Brezing Christina A, Levin Frances R
Division on Substance Use Disorders, New York State Psychiatric Institute, New York, NY, United States.
Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States.
Front Psychiatry. 2022 Oct 19;13:1035345. doi: 10.3389/fpsyt.2022.1035345. eCollection 2022.
Cannabis use and Cannabis Use Disorder (CUD) have been increasing. There are no FDA approved medications and evidence-based psychotherapy is limited by insufficient providers, serving very few patients effectively. The lack of resources for prevention and treatment of CUD has resulted in a significant gap between the need for services and access to treatment. The creation of a scalable system to prevent, screen, refer and provide treatment for a chronic, relapsing diagnosis like CUD could be achieved through the application of technology. Many studies have utilized ecological momentary assessments (EMA) in treatment seeking and non-treatment seeking cannabis users. EMA allows for repeated, intensive, longitudinal data collection . EMA has been studied in cannabis use and its association with affect, craving, withdrawal, other substances, impulsivity, and interpersonal behaviors. EMA has the potential to serve as a valuable monitoring tool in prevention, screening, and treatment for CUD. Research has also focused on the development of internet and application-based treatments for CUD, including a currently available prescription digital therapeutic. Treatment options have expanded to more broadly incorporate telehealth as an option for CUD treatment with broad acceptance and change in regulation following the COVID-19 pandemic. While technology has limitations, including cost, privacy concerns, and issues with engagement, it will be a necessary medium to meet societal health needs as a consequence of an ever-changing cannabis regulatory landscape. Future work should focus on improving existing platforms while ethically incorporating other functions (e.g., sensors) to optimize a public and clinical health approach to CUD.
大麻使用及大麻使用障碍（CUD）呈上升趋势。目前尚无美国食品药品监督管理局（FDA）批准的药物，且循证心理治疗因提供者不足而受限，能有效治疗的患者极少。CUD预防和治疗资源的匮乏导致了服务需求与治疗可及性之间的巨大差距。通过应用技术，有可能创建一个可扩展的系统，用于预防、筛查、转诊并为像CUD这样的慢性复发性疾病提供治疗。许多研究已在寻求治疗和未寻求治疗的大麻使用者中运用了生态瞬时评估（EMA）。EMA允许进行重复、密集的纵向数据收集。EMA已在大麻使用及其与情绪、渴望、戒断、其他物质、冲动性和人际行为的关联方面得到研究。EMA有潜力成为CUD预防、筛查和治疗中的宝贵监测工具。研究还聚焦于开发基于互联网和应用程序的CUD治疗方法，包括一种目前可用的处方数字疗法。治疗选择已扩展，更广泛地将远程医疗纳入CUD治疗选项，在2019冠状病毒病大流行后得到广泛接受且监管有所变化。虽然技术存在局限性，包括成本、隐私担忧和参与度问题，但鉴于大麻监管环境不断变化，它将成为满足社会健康需求的必要媒介。未来的工作应专注于改进现有平台，同时在伦理上纳入其他功能（如传感器），以优化针对CUD的公共和临床健康方法。
