsecondary students. With increasing numbers of jurisdictions legalizing recreational cannabis for those who reach a legal age that is likely to occur during postsecondary years, it is important to identify effective ways to ameliorate cannabis-related problems in this group. A systematic review of brief interventions (BI) for cannabis use and problems among postsecondary students was conducted. We included randomized trials of BIs involving postsecondary students between the ages of 18 and 25 years. Seven articles, representing five unique randomized trials from four electronic databases (MEDLINE, EMBASE, CINAHL, PsycINFO) were eligible for inclusion. The results provided only modest evidence for beneficial impact of these programs. Although success in reducing the frequency and quantity of cannabis use was observed over 30-day follow-up periods in some studies, no studies reported positive longer-term effects on cannabis use. Finally, several methodological concerns were noted, particularly unclear randomization and blinding processes. More research is needed to establish whether these interventions are effective in the postsecondary setting, and how they might best be implemented.
KeywordsCannabis Brief intervention Young adults Postsecondary Students Marijuana-related consequences
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Not applicable since the paper is not a research study, as it is a systematic review.
Not applicable since the paper is not a research study, as it is a systematic review.
- Annis, H. M. (1986). A relapse prevention model for treatment of alcoholics (pp. 407–433). Boston, MA: Springer.Google Scholar
- Asbridge, M., Hayden, J. A., & Cartwright, J. L. (2012). Acute cannabis consumption and motor vehicle collision risk: systematic review of observational studies and meta-analysis. BMJ, 344(1), e536.Google Scholar
- Asbridge, M., Mann, R. E., Cusimano, M. D., Trayling, C., Roerecke, M., Tallon, J. M., & Whipp, A. (2014). Cannabis and traffic collision risk: findings from a case-crossover study of injured drivers presenting to emergency departments. International Journal of Public Health, 59(1), 395–404.Google Scholar
- Asbridge, M., Wickens, C. M., Mann, R. E., & Cartwright, J. L. (2017). Alcohol, cannabis and new drivers: handbook of teen and novice drivers. Boca Raton: CRC Press.Google Scholar
- Australian Government (2004). 6.1 Brief interventions—a definition. In: Department of Health Retrieved March 1, 2018, from. http://www.health.gov.au/internet/publications/publishing.nsf/Content/drugtreat-pubs-front9-fa-toc~drugtreat-pubs-front9-fa-secb~drugtreat-pubs-front9-fa-secb-6~drugtreat-pubs-front9-fa-secb-6-1.
- Babor, T. F. (2004). Brief treatments for cannabis dependence: findings from a randomized multisite trial. Journal of Consulting and Clinical Psychology, 72(3), 455–466.Google Scholar
- Bernstein, J., Bernstein, E., Tassiopoulos, K., Heeren, T., Levenson, S., & Hingson, R. (2005). Brief motivational intervention at a clinic visit reduces cocaine and heroin use. Drug and Alcohol Dependence, 77(1), 49–59.Google Scholar
- Boak, A., Hamilton, H. A., Adlaf, E. M., Mann, R. E. (2017). Drug use among Ontario students, 1977-2017: detailed findings from the Ontario student drug use and health survey (OSDUHS) (CAMH research document series no. 46). Toronto: Centre for Addiction and Mental Health. Retrieved February 20, 2018, from https://www.camh.ca/-/media/files/pdf%2D%2D-osduhs/drug-use-among-ontario-students-1977-2017%2D%2D-detailed-findings-from-the-osduhs.pdf?la=en&hash=2B434CDAAD485834497E3B43F2264BDEB255F29F.
