Mason Michael J, Coatsworth J Douglas, Riggs Nathaniel R, Russell Michael, Mennis Jeremy, Zaharakis Nikola, Brown Aaron
Center for Behavioral Health Research, College of Social Work, University of Tennessee, United States of America.
Center for Behavioral Health Research, College of Social Work, University of Tennessee, United States of America.
J Subst Use Addict Treat. 2025 Mar;170:209611. doi: 10.1016/j.josat.2024.209611. Epub 2024 Dec 25.
Two scientific and clinical challenges for treating cannabis use disorder (CUD) are developing efficacious treatments with high likelihood of uptake and scalability, and testing the clinical mechanisms by which treatments work. Because young adults experience more CUD than other age groups, a need exists to test the efficacy and hypothesized causal pathways of novel treatments for CUD. Text-delivered treatments have the potential to reach young adults by increasing access and perceived privacy.
We conducted a randomized clinical trial (n = 1078) of a 4-week CUD treatment with U.S. young adults from Colorado and Tennessee. Participants were allocated to Peer Network Counseling-text (PNC-txt), a text-message delivered brief motivational interviewing informed treatment, or a wait-list control condition, and followed for 6 months.
No significant direct treatment effects on cannabis use were found between experimental conditions. However, significant treatment effects were identified on hypothesized mediators: readiness to change and protective behavioral strategies. Tests of indirect effects using latent change score mediation modeling showed the treatment group (PNC-txt) increased in readiness to change and protective behavioral strategies at the 1-month follow-up period, which led to decreases in the number of days participants used cannabis from baseline to 6-months, compared to controls.
While no direct treatment effects were identified, PNC-txt appears successful in reducing cannabis use relative to controls indirectly by activating participants' motivation to change and through teaching harm reduction strategies. Results suggest targeting readiness to change and protective behavioral strategies as modifiable clinical mechanisms when treating CUD in young adults.
治疗大麻使用障碍（CUD）面临两项科学和临床挑战，即开发出有高采用率和可扩展性的有效治疗方法，以及测试治疗起效的临床机制。由于年轻人比其他年龄组经历更多的CUD，因此有必要测试新型CUD治疗方法的疗效和假设的因果途径。通过文本提供的治疗方法有可能通过增加可及性和感知到的隐私性来覆盖年轻人。
我们对来自科罗拉多州和田纳西州的美国年轻成年人进行了一项为期4周的CUD治疗随机临床试验（n = 1078）。参与者被分配到同伴网络咨询-文本（PNC-txt）组，这是一种通过短信提供的简短动机性访谈指导治疗，或等待名单对照条件，并随访6个月。
在实验条件之间未发现对大麻使用有显著的直接治疗效果。然而，在假设的中介因素上发现了显著的治疗效果：改变的准备程度和保护性的行为策略。使用潜在变化分数中介模型的间接效应测试表明，治疗组（PNC-txt）在1个月随访期时改变的准备程度和保护性的行为策略有所增加，这导致与对照组相比，参与者从基线到6个月使用大麻的天数减少。
虽然未发现直接治疗效果，但PNC-txt似乎通过激发参与者改变的动机并通过教授减少伤害策略，相对于对照组间接成功减少了大麻使用。结果表明，在治疗年轻成年人的CUD时，将改变的准备程度和保护性的行为策略作为可改变的临床机制。
