Approach Bias Modification for the Treatment of Cannabis Use Disorder

项目摘要/摘要

PROJECT SUMMARY / ABSTRACT Cannabis use disorder (CUD) is increasingly common, yet available treatments are inadequate. To date there are no FDA-approved medications, and while psychosocial interventions are modestly effective, their durability is limited and abstinence rates are low. Investigation of novel adjunctive treatments for CUD is warranted. Biases in cognitive processing of drug-related stimuli play an important role in the development and maintenance of addictive disorders. Growing evidence suggests that attenuation of drug-related automatic approach tendencies offers a promising new treatment approach. Approach bias modification (ABM) involves manipulating stimulus-response contingencies during a computerized task in order to attenuate approach bias and reduce drug use. In recent clinical trials, ABM reduced alcohol relapse rates by 10-13% at one-year follow-up, decreased mesolimbic neural activity in response to alcohol cues, and reduced nicotine consumption and dependence severity. ABM has not yet been tested with cannabis users. The candidate recently completed a four-session laboratory-based pilot study demonstrating that ABM training is safe, tolerable, and feasible in non-treatment seeking adults with CUD (N=33). Participants receiving ABM showed blunted cannabis cue-induced craving, and there was a trend for gender modification of ABM on cannabis use. Given these promising preliminary findings, ABM may be a powerful adjunct to existing psychosocial interventions. In the proposed career development award, the candidate aims to determine if a four-session intervention combining ABM with MET/CBT can reduce cannabis cue-induced reactivity (Aim 1) and improve cannabis use outcomes (Aim 2) in treatment-seeking adults with CUD. Additionally, the candidate will determine if gender moderates the effect of ABM on cue-reactivity and cannabis use (Exploratory Aim). Development of a novel, effective treatment for CUD would have the potential to help the estimated one million cannabis using Americans that seek treatment each year. Of note, ABM has no side effects, is cost-efficient, and may focally target cognitive mechanisms associated with CUD.