Connor Jason P, Manthey Jakob, Hall Wayne, Stjepanović Daniel
National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Australia.
Discipline of Psychiatry, School of Medicine, The University of Queensland, Herston, Australia.
Eur Arch Psychiatry Clin Neurosci. 2025 Mar;275(2):327-339. doi: 10.1007/s00406-024-01829-5. Epub 2024 May 23.
This data synthesis examined the effectiveness of behavioural and pharmacological approaches for cannabis treatment. We integrated findings from high level evidence studies and prioritised data from Europe when available. The synthesis found that only a relatively small number of published behavioural and pharmacological studies on cannabis interventions have been conducted in Europe. Applying both European and non-European data, it was found that Cognitive Behavioural Therapy (CBT) and/or Motivational Enhancement Therapy (MET) improved short-term outcomes in the frequency of cannabis use and dependency severity, although abstinence outcomes were less consistent. These improvements were typically not maintained nine months after treatment. CBT and MET (or combined CBT + MET) treatments that extend beyond four sessions were more effective than fewer sessions over a shorter duration. Combining CBT or MET (or combined CBT + MET) with adjunctive Contingency Management (CM) improved therapeutic outcomes. No pharmacotherapies have been approved for the management of cannabis use, cannabis use disorders or cannabis withdrawal. Despite only weak evidence to support the use of pharmacological agents, some are used 'off-label' to manage withdrawal symptoms outside clinical trials.
本数据综合分析考察了行为疗法和药物疗法对大麻治疗的有效性。我们整合了高水平证据研究的结果,并在有可用数据时优先选用欧洲的数据。综合分析发现,欧洲开展的关于大麻干预的已发表行为学和药物学研究数量相对较少。综合运用欧洲和非欧洲的数据发现,认知行为疗法(CBT)和/或动机增强疗法(MET)改善了大麻使用频率和依赖严重程度方面的短期结果,尽管戒断结果不太一致。这些改善通常在治疗九个月后无法维持。超过四个疗程的CBT和MET(或联合CBT+MET)治疗比疗程较短、次数较少的治疗更有效。将CBT或MET(或联合CBT+MET)与辅助性应急管理(CM)相结合可改善治疗效果。尚无药物疗法被批准用于管理大麻使用、大麻使用障碍或大麻戒断。尽管仅有微弱证据支持使用药物制剂,但有些药物在临床试验之外被“超适应证”用于管理戒断症状。