Women with children who used cannabis before treatment were most likely to drop out | Research

The takeaway

Among 3,814 cannabis use disorder outpatients, females with children who used cannabis in the month before treatment had the lowest treatment adherence, while pre-treatment use predicted worse outcomes for women more than men.

People interested in gender differences in cannabis use disorder treatment and barriers to treatment completion.

Having children predicted dropout specifically for women, not men

What the researchers found

Sex moderated the relationship between number of children and treatment adherence: having more children predicted lower adherence specifically in females. Pre-treatment cannabis use also predicted lower adherence more strongly in females. Women with children were more likely to drop out of treatment compared to men with children.

Why it matters

Understanding why women drop out of cannabis treatment at higher rates can inform targeted interventions. The finding that childcare responsibilities specifically predict female dropout suggests practical barriers, not just clinical factors, drive the gender gap.

The numbers in context

3,814 outpatients with cannabis use disorder. Sex moderated effects of children and pre-treatment use on adherence. Females with children: higher dropout. Pre-treatment cannabis use: stronger negative effect on adherence for females.

How the study worked

Multicentric retrospective observational study of 3,814 outpatients diagnosed with cannabis use disorder. Electronic health records analyzed for treatment admission characteristics, adherence, and discharge outcomes. Moderation analyses tested sex as a moderator.

What this study cannot tell us

Retrospective design with electronic health records that may have missing data. Cannot determine specific reasons for dropout. Cultural factors from the study country may not generalize. Pre-treatment cannabis use was binary (yes/no) without dose information.

How to read the evidence

Large multicentric study with moderation analysis. Limited by retrospective design and administrative data sources.

When this study was published

Published in 2024 in Addictive Behaviors.

The bigger picture

Cannabis treatment research has paid insufficient attention to gender-specific barriers. This large multicentric study identifies actionable targets: childcare support and pre-treatment engagement for women with children could improve treatment completion rates.

Questions still open

Would providing childcare during treatment sessions improve female adherence? Should treatment intensity be adjusted based on pre-treatment cannabis use for women? What other practical barriers drive the gender gap in treatment retention?

Common questions

Do men and women respond differently to cannabis treatment?

In this study of nearly 4,000 patients, women were more likely to drop out, particularly those with children and those who used cannabis in the month before starting treatment. Men were less affected by these factors.

What can improve treatment for women with cannabis use disorder?

The authors suggest enhanced contingency management programs for women with children, along with sex-sensitive therapist training. Addressing practical barriers like childcare could improve treatment retention.

Read the original research

The moderating role of sex in the relationship between cannabis use treatment admission profile and treatment processes and outcomes: A gender perspective.

Addictive behaviors, 157, 108103

View on PubMed ↗Publisher’s paper ↗

Citation

Dacosta-Sánchez, Daniel; Michelini, Yanina; Pilatti, Angelina; Fernández-Calderón, Fermín; Lozano, Óscar M; González-Ponce, Bella M. (2024). The moderating role of sex in the relationship between cannabis use treatment admission profile and treatment processes and outcomes: A gender perspective.. Addictive behaviors, 157, 108103. https://doi.org/10.1016/j.addbeh.2024.108103