- Brown, T. G., Dongier, M., Ouimet, M. C., Tremblay, J., Chanut, F., Legault, L., & Ng Ying Kin, N. M. (2010). Brief motivational interviewing for DWI recidivists who abuse alcohol and are not participating in DWI intervention: a randomized controlled trial. Alcoholism: Clinical and Experimental Research, 34(2), 292–301. https://doi.org/10.1111/j.1530-0277.2009.01092.x.Google Scholar
- Callaghan, R. C., Sanches, M., & Gatley, J. M. (2013). Impacts of the minimum legal drinking age legislation on in-patient morbidity in Canada, 1997–2007: a regression-discontinuity approach. Addiction, 108(9), 1590–1600.Google Scholar
- Callaghan, R. C., Sanches, M., Gatley, J. M., & Stockwell, T. (2014). Impacts of drinking-age laws on mortality in Canada, 1980–2009. Drug and Alcohol Dependence, 138(1), 137–145.Google Scholar
- Carpenter, C., & Dobkin, C. (2009). The effect of alcohol consumption on mortality: regression discontinuity evidence from the minimum drinking age. American Economic Journal: Applied Economics, 1(1), 164–182.Google Scholar
- Cohen, J. (1988). Statistical power analysis for the behavioural sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
- Cole, M. G. (2008). Brief interventions to prevent depression in older subjects: a systematic review of feasibility and effectiveness. The American Journal of Geriatric Psychiatry, 16(6), 435–443.Google Scholar
- Cooper, K., Chatters, R., Kaltenthaler, E., & Wong, R. (2015). Psychological and psychosocial interventions for cannabis cessation in adults: A systematic review short report. Health Technology Assessment, 19(56), 1–130.Google Scholar
- Copeland, J., Swift, W., Roffman, R., & Stephens, R. (2001). A randomized controlled trial of brief cognitive-behavioral interventions for cannabis use disorder. Journal of Substance Abuse Treatment, 21(2), 55–64.Google Scholar
- Crépault, J. F., Rehm, J., & Fischer, B. (2016). The Cannabis policy framework by the Centre for Addiction and Mental Health: a proposal for a public health approach to cannabis policy in Canada. International Journal of Drug Policy, 34(1), 1–4.Google Scholar
- Cunningham, J. A., Wild, T. C., Cordingley, J., Van Mierlo, T., & Humphreys, K. (2009). A randomized controlled trial of an internet-based intervention for alcohol abusers. Addiction, 104(12), 2023–2032.Google Scholar
- Erickson, S. J., Gerstle, M., & Feldstein, S. W. (2005). Brief interventions and motivational interviewing with children, adolescents, and their parents in pediatric health care settings: a review. Archives of Pediatrics & Adolescent Medicine, 159(12), 1173–1180.Google Scholar
- Fischer, B., Dawe, M., McGuire, F., Shuper, P. A., Capler, R., Bilsker, D., Jones, W., Taylor, B., Rudzinski, K., & Rehm, J. (2013). Feasibility and impact of brief interventions for frequent cannabis users in Canada. Journal of Substance Abuse Treatment, 44(1), 132–138. https://doi.org/10.1016/j.jsat.2012.03.006.Google Scholar
- Flam-Zalcman, R., Mann, R. E., Stoduto, G., Nochajski, T. H., Rush, B. R., Koski-Jännes, A., & Rehm, J. (2012). Evidence from regression-discontinuity analyses for beneficial effects of a criterion-based increase in alcohol treatment. International Journal of Methods in Psychiatric Research, 22(1), 59–70. https://doi.org/10.1002/mpr.1374.Google Scholar
- Fuster, D., Cheng, D. M., Wang, N., Bernstein, J. A., Palfai, T. P., Alford, D. P., & Samet, J. H. (2016). Brief intervention for daily marijuana users identified by screening in primary care: a subgroup analysis of the ASPIRE randomized clinical trial. Journal of Substance Abuse Treatment, 37(2), 336–342. https://doi.org/10.1080/08897077.2015.1075932.Google Scholar
- Gage, S. H., Hickman, M., & Zammit, S. (2016). Association between cannabis and psychosis: epidemiologic evidence. Biological Psychiatry, 79(7), 549–556.Google Scholar
- Gogtay, N., Giedd, J. N., Lusk, L., Hayashi, K. M., Greenstein, D., Vaituzis, A. C., & Nugent, T. F., III. (2004). Dynamic mapping of human cortical development during childhood through early adulthood. Proceedings of the National Academy of Sciences of the United States of America, 101(21), 8174–8179. https://doi.org/10.1073/pnas.0402680101.Google Scholar
- Government of Canada (2018). Cannabis in Canada: get the facts. Retrieved January 25, 2018, from https://www.canada.ca/en/services/health/campaigns/cannabis.html?utm_source=google&utm_medium=cpc_en&utm_content=misc_1&utm_campaign=cannabis-18.
