Evidence-based treatments for adolescents with cannabis use disorders in the Spanish Public Health System

• Published in: International journal of clinical and health psychology 2014-09, Vol.14 (3), p.186-194
• Main Authors: Fernández-Artamendi, Sergio, Fernández-Hermida, José Ramón, Godley, Mark D., Secades-Villa, Roberto
• Format: Article
• Language: English
• Subjects: Adolescentes; Adolescents; Aproximación de reforzamiento comunitario; Cannabis; Community Reinforcement Approach; Contingency Management; Control de contingencias; Drug use; Estudio cuasi-experimental; Public health; Quasi-experimental study; Studies; Substance abuse treatment; Teenagers; Vouchers
• ISSN: 1697-2600; 2174-0852
• DOI: 10.1016/j.ijchp.2014.04.001

The goal of the present study is to describe the implementation of two Evidence-based treatments (EBT) for adolescent Cannabis Use Disorders (CUD) in the Spanish Public Health System, and its main clinical outcomes. Adolescent Community Reinforcement Approach (A-CRA) and Contingency Management (CM) were chosen as the most efficacious treatment programs for this population. A total of 26 adolescent cannabis users entered the study (91.7% male; age=16.50) at two outpatient clinical facilities in Spain. A quasi-experimental design was utilized, with one group receiving A-CRA only and the other A-CRA+CM. Implementation of both EBTs resulted feasible, with positive clinical outcomes. Results indicated that A-CRA has positive retention (81.3%) and abstinence rates (68.8%). Results for the group receiving A-CRA+CM were not significantly better than A-CRA in retention (100%) or abstinence (75.5%), although sample is too small to establish firm conclusions. Cannabis-related problems and depressive symptomatology also decreased during treatment. Several limitations prevent us from determining the clinical efficacy of A-CRA in this study. The process of translating EBT's to clinical contexts presented with many difficulties that need to be overcome. Recommendations are made for further attempts to implement EBTs in these contexts. El objetivo de este estudio era describir la implementación en el Sistema Público de Salud de dos programas basados en la evidencia (PBE) para adolescentes con trastornos por consumo de cannabis, y sus principales resultados. La Aproximación de Reforzamiento Comunitario para Adolescentes (A-CRA) y el Control de Contingencias (MC) fueron elegidos como los programas de intervención más eficaces para esta población. Un total de 26 adolescentes participaron en el estudio (91.7% chicos; edad media=16.50 años) en dos centros de carácter ambulatorio en España. Se utilizó un diseño cuasi-experimental, donde un grupo recibió A-CRA y el otro A-CRA+MC. La implementación de ambos programas resultó factible, con resultados clínicos positivos. El A-CRA ofreció buenas tasas de retención (81.3%) y abstinencia (68.6%). Los resultados del grupo A-CRA+MC no fueron significativamente mejores que los del A-CRA en retención (100%) o abstinencia (75.5%), aunque el limitado tamaño muestral no permite establecer conclusiones firmes. Los problemas asociados al cannabis y la sintomatología depresiva se redujeron durante el tratamiento. Varias limitaciones nos impiden