Treatment models for targeting tobacco use during treatment for cannabis use disorder: Case series
Treatment models for targeting tobacco use during treatment for cannabis use disorder: Case series
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DOI：
10.1016/j.addbeh.2014.04.010
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发表时间：
2014-08-01
影响因子：
4.4
通讯作者：
Stanger, Catherine
中科院分区：
文献类型：
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作者：
Lee, Dustin C.;Budney, Alan J.;Stanger, Catherine
大约50%寻求大麻使用障碍（CUD）治疗的人也吸烟，吸烟是CUD治疗结果不佳的预测因素。戒烟与长期戒酒和戒除非法药物有关，但目前还没有针对吸烟的CUD既定治疗方法。本报告重点介绍了与大麻和烟草同时使用有关的问题，并讨论了针对这两种物质的潜在治疗方法。数据来自参与干预措施的前六名参与者，该干预措施旨在同时针对寻求CUD治疗的个人的烟草使用。为期12周的课程包括计算机辅助的动机增强疗法、认知行为疗法和应急管理，即，基于禁欲的CUD激励措施。此外，鼓励参与者完成可选的烟草干预，包括尼古丁替代疗法和计算机辅助提供针对烟草和大麻使用者的行为治疗。所有参与者都完成了大麻干预和至少一部分烟草干预：所有人都完成了至少一个烟草计算机模块（平均= 2.5个模块），50%的人开始了尼古丁替代疗法。六分之五的参与者实现了对大麻的戒断。尝试戒烟的人数低于预期，但所有参与者都试图在治疗期间减少烟草使用。在治疗CUD期间同时靶向烟草不会对大麻结果产生负面影响。烟草干预的参与率很高，但戒烟结果很差，这表明可能需要替代策略来更有效地促使戒烟尝试和提高戒烟率。(C)2014爱思唯尔有限公司版权所有。
Approximately 50% of individuals seeking treatment for cannabis use disorders (CUD) also smoke tobacco, and tobacco smoking is a predictor of poor outcomes for those in treatment for CUD. Quitting tobacco is associated with long-term abstinence from alcohol and illicit drugs, yet there are no established treatments for CUD that also target tobacco smoking. This report highlights issues related to cannabis and tobacco co-use and discusses potential treatment approaches targeting both substances. Data is shared from the first six participants enrolled in an intervention designed to simultaneously target tobacco use in individuals seeking treatment for CUD. The twelve-week program comprised computer-assisted delivery of Motivational Enhancement Therapy, Cognitive Behavioral Therapy, and, Contingency Management, i.e., abstinence-based incentives for CUD. In addition, participants were encouraged to complete an optional tobacco intervention consisting of nicotine-replacement therapy and computer-assisted delivery of a behavioral treatment tailored for tobacco and cannabis users. All participants completed the cannabis intervention and at least a portion of the tobacco intervention: all completed at least one tobacco computer module (mean = 2.5 modules) and 50% initiated nicotine replacement therapy. Five of six participants achieved abstinence from cannabis. The number of tobacco quit attempts was lower than expected, however all participants attempted to reduce tobacco use during treatment. Simultaneously targeting tobacco during treatment for CUD did not negatively impact cannabis outcomes. Participation in the tobacco intervention was high, but cessation outcomes were poor suggesting that alternative strategies might be needed to more effectively prompt quit attempts and enhance quit rates. (C) 2014 Elsevier Ltd. All rights reserved.