- Hall, W. (2015). What has research over the past two decades revealed about the adverse health effects of recreational cannabis use? Addiction, 110(1), 19–35.Google Scholar
- Henry-Edwards, S., Humeniuk, R., Ali, R., Monteiro, M., & Poznyak, V. (2005). Brief intervention for substance use: a manual for use in primary care. In: World Health Organization. Retrieved May 15, 2018, from http://www.who.int/substance_abuse/activities/en/Draft_Brief_Intervention_for_Substance_Use.pdf.
- Hoch, E., Preuss, U. W., Ferri, M., & Simon, R. (2016). Digital interventions for problematic cannabis users in non-clinical settings: findings from a systematic review and meta-analysis. European Addiction Research, 22(5), 233–242.Google Scholar
- Ialomiteanu, A., Hamilton, H. A., Hamilton, E. M., & Mann, R. E. (2016). CAMH Monitor eReport 2015: substance use, mental health and well being among Ontario adults, 1977–2013. Toronto: Centre for Addiction and Mental Health.Google Scholar
- Ialomiteanu, A., Hamilton, H. A., Adlaf, E. M., & Mann, R. E. (2018). CAMH Monitor eReport 2018: substance use, mental health and well being among Ontario adults, 1977–2017. Toronto: Centre for Addiction and Mental Health.Google Scholar
- Johnston, L. D., Miech, R. A., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E., & Patrick, M. E. (2018). Monitoring the future national survey results on drug use: 1975–2017: overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, The University of Michigan.Google Scholar
- Kalant, H., Corrigall, W., Hall, W., & Smart, R. (1999). The health effects of cannabis (pp. 173–191). Toronto: Addiction Research Foundation.Google Scholar
- Laporte, C., Vaillant-Roussel, H., Pereira, B., Blanc, O., Eschalier, B., Kinouani, S., & Brousse, G. (2017). Cannabis and young users—a brief intervention to reduce their consumption (CANABIC): a cluster randomized controlled trial in primary care. The Annals of Family Medicine, 15(2), 131–139. https://doi.org/10.1370/afm.2003.Google Scholar
- Lee, C. M., Kilmer, J. R., Neighbors, C., Atkins, D. C., Zheng, C., Walker, D. D., & Larimer, M. E. (2013). Indicated prevention for college student marijuana use: a randomized controlled trial. Journal of Consulting and Clinical Psychology, 81(4), 702–709. https://doi.org/10.1037/a0033285.Google Scholar
- Li, M. C., Brady, J. E., DiMaggio, C. J., Lusardi, A. R., Tzong, K. Y., & Li, G. (2012). Marijuana use and motor vehicle crashes. Epidemiologic Reviews, 34(1), 65–72.Google Scholar
- Mann, R. E., Stoduto, G., Ialomiteanu, A., Asbridge, M., Smart, R. G., & Wickens, C. M. (2010). Self-reported collision risk associated with Cannabis use and driving after Cannabis use among Ontario adults. Traffic Injury Prevention, 11(2), 115–122. https://doi.org/10.1080/15389580903536704.Google Scholar
- McCambridge, J., & Strang, J. (2004). The efficacy of single-session motivational interviewing in reducing drug consumption and perceptions of drug-related risk and harm among young people: results from a multi-site cluster randomized trial. Addiction, 99(1), 39–52.Google Scholar
- Meier, M. H., Caspi, A., Ambler, A., Harrington, H., Houts, R., Keefe, R. S., & McDonald, K. (2012). Persistent cannabis users show neuropsychological decline from childhood to midlife. Proceedings of the National Academy of Sciences of the United States of America, 109(40), E2657–E2664. https://doi.org/10.1073/pnas.1206820109.Google Scholar
- Miller, W. R. (1983). Motivational interviewing with problem drinkers. Behavioural Psychotherapy, 11(2), 147–172. https://doi.org/10.1017/S0141347300006583.
