Motivational interviewing in primary care revealed why teens use cannabis: mainly emotional coping | Research

The takeaway

In motivational therapy sessions with 56 frequently cannabis-using youth, most reported using primarily for emotional coping, identified education/career goals as their one-year priorities, and recognized that using less cannabis would help them achieve their goals.

Clinicians working with teens, parents wanting to understand teen cannabis use motivations, and anyone interested in practical approaches to youth cannabis reduction.

Top reason for teen cannabis use: emotional coping; top goal: education/career progress

What the researchers found

Most youth reported their main reason for cannabis use was emotional coping. Negative feelings were a top-3 trigger. Distraction was the most common alternative strategy. Education/career was the most common one-year goal. Over half identified family as a very important value. Top pros of using less: achieving goals, self-improvement, saving money.

Why it matters

This shows that frequent young cannabis users are not apathetic. They have goals, values, and ambivalence about their use. Meeting them with motivational therapy in primary care can elicit this information and create leverage for change.

The numbers in context

56 completed session 1, 46 completed session 2. Main reason: emotional coping. Top trigger: negative feelings. Alternative: distraction. 1-year goals: education/career. Most important value: family (>50%). Contemplation group: relationships were both pro and con of change.

How the study worked

Content analysis of two Motivational Enhancement Therapy (MET) sessions with 56 primary care patients aged 15-24 using cannabis 3+ times/week, comparing youth in pre-contemplation versus contemplation stages of change.

What this study cannot tell us

Pilot study without a control group measuring outcomes. Small sample. Self-reported information in a therapeutic context may be subject to social desirability. Brief 2-session intervention.

How to read the evidence

Preliminary: pilot study characterizing MET content without outcome measurement.

When this study was published

Published in 2019.

The bigger picture

The fact that emotional coping is the primary driver of frequent teen cannabis use suggests that teaching better coping skills, not just warning about cannabis, should be central to prevention. Primary care is an underutilized setting for these conversations.

Questions still open

Does the information gathered in MET sessions translate to actual behavior change? Would teaching emotional regulation skills reduce cannabis use better than information-based prevention? Could MET in primary care be scaled?

Common questions

Why do teens use cannabis frequently?

In this study, emotional coping was the primary reason. Negative feelings were a top trigger. Notably, these same teens had clear goals around education and career and recognized that using less cannabis would help them achieve those goals.

Can talking about cannabis in a doctor's office help?

This study suggests yes. Brief motivational therapy in primary care revealed teens' goals, values, and ambivalence about use, creating natural leverage points for change without lecturing or confrontation.

Read the original research

Engaging Youth (Adolescents and Young Adults) to Change Frequent Marijuana Use: Motivational Enhancement Therapy (MET) in Primary Care.

Journal of pediatric nursing, 49, 24-30

View on PubMed ↗Publisher’s paper ↗

Citation

Kells, Meredith; Burke, Pamela J; Parker, Sarah; Jonestrask, Cassandra; Shrier, Lydia A. (2019). Engaging Youth (Adolescents and Young Adults) to Change Frequent Marijuana Use: Motivational Enhancement Therapy (MET) in Primary Care.. Journal of pediatric nursing, 49, 24-30. https://doi.org/10.1016/j.pedn.2019.08.011