Combined pharmacotherapy and evidence-based psychosocial Cannabis treatment for youth and selection of cannabis-using friends.
Cannabis-using friends
MET-CBT
Mediation
Peer influence
Topiramate
Journal
Drug and alcohol dependence
ISSN: 1879-0046
Titre abrégé: Drug Alcohol Depend
Pays: Ireland
ID NLM: 7513587
Informations de publication
Date de publication:
01 08 2021
01 08 2021
Historique:
received:
13
10
2020
revised:
13
02
2021
accepted:
27
03
2021
pubmed:
31
5
2021
medline:
22
9
2021
entrez:
30
5
2021
Statut:
ppublish
Résumé
Theoretical models of behavior change argue that youth should decrease their time with cannabis-using friends and increase their time with non-using friends during treatment. Informed by behavior-change models of recovery and socialization and selection peer-influence models, the current study examined whether combining evidence-based psychosocial treatment with adjunctive pharmacotherapy helps youth decrease their affiliations with cannabis-using friends and increase their affiliations with non-using friends during cannabis misuse treatment. Youth ages 15-24 years (51 % male), participated in a double-blind randomized clinical trial that tested the effects of motivational enhancement and cognitive behavioral therapy (MET-CBT) plus topiramate (N = 39) or placebo (N = 26) on cannabis craving and use. Ecological momentary assessment data, collected via smartphones throughout the six-week intervention, assessed youths' time with cannabis-using and non-using friends, cannabis use, and craving in daily life. Multiple group multilevel structural equation modeling tested study hypotheses. Across the topiramate (48 % completion rate) and placebo (77 % completion rate) conditions, greater time spent with cannabis-using friends promoted greater next day cannabis use and craving (socialization effect). In turn, cannabis craving, but not use, promoted continued selection of cannabis-using friends. This indirect effect was only supported in the placebo condition due to the selection piece of this cycle not being significant for youth who received topiramate. Neither cannabis craving nor use were associated with time with non-using friends the next day. MET-CBT and adjunctive topiramate pharmacotherapy interrupted youth selection processes. This finding suggests that changing peer affiliations could be one mechanism by which treatments can work.
Sections du résumé
BACKGROUND
Theoretical models of behavior change argue that youth should decrease their time with cannabis-using friends and increase their time with non-using friends during treatment. Informed by behavior-change models of recovery and socialization and selection peer-influence models, the current study examined whether combining evidence-based psychosocial treatment with adjunctive pharmacotherapy helps youth decrease their affiliations with cannabis-using friends and increase their affiliations with non-using friends during cannabis misuse treatment.
METHODS
Youth ages 15-24 years (51 % male), participated in a double-blind randomized clinical trial that tested the effects of motivational enhancement and cognitive behavioral therapy (MET-CBT) plus topiramate (N = 39) or placebo (N = 26) on cannabis craving and use. Ecological momentary assessment data, collected via smartphones throughout the six-week intervention, assessed youths' time with cannabis-using and non-using friends, cannabis use, and craving in daily life. Multiple group multilevel structural equation modeling tested study hypotheses.
RESULTS
Across the topiramate (48 % completion rate) and placebo (77 % completion rate) conditions, greater time spent with cannabis-using friends promoted greater next day cannabis use and craving (socialization effect). In turn, cannabis craving, but not use, promoted continued selection of cannabis-using friends. This indirect effect was only supported in the placebo condition due to the selection piece of this cycle not being significant for youth who received topiramate. Neither cannabis craving nor use were associated with time with non-using friends the next day.
CONCLUSIONS
MET-CBT and adjunctive topiramate pharmacotherapy interrupted youth selection processes. This finding suggests that changing peer affiliations could be one mechanism by which treatments can work.
Identifiants
pubmed: 34052685
pii: S0376-8716(21)00242-8
doi: 10.1016/j.drugalcdep.2021.108747
pmc: PMC8282736
mid: NIHMS1709351
pii:
doi:
Substances chimiques
Topiramate
0H73WJJ391
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
108747Subventions
Organisme : NIAAA NIH HHS
ID : F32 AA028414
Pays : United States
Organisme : NIDA NIH HHS
ID : R01 DA026778
Pays : United States
Organisme : NIAAA NIH HHS
ID : T32 AA007459
Pays : United States
Organisme : NIAAA NIH HHS
ID : K23 AA024808
Pays : United States
Organisme : NIAAA NIH HHS
ID : K24 AA026326
Pays : United States
Informations de copyright
Copyright © 2021 Elsevier B.V. All rights reserved.
Références
J Stud Alcohol Drugs. 2018 Mar;79(2):182-189
pubmed: 29553344
Addiction. 2009 Jun;104(6):927-39
pubmed: 19344442
Neuropharmacology. 2006 Jun;50(7):845-57
pubmed: 16490221
Addict Biol. 2016 Jan;21(1):171-82
pubmed: 25353306
Subst Abuse. 2019 Jun 14;13:1178221819852644
pubmed: 31236010
Drug Alcohol Depend. 2014 Oct 1;143:181-8
pubmed: 25150401
Neuron. 2011 Feb 24;69(4):695-712
pubmed: 21338880
Drug Alcohol Depend. 2016 Aug 01;165:203-12
pubmed: 27354234
J Abnorm Child Psychol. 2015 Aug;43(6):1131-43
pubmed: 25601099
PLoS One. 2014 Jun 19;9(6):e100121
pubmed: 24945357
Child Dev. 1995 Feb;66(1):139-51
pubmed: 7497821
Soc Networks. 2018 Oct;55:86-96
pubmed: 30923419
Subst Use Misuse. 2014 Feb;49(3):234-42
pubmed: 23965039
Pediatr Neurol. 2004 Nov;31(5):349-52
pubmed: 15519117
Curr Addict Rep. 2018 Jun;5(2):134-145
pubmed: 30416931
Curr Addict Rep. 2016 Jun;3(2):145-156
pubmed: 27570728
Prev Sci. 2015 Aug;16(6):832-43
pubmed: 25943034
Subst Abus. 2015;36(3):380-8
pubmed: 24960629
J Res Adolesc. 2011 Mar 1;21(1):166-179
pubmed: 23730122
Drug Alcohol Depend. 2020 Apr 1;209:107897
pubmed: 32058245
Psychol Methods. 2010 Sep;15(3):209-33
pubmed: 20822249
J Clin Psychopharmacol. 2018 Apr;38(2):134-137
pubmed: 29424802
Alcohol Clin Exp Res. 2019 Apr;43(4):578-592
pubmed: 30779445
Curr Addict Rep. 2017 Jun;4(2):90-99
pubmed: 29104847
Addict Behav. 2018 Aug;83:154-159
pubmed: 29329753
Drug Alcohol Depend. 2015 Feb 1;147:20-5
pubmed: 25578250
Nicotine Tob Res. 2014 Mar;16(3):288-96
pubmed: 24057996
Alcohol Clin Exp Res. 2008 Mar;32(3):489-97
pubmed: 18215213
Addiction. 2012 Feb;107(2):289-99
pubmed: 21917054