No Evidence-Based Intervention Effectively Reduces Cannabis Use in Young Adults With Psychosis, Review Finds | Research

The takeaway

A scoping review found that no intervention has been proven to effectively reduce cannabis use in young adults with psychosis, though motivational interviewing, CBT, and family skills training show at least minimal evidence.

Clinicians treating early psychosis, addiction specialists, young adults with psychosis who use cannabis.

No evidence-based intervention proven effective for cannabis reduction in youth with psychosis

What the researchers found

Young adults with psychosis use cannabis for pleasure, to reduce dysphoria, and for social reasons. Motivations for cessation include insight about cannabis-psychosis interactions, incompatibility with goals, and social support. Interventions with at least minimal evidence include motivational interviewing, cognitive-behavioral strategies, and family skills training. No intervention has demonstrated robust effectiveness in this population.

Why it matters

Cannabis use in young adults with psychosis is extremely common and associated with worse outcomes, yet clinicians have no proven intervention to offer. Understanding why this population uses cannabis and what motivates them to stop could inform better-designed interventions.

The numbers in context

3,216 articles screened. 46 included. Use motivations: pleasure, dysphoria reduction, social/recreational. Cessation motivations: insight about cannabis-psychosis link, goal incompatibility, social support. Motivational interviewing, CBT, and family skills training have minimal evidence.

How the study worked

Scoping review with systematic literature search in December 2022. Screened 3,216 titles/abstracts and 136 full texts, resulting in 46 included articles on motivations for use/cessation and psychosocial interventions.

What this study cannot tell us

Scoping review cannot assess intervention quality as rigorously as a systematic review. Heterogeneous study designs. Many studies had small samples. Publication bias may favor positive results.

How to read the evidence

Comprehensive scoping review of 46 articles, limited by heterogeneous study quality and lack of robust evidence for any intervention.

When this study was published

Published 2023.

The bigger picture

The treatment gap for cannabis use in psychosis is striking given how common and harmful the combination is. The review suggests future interventions should be matched to specific motivations: behavioral activation for pleasure-seeking, family interventions for social support, and motivational approaches for building insight.

Questions still open

Would interventions matched to specific use motivations be more effective?
Can family-based approaches leverage social networks that motivate cessation?

Common questions

Why do young people with psychosis use cannabis?

This review found they use cannabis for pleasure, to reduce negative feelings, and for social reasons. They are motivated to stop when they understand the cannabis-psychosis connection and when it conflicts with their goals.

What treatments help reduce cannabis use in psychosis?

No intervention has been proven robustly effective. Motivational interviewing, cognitive-behavioral strategies, and family skills training show the most promise but need more research.

Read the original research

Scoping Review of Cannabis-Reduction Psychosocial Interventions and Reasons for Use among Young Adults with Psychosis.

Journal of dual diagnosis, 19(2-3), 124-150

View on PubMed ↗Publisher’s paper ↗

Citation

Petros, Ryan; Walker, Denise D; Pierce, Adam; Monroe-DeVita, Maria. (2023). Scoping Review of Cannabis-Reduction Psychosocial Interventions and Reasons for Use among Young Adults with Psychosis.. Journal of dual diagnosis, 19(2-3), 124-150. https://doi.org/10.1080/15504263.2023.2226024