How People Explained Their First Marijuana Lapse Predicted Whether They Returned to Regular Use

Among 75 adults who lapsed after marijuana cessation treatment, those who blamed themselves, saw the cause as permanent, and believed it affected everything were significantly more likely to relapse fully over the next six months.

Stephens, R S et al.·Addictive behaviors·1994·Moderate EvidenceProspective Cohort
RTHC-00051Prospective CohortModerate Evidence1994RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Prospective Cohort
Evidence
Moderate Evidence
Sample
N=75

What This Study Found

Researchers tested the Abstinence Violation Effect (AVE) theory with marijuana users. The AVE proposes that how someone interprets their first lapse after attempting to quit determines whether they return to regular use.

Seventy-five adults who completed either relapse prevention or social support treatment for marijuana dependence subsequently lapsed. The study examined how their attributions for the lapse related to outcomes.

Those who attributed the lapse to internal causes (their own fault), stable causes (permanent factors), and global causes (affecting all areas of life) were significantly more likely to report concurrent relapse. Perceived loss of control during the lapse also predicted relapse.

Further, internal and global attributions predicted marijuana use over the subsequent six months, suggesting these thinking patterns had lasting effects on behavior. Notably, the relapse prevention treatment, which was designed to modify these attributions, did not successfully change how participants reacted to their lapses.

Key Numbers

75 adults who lapsed. Two treatment conditions: relapse prevention and social support. Three attribution dimensions measured: internal, stable, global. Follow-up: 6 months post-lapse.

How They Did This

Prospective analysis within a treatment trial. Seventy-five adults who lapsed after completing either relapse prevention or social support group treatment for marijuana cessation. Attributions, guilt, and perceived control were assessed at the time of lapse. Marijuana use was tracked for six months following the lapse.

Why This Research Matters

This study demonstrated that cognitive patterns around relapse, specifically how people explain their slip-ups, play a meaningful role in marijuana cessation outcomes. The finding that relapse prevention treatment failed to modify these patterns identified a gap in existing treatment approaches.

The Bigger Picture

The Abstinence Violation Effect has been extensively studied with alcohol and other substances. This study extended it to marijuana, suggesting that the psychological mechanisms of relapse are similar across substance types and that addressing self-blame and catastrophic thinking after a lapse could improve cessation outcomes.

What This Study Doesn't Tell Us

Relatively small sample. The assessment of attributions at the time of lapse may have been influenced by current use status. The study cannot determine whether attributions caused relapse or whether imminent relapse shaped how people explained their lapse.

Questions This Raises

  • ?Can intervention at the point of lapse change attribution patterns and improve outcomes?
  • ?Why did relapse prevention treatment fail to modify reactions to lapse?
  • ?Would cognitive-behavioral techniques focused specifically on attribution modification be more effective?

Trust & Context

Key Stat:
Internal and global attributions for a lapse predicted marijuana use over 6 months
Evidence Grade:
A prospective analysis within a treatment trial with 6-month follow-up. Good design for testing the AVE construct but limited sample size.
Study Age:
Published in 1994. Treatment approaches for cannabis use disorder have evolved, though attribution-focused interventions remain underexplored.
Original Title:
Testing the abstinence violation effect construct with marijuana cessation.
Published In:
Addictive behaviors, 19(1), 23-32 (1994)
Database ID:
RTHC-00051

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Enrolls participants and follows them forward in time.

What do these levels mean? →

Frequently Asked Questions

What is the abstinence violation effect?

The idea that how someone explains their first slip-up after quitting (blaming themselves, seeing it as permanent) influences whether they return to regular use. Self-blame and loss of control predicted full relapse.

Did relapse prevention treatment help?

Not for this specific mechanism. Relapse prevention treatment did not successfully modify how participants reacted to their lapses, suggesting this is a difficult pattern to change.

Read More on RethinkTHC

Cite This Study

RTHC-00051·https://rethinkthc.com/research/RTHC-00051

APA

Stephens, R S; Curtin, L; Simpson, E E; Roffman, R A. (1994). Testing the abstinence violation effect construct with marijuana cessation.. Addictive behaviors, 19(1), 23-32.

MLA

Stephens, R S, et al. "Testing the abstinence violation effect construct with marijuana cessation.." Addictive behaviors, 1994.

RethinkTHC

RethinkTHC Research Database. "Testing the abstinence violation effect construct with marij..." RTHC-00051. Retrieved from https://rethinkthc.com/research/stephens-1994-testing-the-abstinence-violation

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.