Engaging & treating young court referred marijuana users

尽管大量个人专门为大麻依赖这一主要问题寻求治疗，但人们对治疗这一群体的有效策略知之甚少。被法院系统转介接受治疗的年轻成年大麻使用者的特点是，在标准的门诊方法中，他们的保留率和结果都很差。以这一人群为目标，解决他们的低积极性和促进治疗参与，可能是对有可能发展为更严重的药物使用和相关法律问题的人群进行早期干预的有效战略。旨在促进这一高度矛盾群体的变革动力的动机强化疗法和旨在促进治疗保留和戒除的应急管理是有前景的战略，因为它们在其他药物滥用人群中获得了高水平的经验支持，并且适合这里的目标人群。在这项研究中，150名由缓刑监督官推荐进行大麻使用评估和治疗的年轻人将被随机分配到四种情况之一：(1)标准心理教育药物咨询，(2)应急管理加药物咨询，(3)动机增强疗法(MET)，(4)应急管理加MET。主要结果将是保留治疗，减少大麻使用，并诱导进行长期治疗。研究治疗将持续8周，并将以个人为基础提供给受试者。在停止研究治疗后1、3、6、9和12个月的随访将评估治疗效果的持久性和/或延迟出现。

Although large numbers of individuals seek treatment specifically for a principal problem of marijuana dependence, little is known about effective strategies to treat this population. Young adult marijuana users who have been referred by the court system for treatment are characterized by poor retention and outcome in standard outpatient approaches. Targeting this population and addressing their low level of motivation and facilitating treatment engagement may be an effective strategy for early intervention with a population at risk for progression to more severe drug use and associated legal problems. Motivational Enhancement Therapy, directed to fostering motivation for change in this highly ambivalent group, and Contingency Management, directed to foster treatment retention and abstinence, are promising strategies, given their high level of empirical support in other substance-abusing populations and their suitability of the population targeted here. In this study 150 young adults referred by their probation officers for evaluation and treatment of marijuana use will be randomly assigned, using randomization, one of four conditions: (1) standard psychoeducational drug counseling, (2) contingency management plus drug counseling, (3) Motivational Enhancement Therapy (MET), and (4) Contingency Management plus MET. Primary outcomes will be retention in treatment, reduction in marijuana use, and induction to long-term treatment. Study treatments will last 8 we4eks and will be delivered to subjects on an individual basis. Follow-ups at 1,3,6,9 and 12 months after cessation of study treatment will assess the durability and/or delayed emergence of treatment effects.