Cannabis dependence is the most common illicit substance dependence in the U.S. and people with cannabis dependence are highly vulnerable to anxiety disorders. The co-occurrence of anxiety disorders among those with cannabis dependence is a pressing public health matter given elevated anxiety is related to poorer cannabis treatment outcomes. Integrative models suggest that cannabis-related problems among those with anxiety disorders may be maintained by a reliance on cannabis to manage anxiety and cannabis withdrawal. Although effort has been undertaken to evaluate treatments for cannabis dependence and anxiety disorders in isolation, investigations of the treatment of these conditions when they co-occur have been virtually absent. Motivation enhancement therapy (MET) combined with cognitive-behavioral therapy (CBT) is an efficacious intervention for cannabis dependence, yet outcomes are highly limited for anxious patients. One novel and promising approach to treating anxiety disorders is the use of transdiagnostic anxiety treatments that facilitate the treatment of patients with anxiety psychopathology regardless of the specific type of anxiety disorder. One such treatment, False Safety Behavior Elimination Treatment (FSET), may be particularly useful with cannabis dependent anxious patients as it focuses on the elimination of behaviors that may be effective in decreasing anxiety in the short-term, but can maintain and even exacerbate anxiety in the long-term (i.e., false safety behaviors). The use of cannabis to manage anxiety can, therefore, be targeted in such a treatment. The objective of this project is to test the feasibility and utility of a novel, integrated approach to treatment of patients with cannabis dependence and anxiety disorders who use cannabis as a maladaptive coping strategy. Phase I of the proposed project will feature the development and refinement of a specialized group protocol (i.e., Integrated Cannabis and Anxiety Reduction Treatment or ICART) for integrating MET-CBT for cannabis dependence with FSET. MET will be used to increase motivation to quit cannabis, CBT for cannabis dependence to teach patients skills to manage high-risk cannabis use situations, and FSET will be used to teach patients skills to manage their anxiety. The initial protocol will be modified based on the experience gained in the treatment of two groups (6 patients each) with the integrated treatment. Phase II will be a randomized controlled trial examining the relative efficacy of the refined ICART treatment (n = 30) versus MET-CBT alone (n = 30). After post-treatment assessments, the ICART group will be followed for 3 months to examine maintenance of gains;the participants originally assigned to the control condition will be offered ICART. It is hypothesized that ICART will produce better outcomes than the control. Based on the outcome of this preliminary trial, the ICART protocol will be further refined and readied for larger-scale clinical trials.

Public Health Relevance

Although people with cannabis dependence are highly vulnerable to anxiety disorders, and elevated anxiety is related to poorer cannabis dependence treatment outcomes, previous research has not examined how to effectively treat patients with co-occurring cannabis dependence and anxiety disorders. The goal of the current research is to develop and evaluate the feasibility of a specialized therapy for treating these persons. The overarching aim is to decrease cannabis use, cannabis-related problems and withdrawal symptoms, anxiety, and disability while simultaneously improving quality of life and examining possible mechanisms underlying treatment outcomes.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Planning Grant (R34)
Project #
5R34DA031937-02
Application #
8545755
Study Section
Special Emphasis Panel (ZRG1-RPIA-N (09))
Program Officer
Chambers, Jessica Campbell
Project Start
2012-09-15
Project End
2015-07-31
Budget Start
2013-08-01
Budget End
2014-07-31
Support Year
2
Fiscal Year
2013
Total Cost
$198,810
Indirect Cost
$49,690
Name
Louisiana State University A&M Col Baton Rouge
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
075050765
City
Baton Rouge
State
LA
Country
United States
Zip Code
70803
Ecker, Anthony H; Buckner, Julia D (2018) Cannabis-Related Problems and Social Anxiety: The Mediational Role of Post-Event Processing. Subst Use Misuse 53:36-41
Buckner, Julia D; Jeffries, Emily R; Crosby, Ross D et al. (2018) The impact of PTSD clusters on cannabis use in a racially diverse trauma-exposed sample: An analysis from ecological momentary assessment. Am J Drug Alcohol Abuse 44:532-542
Ecker, Anthony H; Buckner, Julia D (2018) The Interactive Influence of Social Anxiety and Experimentally Induced Postevent Processing on Cannabis Use. Transl Issues Psychol Sci 4:33-42
Buckner, Julia D; Zvolensky, Michael J; Ecker, Anthony H et al. (2018) Integrated cognitive behavioral therapy for comorbid cannabis use and anxiety disorders: A pilot randomized controlled trial. Behav Res Ther :
Buckner, Julia D; Walukevich, Katherine A; Henslee, Amber M (2018) Event-Specific Cannabis Use and Cannabis Use Motives. Subst Use Misuse 53:1093-1098
Buckner, Julia D; Walukevich, Katherine A; Lemke, Austin W et al. (2018) The Impact of University Sanctions on Cannabis Use: Individual Difference Factors that Predict Change in Cannabis Use. Transl Issues Psychol Sci 4:76-84
Buckner, Julia D; Lemke, Austin W; Walukevich, Katherine A (2017) Cannabis use and suicidal ideation: Test of the utility of the interpersonal-psychological theory of suicide. Psychiatry Res 253:256-259
Ecker, Anthony H; Dean, Kimberlye E; Buckner, Julia D et al. (2017) Perceived injunctive norms and cannabis-related problems: The interactive influence of parental injunctive norms and race. J Ethn Subst Abuse :1-13
Ecker, Anthony H; Cohen, Alex S; Buckner, Julia D (2017) Overestimation of close friend drinking problems in the prediction of one's own drinking problems. Addict Behav 64:107-110
Buckner, Julia D; Zvolensky, Michael J; Ecker, Anthony H et al. (2017) Anxiety and cannabis-related problem severity among dually diagnosed outpatients: The impact of false safety behaviors. Addict Behav 70:49-53

Showing the most recent 10 out of 42 publications