Integrated cognitive behavioral therapy for comorbid cannabis use and anxiety disorders: A pilot randomized controlled trial

• Published in: Behaviour research and therapy 2019-04, Vol.115, p.38-45
• Main Authors: Buckner, Julia D., Zvolensky, Michael J., Ecker, Anthony H., Schmidt, Norman B., Lewis, Elizabeth M., Paulus, Daniel J., Lopez-Gamundi, Paula, Crapanzano, Kathleen A., Bakhshaie, Jafar
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anxiety disorders; Anxiety Disorders - psychology; Anxiety Disorders - therapy; Behavior modification; Cannabis; Clinical trials; Cognitive ability; Cognitive Behavioral Therapy; Cognitive therapy; Comorbidity; Diagnosis, Dual (Psychiatry); Drug abuse; Dual diagnosis; Efficacy; Female; Help seeking behavior; Humans; Integrated treatment; Male; Marijuana; Marijuana Use - psychology; Marijuana Use - therapy; Motivation; Patients; Pilot Projects; Psychosocial factors; Psychosocial therapy; Public health; Substance abuse; Treatment Outcome; Young Adult
• ISSN: 0005-7967; 1873-622X
• DOI: 10.1016/j.brat.2018.10.014

Cannabis use disorder (CUD) is the most common illicit substance use disorder and individuals with CUD have high rates of comorbid anxiety disorders. Comorbidity between CUD and anxiety disorders is of public health relevance given that although motivation enhancement therapy (MET) combined with cognitive-behavioral therapy (CBT) is an efficacious intervention for CUD, outcomes are worse for patients with elevated anxiety. The current study tested the acceptability and efficacy of the integration of a transdiagnostic anxiety CBT (i.e., treatment of patients with any anxiety disorder) with MET-CBT (integrated cannabis and anxiety reduction treatment, or ICART) for CUD compared to MET-CBT alone. Treatment-seeking cannabis users (56.4% male, Mage = 23.2, 63.3% non-Hispanic White) with CUD and at least one comorbid anxiety disorder were randomly assigned to ICART (n = 27) or MET-CBT (n = 28). Patients in the ICART condition attended significantly more treatment sessions than those in the MET-CBT condition. Patients in the ICART condition were more likely to be abstinent post-treatment than those in MET-CBT. Further, treatment produced decreases in cannabis use and related problems. Notably, therapy type did not moderate the impact of treatment on frequency of use and related problems. Together, these data suggest that ICART may be at least as efficacious as a gold-standard psychosocial CUD treatment, MET-CBT, for a difficult-to-treat subpopulation of cannabis users. •Integrated cannabis and anxiety reduction treatment (ICART) was pilot tested.•ICART demonstrated evidence of acceptability.•ICART resulted in greater cannabis abstinence than MET-CBT.•Both ICART and MET-CBT reduced cannabis use and related problems.