• J Subst Abuse Treat · Jun 2007

    Clinical Trial

    A stepped care approach for reducing cannabis use in opioid-dependent outpatients.

    • Michael Kidorf, Karin Neufeld, Van L King, Michael Clark, and Robert K Brooner.
    • The Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bayview Medical Center, Baltimore, MD 21224, USA. mkidorf@jhmi.edu
    • J Subst Abuse Treat. 2007 Jun 1;32(4):341-7.

    AbstractThis study evaluated rates of cannabis use and the effectiveness of an adaptive stepped care intervention for reducing cannabis use in methadone maintenance patients. Patients testing cannabis positive during a 6-month baseline were advanced to more weekly counseling (up to 9 hours per week) until producing four consecutive weeks of cannabis- and other drug-negative urine samples. Patients were followed up for 1 year. Continued access to uninterrupted methadone delivery was ultimately contingent upon attending scheduled counseling and achieving abstinence from all drug use. The results showed that 18% of the clinic census (n = 57) tested positive for cannabis. The effectiveness of the intervention was assessed for 15 patients testing positive for cannabis exclusively. Ten of these patients (67%) discontinued cannabis use prior to the intervention and remained at reduced care. Four of the five patients who were advanced to higher steps of care ultimately discontinued cannabis use; one left treatment against medical advice. The results suggest that motivated stepped care is an effective intervention for reducing cannabis use.

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