Developments in the treatment of cannabis use disorder

Purpose of review To describe recent developments in the treatment of cannabis abuse and dependence in the general and special populations. Recent findings The research literature on randomised controlled trials of interventions for cannabis use disorder is only a decade old. In the past year only one such trial has been accepted for publication. This trial of cognitive-behavioural interventions compared two sessions of motivational enhancement therapy with nine sessions of a multi-component therapy that added cognitive-behavioural therapy and case management. At 4 months from randomisation the nine-session treatment reduced cannabis smoking and associated consequences, such as dependence symptoms, significantly more than the two-session treatment, which significantly reduced cannabis use relative to the delayed treatment controlled condition. At 15 months follow-up the superior outcome for the more intensive intervention had dissipated; however, a significant improvement from baseline was maintained. There were no sex or ethnic differences in treatment outcome. These findings are consistent with those of similar trials. Summary There is a paucity of research into pharmacological and psychological interventions for cannabis use disorder. There are no accepted pharmacotherapies available. Whereas relatively brief cognitive-behavioural therapy has the strongest evidence of success for adults with cannabis dependence, among adolescents involved in the juvenile justice system and those with severe, persistent mental illness, longer and more intensive therapies provided by interdisciplinary teams may be required.