- Miller, W. R., & Taylor, C. A. (1980). Relative effectiveness of bibliotherapy, individual and group self-control training in the treatment of problem drinkers. Addictive Behaviors, 5(1), 13–24.Google Scholar
- Miller, W. R., & Hester, R. K. (1986). The effectiveness of alcoholism treatment: What research reveals (pp. 121–173). New York, NY: Plenum.Google Scholar
- Moore, T. H., Zammit, S., Lingford-Hughes, A., Barnes, T. R., Jones, P. B., Burke, M., & Lewis, G. (2007). Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. The Lancet, 370(9584), 319–328.Google Scholar
- Norberg, M. M., Kezelman, S., & Lim-Howe, N. (2013). Primary prevention of cannabis use: a systematic review of randomized controlled trials. PLoS One, 8(1), e53187.Google Scholar
- Nutt, D. J., King, L. A., & Phillips, L. D. (2010). Drug harms in the UK: a multicriteria decision analysis. The Lancet, 376(9752), 1558–1565.Google Scholar
- Palfai, T. P., Saitz, R., Winter, M., Brown, T. A., Kypri, K., Goodness, T. M., O’Brien, L. M., & Lu, J. (2014). Web-based screening and brief intervention for student marijuana use in a university health center: pilot study to examine the implementation of eCHECKUP TO GO in different contexts. Addictive Behaviors, 39(9), 1346–1352. https://doi.org/10.1016/j.addbeh.2014.04.025.Google Scholar
- Sanchez-Craig, M., Annis, H. M., Bronet, A. R., & MacDonald, K. R. (1984). Random assignment to abstinence and controlled drinking: evaluation of a cognitive-behavioral program for problem drinkers. Journal of Consulting and Clinical Psychology, 52(3), 390–403.Google Scholar
- Scottish Intercollegiate Guidelines Network (2018). Methodology checklist 2: randomized controlled trials. Retrieved February 3, 2018, from https://www.sign.ac.uk/checklists-and-notes.html.
- Sobell, M. B., & Sobell, L. C. (1993). Problem drinkers: guided self-change treatment. New York: Guilford Press.Google Scholar
- Substance Abuse and Mental Health Services Administration. (1999). Treatment Improvement Protocol (TIP) Series, No. 34. Rockville: Center for Substance Abuse Treatment.Google Scholar
- The National Academies of Sciences, Engineering, and Medicine. (2016). The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for research. Washington, WA: The National Academies Press.Google Scholar
- United Nations Office on Drugs and Crime (2017). World drug report 2017 global overview of drug demand and supply: latest trends, cross-cutting issues. United Nations. Retrieved January 22, 2018, from https://www.unodc.org/wdr2017/field/Booklet_2_HEALTH.pdf.
- Werch, C. E., Moore, M. J., Bian, H., DiClemente, C. C., Ames, S. C., Weiler, R. M., Thombs, D., Pokorny, S. B., & Huang, I. (2008). Efficacy of a brief image-based multiple-behavior intervention for college students. Annals of Behavioral Medicine, 36(2), 149–157. https://doi.org/10.1007/s12160-008-9055-6.Google Scholar
- Wettlaufer, A., Florica, R. O., Asbridge, M., Beirness, D., Brubacher, J., Callaghan, R., Fischer, B., Gmel, G., Imtiaz, S., Mann, R. E., McKiernan, A., & Rehm, J. (2017). Estimating the harms and costs of cannabis-attributable collisions in the Canadian provinces. Drug and Alcohol Dependence, 173, 185–190. https://doi.org/10.1016/j.drugalcdep.2016.12.024.Google Scholar
- Wickens, C. M., Flam-Zalcman, R., Stoduto, G., Docherty, C., Watson, T. M., Van der Maas, M., & Thomas, R. K. (2017). The impact of remedial programme participation on convicted drinking drivers’ alcohol and other drug use 6 months following programme completion. International Journal of Mental Health and Addiction, 16(3), 598–616. https://doi.org/10.1007/s11469-017-9799-y.Google Scholar
- Wickens, C. M., Flam-Zalcman, R., Mann, R. E., Stoduto, G., Nochajski, T., Koski-Jännes, A., & LaFontaine, S. (2018). Evaluating moderators of beneficial effects of severity-based assignment to substance use treatments in impaired drivers. Journal of Substance Abuse Treatment, 93, 49–56.Google Scholar