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

The takeaway

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.

Addiction researchers designing clinical trials, clinicians treating cannabis use disorder, and people trying to reduce their cannabis use.

Risk level reduction showed substantial effect on cannabis problems (eta-squared = .12)

What the researchers 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.

Why it 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 numbers in context

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 the study worked

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.

What this study cannot 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.

How to read the evidence

Moderate: secondary analysis of a well-designed RCT with 225 participants, but risk levels are researcher-defined and not yet externally validated.

When this study was published

Published in 2022.

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.

Questions still open

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?

Common 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 the original research

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

View on PubMed ↗Publisher’s paper ↗

Citation

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