Reducing cannabis use risk level was linked to less anxiety and fewer cannabis-related problems

In a 225-person clinical trial, reducing cannabis use frequency and quantity to lower risk levels was associated with decreased anxiety, depression, and cannabis-related problems.

Sherman, Brian J et al.·Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors·2022·Moderate EvidenceRandomized Controlled Trial
RTHC-04216Randomized Controlled TrialModerate Evidence2022RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Randomized Controlled Trial
Evidence
Moderate Evidence
Sample
N=225

What This Study Found

Cannabis risk levels based on frequency and quantity were sensitive to reductions in use. Greater magnitude of risk level reduction was associated with greater decreases in depression, anxiety, and cannabis-related problems.

Key Numbers

225 treatment-seeking adults (mean age 30.6, 70.2% male, 42.2% non-White). Risk level changes from baseline to end-of-treatment were significant for both frequency (p=.004) and quantity (p<.001). Effect sizes for cannabis-related problems were substantial (partial eta-squared = .12).

How They Did This

Secondary analysis of a 12-week double-blind randomized placebo-controlled medication trial for cannabis cessation (N=225). Frequency and quantity defined high-, medium-, and low-risk levels. Anxiety and depression assessed with HADS; problems with the Marijuana Problems Scale.

Why This Research Matters

Since most CUD treatment trials fail to achieve abstinence, identifying clinically meaningful reduction targets gives researchers and clinicians a more realistic way to measure treatment success.

The Bigger Picture

This study supports the idea that abstinence is not the only meaningful outcome in cannabis use disorder treatment. Reducing use to lower risk levels produces measurable functional improvements.

What This Study Doesn't Tell Us

Secondary analysis of a trial designed for cessation, not reduction. Risk levels were defined by the researchers and not yet validated externally. The 12-week timeframe may not capture long-term outcomes.

Questions This Raises

  • ?Should clinical trials for CUD adopt risk reduction as a primary endpoint?
  • ?What specific frequency and quantity thresholds define clinically meaningful risk levels?
  • ?Would these findings hold in longer-term follow-up?

Trust & Context

Key Stat:
Risk level reduction showed substantial effect on cannabis problems (eta-squared = .12)
Evidence Grade:
Moderate: secondary analysis of a well-designed RCT with 225 participants, but risk levels are researcher-defined and not yet externally validated.
Study Age:
Published in 2022.
Original Title:
Evaluating cannabis use risk reduction as an alternative clinical outcome for cannabis use disorder.
Published In:
Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, 36(5), 505-514 (2022)
Database ID:
RTHC-04216

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled TrialGold standard for testing treatments
This study
Cohort / Case-Control
Cross-Sectional / Observational
Case Report / Animal Study

Participants are randomly assigned to treatment or placebo groups to test cause and effect.

What do these levels mean? →

Frequently Asked Questions

What counts as a risk level reduction?

The researchers defined high, medium, and low risk levels based on both frequency (days per week) and quantity (grams per using day). Moving from a higher to a lower category counted as a risk level reduction.

Why is this approach important?

Abstinence is rarely achieved in CUD treatment trials. If reducing use to lower levels produces meaningful improvements in functioning, it provides a more achievable and still clinically valuable treatment goal.

Did reducing frequency or quantity matter more?

Both were associated with improvements. Frequency-based risk reduction was linked to less depression, anxiety, and cannabis problems. Quantity-based reduction was linked to less anxiety and fewer problems.

Read More on RethinkTHC

Cite This Study

RTHC-04216·https://rethinkthc.com/research/RTHC-04216

APA

Sherman, Brian J; Sofis, Michael J; Borodovsky, Jacob T; Gray, Kevin M; McRae-Clark, Aimee L; Budney, Alan J. (2022). Evaluating cannabis use risk reduction as an alternative clinical outcome for cannabis use disorder.. Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, 36(5), 505-514. https://doi.org/10.1037/adb0000760

MLA

Sherman, Brian J, et al. "Evaluating cannabis use risk reduction as an alternative clinical outcome for cannabis use disorder.." Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, 2022. https://doi.org/10.1037/adb0000760

RethinkTHC

RethinkTHC Research Database. "Evaluating cannabis use risk reduction as an alternative cli..." RTHC-04216. Retrieved from https://rethinkthc.com/research/sherman-2022-evaluating-cannabis-use-risk

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.