Trimbos Institute, Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS Utrecht, The Netherlands.
Drug Alcohol Depend. 2013 Dec 1;133(2):776-80. doi: 10.1016/j.drugalcdep.2013.08.011. Epub 2013 Aug 26.
Relatively few cannabis dependent people seek treatment and little is known about determinants of treatment seeking.
Treatment determinants were compared among 70 DSM-IV cannabis dependent patients and 241 non-treatment seeking DSM-IV cannabis dependent community subjects. In addition, perceived facilitators for treatment seeking were assessed in patients, whereas perceived barriers were assessed in 160/241 cannabis dependent community subjects not prepared to seek treatment (precluders), of whom 63/160 showed an objective treatment need, and 30/241 showed a subjective treatment need.
Compared to non-treatment seekers, patients reported more cannabis use (176.9 versus 82.8 joints monthly), more symptoms of dependence (5.6 versus 4.5), higher perceived lack of social support (70.0% versus 41.1%), more pressure to seek treatment (58.6% versus 21.6%), a more positive attitude to treatment, and more previous treatments. In addition, patients reported more mental health problems (internalising disorders 57.1% versus 24.5%; externalising disorders 52.9% versus 35.3%) and more functional impairments (8.4 versus 4.8 monthly days out of role). Cannabis dependent 'precluders' reported desire for self-reliance (50.0%), preference for informal help (22.5%), and absent treatment need (16.9%) as their main reasons not to seek treatment, whereas cannabis dependent community subjects with a subjective treatment need mainly expressed desire for self-reliance (36.7%), treatment ineffectiveness (16.7%), and avoiding stigma (13.3%).
Functional impairment, mental health problems and social pressure are important reasons to seek treatment in people with cannabis dependence. Treatment participation might improve if desire for self-reliance and the preference for informal help are considered, and perceived ineffectiveness of treatment and stigmatisation are publicly addressed.
寻求治疗的大麻依赖者相对较少，对寻求治疗的决定因素知之甚少。
将 70 名 DSM-IV 大麻依赖患者和 241 名非治疗寻求 DSM-IV 大麻依赖社区患者的治疗决定因素进行比较。此外，在患者中评估寻求治疗的感知促进因素，而在 160/241 名不准备寻求治疗的大麻依赖社区患者（排斥者）中评估感知障碍，其中 63/160 人有客观治疗需求，30/241 人有主观治疗需求。
与非治疗寻求者相比，患者报告的大麻使用量更多（176.9 与 82.8 支/月），依赖症状更严重（5.6 与 4.5），感知社会支持不足的比例更高（70.0%与 41.1%），寻求治疗的压力更大（58.6%与 21.6%），对治疗的态度更积极，治疗次数更多。此外，患者报告的心理健康问题更多（内化障碍 57.1%与 24.5%；外化障碍 52.9%与 35.3%）和功能障碍更严重（8.4 与 4.8 个月缺勤日）。大麻依赖“排斥者”报告不寻求治疗的主要原因是自力更生的愿望（50.0%）、偏好非正式帮助（22.5%）和缺乏治疗需求（16.9%），而有主观治疗需求的大麻依赖社区患者主要表达自力更生的愿望（36.7%）、治疗无效（16.7%）和避免污名化（13.3%）。
在大麻依赖者中，功能障碍、心理健康问题和社会压力是寻求治疗的重要原因。如果考虑到自力更生的愿望和对非正式帮助的偏好，以及治疗效果不佳和污名化的问题得到公开解决，那么治疗参与度可能会提高。
