Mindfulness therapy added to standard inpatient treatment did not outperform standard care for adolescent cannabis use disorder | Research

The takeaway

In an RCT of 84 adolescent inpatients with cannabis use disorder, adding mindfulness-based group therapy to standard treatment did not produce better cannabis use outcomes at 6 months, though both groups showed significant reductions.

Adolescent addiction treatment providers, inpatient program designers, and mindfulness intervention researchers

Both groups reduced cannabis use; standard care performed as well or better

What the researchers found

Both groups showed significant reductions in cannabis use days at 6-month follow-up (effect sizes d = -0.72 and -0.75). While mindfulness therapy showed minor initial benefits for craving and severity, standard treatment alone showed greater reduction in severity (d = 0.78) and reward craving (d = 0.28) at 6 months. Mindfulness therapy did improve self-regulation skills. Systematic dropout was observed in the mindfulness group.

Why it matters

Despite high relapse rates in adolescent cannabis treatment, this study found standard inpatient care is already effective, and adding mindfulness therapy did not improve cannabis outcomes despite being feasible and well-received.

The numbers in context

84 adolescent inpatients; both groups reduced cannabis use days at 6 months (d = -0.72 and -0.75); TAU better at reducing SUD severity (d = 0.78) and reward craving (d = 0.28); Mind it! better for mindfulness/self-regulation (d = 0.27); systematic dropout in Mind it! group

How the study worked

Randomized controlled trial of 84 adolescent inpatients (15-19 years) with cannabis use disorder in Germany. Participants received standard multi-component treatment (TAU) with or without an add-on mindfulness-based group therapy ("Mind it!"). Assessments at pre-, post-, and 6-month follow-up.

What this study cannot tell us

Small sample size (84); systematic dropout in mindfulness group; single-site German inpatient setting; 6-month follow-up may be too short; cannot determine which TAU components drove the effect; cultural context may not generalize

How to read the evidence

Registered RCT with validated outcomes, but small sample, systematic dropout in intervention group, and single-site design.

When this study was published

2024 study, registered 2018

The bigger picture

The strong performance of standard treatment and the dropout issues with mindfulness therapy suggest that existing evidence-based programs for adolescent cannabis use disorder may already be near-optimal, and that adherence to add-on interventions is a key challenge.

Questions still open

Would outpatient or digital mindfulness approaches have better adherence? Could mindfulness-related self-regulation skills provide long-term benefits not captured at 6 months?

Common questions

Did mindfulness help adolescents quit cannabis?

Not more than standard treatment. Both groups significantly reduced cannabis use days at 6 months with similar effect sizes. Standard treatment alone actually showed better reductions in cannabis use disorder severity and reward craving at follow-up.

Was there any benefit to the mindfulness addition?

Mindfulness therapy did show some minor early benefits for craving reduction and improved self-regulation skills (mindfulness) at 6-month follow-up. However, a systematic dropout pattern in the mindfulness group was concerning, suggesting adherence challenges for this intervention format in adolescent inpatients.

Read the original research

Mind it! A mindfulness-based group psychotherapy for substance use disorders in adolescent inpatients.

European child & adolescent psychiatry, 33(12), 4205-4217

View on PubMed ↗Publisher’s paper ↗

Citation

Legenbauer, Tanja; Baldus, Christiane; Jörke, Carina; Kaffke, Lara; Pepic, Amra; Daubmann, Anne; Zapf, Antonia; Holtmann, Martin; Arnaud, Nicolas; Thomasius, Rainer. (2024). Mind it! A mindfulness-based group psychotherapy for substance use disorders in adolescent inpatients.. European child & adolescent psychiatry, 33(12), 4205-4217. https://doi.org/10.1007/s00787-024-02465-z