Digital outreach for problematic cannabis users
Digital interventions can be effective in reducing problematic cannabis use.
That’s the conclusion of a new systematic review and meta-analysis of Digital Interventions for Problematic Cannabis Users in Non-Clinical Settings published n the May 2016 edition of European Addiction Research.
The authors, Eva Hoch, Ulrich Preuss, Marica Ferri & Roland Simon, undertook the review because traditional cannabis-treatment services are only able to reach a small proportion of people with cannabis-related problems.
The researchers identified 52 studies of which just four met their inclusion criteria (essentially randomised controlled trials examining the effects of internet- or computer-based interventions).
The four studies (one in the USA, one in Australia, two in Europe) were all web-based and are summarised as:
- A web-based screening followed by a brief motivational intervention tested on 341 17-19 college students
- A web-based screening followed by a web-based motivational interview aimed at 67 adult users recruited online
- A fully self-guided web-based intervention with 6 modules of motivational enhancement and CBT to 230 individuals recruited on and offline
- An online chat-based intervention with 1292 users recruited online
The research concentrated mainly on whether these interventions resulted in a reduction in cannabis use (measured via self-report).
The researchers found that web- and computer-based interventions can be effective at reducing cannabis use. All four studies were conducted using participants drawn from the general population. They targeted older adolescents and adults with problematic cannabis use.
The largest treatment effects were found for the web-based online chat with a trained psychotherapist, plus online diary with weekly personalized, written feedback based on CBT/Motivational Interviewing.
The smallest treatment effects were found in relation to a study that provided a brief web-based screening followed by a brief web-based personalized feedback intervention. The intervention was probably less effective in reducing cannabis use due to the short duration of the intervention and the lack of contact between students and a drug counselor.
The researchers argue that the fact that very few problematic cannabis users make use of the traditional addiction treatment system, public health systems are faced with the challenge of reaching out to individuals who use cannabis to a risky or harmful degree, but are not motivated to seek treatment.
The main reasons for low levels of treatment-seeking among cannabis users include lack of interest in, knowledge of, or motivation to seek treatment; a lack of treatment centres; long waiting times; high cost of treatment; problems meeting program eligibility criteria; and transport. However, the most frequently reported barrier to entry into treatment is the stigma stemming from being labeled as an illicit drug user, along with the associated privacy concerns.
The researchers therefore advocate the use of digital interventions for problematic cannabis users especially in areas where physical treatment facilities are scarce, including rural communities, arguing that digital interventions can be communicated and promoted through various channels, including:
- Post or email campaigns advertising cannabis use programs targeted to at-risk groups such as high school graduates, military conscripts, students in their first year of further education, and unemployed young people at job centres.
- Online advertisement through social media, search engines, and music- and video-sharing websites.
- Mobile advertising (including SMS, MMS and advertisements served and processed via online channels).
Digital treatments are a promising way of reducing problematic cannabis use outside clinical settings. Such treatments have the potential to make treatment more accessible to cannabis users in the general population, and may help overcome existing barriers to treatment.