Young Psychosis Patients Kept Using Cannabis Because They Lacked Alternative Coping Strategies | Research

The takeaway

Focus groups with 16 young adults with first-episode psychosis found that despite recognizing cannabis conflicted with their life goals, most continued using because they lacked replacement strategies for social connection, enjoyment, and mood management.

Psychiatrists and therapists working with early psychosis patients; substance use intervention designers; peer support programs.

Patients knew cannabis conflicted with goals but had no replacement coping strategies

What the researchers found

Participants recognized that cannabis use conflicted with their life goals but maintained use because they perceived it as facilitating social interactions, enjoyable activities, and improved mental health. The primary barrier to quitting was having no replacement strategies to compensate for these perceived benefits.

Why it matters

No evidence-based treatment effectively addresses cannabis use disorder in first-episode psychosis. Understanding why patients keep using, despite knowing the risks, points to specific intervention targets: teaching alternative social skills, activity planning, and mood management.

The numbers in context

16 young adults, mean age 23.7. Average cannabis use: 11.8 days in past 30. Study used 3 focus groups and 3 individual interviews. Participants identified social facilitation, enjoyable activities, and mood improvement as primary reasons for continued use.

How the study worked

Three online focus groups and 3 individual interviews with 16 young adults with first-episode psychosis (mean age 23.7) who had used cannabis an average of 11.8 days in the past month. Data analyzed using theory of planned behavior framework with content and thematic analysis.

What this study cannot tell us

Small qualitative sample of 16 participants from a specific clinical context. Self-reported perceptions of cannabis benefits may not reflect actual effects. The theory of planned behavior framework may not capture all relevant factors.

How to read the evidence

Preliminary: small qualitative study providing rich contextual data but limited generalizability.

When this study was published

Published in 2022.

The bigger picture

This study shifts the conversation from "why won't they stop?" to "what would they need to stop?" The answer is not more warnings about risks (patients already know) but concrete alternative strategies for the functions cannabis serves in their lives.

Questions still open

Would interventions that build social skills and activity scheduling reduce cannabis use in this population? Do the perceived benefits of cannabis (social facilitation, mood improvement) persist over time, or do patients gradually recognize diminishing returns?

Common questions

Why do people with psychosis keep using cannabis?

In this study, participants used cannabis for social connection, enjoyable activities, and mood regulation. They were aware of risks but continued because they had no alternative strategies that served the same functions.

What would help psychosis patients stop using cannabis?

The findings suggest that rather than focusing on risks (which patients already understand), interventions should teach concrete replacement strategies: building social skills, scheduling enjoyable activities, and developing mood management techniques.

Read the original research

Young adults with psychosis: Intentions for cannabis reduction and cessation based on theory of planned behavior.

Psychiatric rehabilitation journal, 45(4), 352-361

View on PubMed ↗Publisher’s paper ↗

Citation

Petros, Ryan; Walker, Denise D; Davis, Adam; Monroe-DeVita, Maria. (2022). Young adults with psychosis: Intentions for cannabis reduction and cessation based on theory of planned behavior.. Psychiatric rehabilitation journal, 45(4), 352-361. https://doi.org/10.1037/prj0000542