Brief incentivized abstinence changed cannabis attitudes and reduced use even after incentives stopped

Abstinence-incentivized participants showed significant reductions in cannabis use frequency and biochemically verified THC metabolites at 4-week follow-up compared to monitoring-only controls. 68.4% of abstinence participants set goals to reduce or quit after the intervention. Those without CUD who set reduction goals showed the greatest decreases.

Randomized trial of 220 non-treatment-seeking youth. 126 randomized to 4-week abstinence-based contingency management (incentivized) and 94 to monitoring only. Cannabis use measured by self-report and creatinine-adjusted urine THC-COOH at baseline, end of intervention, and 4-week follow-up.

Most young cannabis users are not seeking treatment. This study shows that a brief period of incentivized abstinence can shift attitudes and reduce use even in youth who were not motivated to change, suggesting a viable harm reduction strategy.

Contingency management is well-established for other substances but underused for cannabis. This study demonstrates it can generate motivation to change even in people who were not looking for help, which could be valuable as cannabis use becomes more normalized.

Relatively short follow-up (4 weeks post-intervention). Youth without CUD responded best, so this may be less effective for those with established disorders. Financial incentives may not be scalable in all settings. Cannot determine durability beyond 4 weeks.