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

The takeaway

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.

Read this if you are trying to quit cannabis and want to understand how your thinking about slip-ups affects your chances of getting back on track.

Internal and global attributions for a lapse predicted marijuana use over 6 months

What the researchers 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.

Why it 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 numbers in context

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 the study worked

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.

What this study cannot 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.

How to read the evidence

A prospective analysis within a treatment trial with 6-month follow-up. Good design for testing the AVE construct but limited sample size.

When this study was published

Published in 1994. Treatment approaches for cannabis use disorder have evolved, though attribution-focused interventions remain underexplored.

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.

Questions still open

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?

Common 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 the original research

Testing the abstinence violation effect construct with marijuana cessation.

Addictive behaviors, 19(1), 23-32

View on PubMed ↗

Citation

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.