Impact of Reduced Cannabis Use on Functional Outcomes

减少大麻使用对功能结果的影响

• 批准号: 10302325
• 负责人: JEAN C. BECKHAM
• 金额: $ 66.69万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2023-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10302325
• 关键词: Abstinence; Accidents; Address; American; Behavior; Behavior Therapy; Cannabis; Clinical; Clinical Trials; Consumption; Data; Data Collection; Development; Ecological momentary assessment; Enrollment; Ensure; Frequencies; Illicit Drugs; Impulsivity; Intervention; Laboratories; Lead; Literature; Memory; Mental Health; Methods; Neuropsychology; Outcome; Outcome Measure; Participant; Persons; Pharmaceutical Preparations; Pharmacotherapy; Phase; Physical activity; Procedures; Prospective Studies; Reinforcement Schedule; Reporting; Research; Self Efficacy; Short-Term Memory; Sleep; Substance Use Disorder; Symptoms; Techniques; Technology; Testing; Time; Traffic accidents; Unemployment; addiction; base; contingency management; craving; driving behavior; drugged driving; functional outcomes; health related quality of life; illicit drug use; marijuana use; marijuana use disorder; marijuana user; mobile computing; non-suicidal self injury; novel strategies; pilot test; portability; sex; substance use treatment; suicidal

Nearly 20 million Americans report use of cannabis in the past month, and heavy cannabis use has increased by nearly 60% in the U.S. since 2007. Heavy cannabis use is associated with lower educational attainment, reduced physical activity, and increased rates of addiction, unemployment, and neuropsychological deficits. Studies by our lab and others suggest that cannabis use is also associated with increased mental health symptoms and suicidal and nonsuicidal self-injury. In addition, cannabis is the illicit drug most strongly associated with drugged driving and traffic accidents, including fatal accidents. While there is evidence that sustained abstinence can lead to improvements in the functional outcomes of former users, the degree to which reductions in cannabis use alone (i.e., in the absence of sustained abstinence) might be associated with positive changes in functional outcomes is currently unknown. This is a critical gap in the literature, as many clinical interventions for cannabis and other drugs are associated with decreases in frequency and quantity of use, but fail to achieve an effect on overall abstinence rates. The overall objective of the present research is to use ecological momentary assessment (EMA), a real-time, naturalistic data collection method, to prospectively study the impact of reduced cannabis use on functional outcomes in heavy cannabis users. EMA addresses several limitations of traditional assessment techniques by enhancing ecological validity, minimizing memory bias, and enabling examination of the impact of context on participants' behavior. Contingency management (CM) will be used to promote reductions in frequency and quantity of cannabis use. CM is an intensive behavioral therapy that is highly effective at producing short-term reductions in illicit drug use. Moreover, we have recently developed a novel approach that leverages mobile technology and recent developments in cannabis testing to make CM for cannabis more portable and feasible. We have pilot-tested this approach with heavy cannabis users and found that it is an acceptable and feasible method to reduce their cannabis use. The present research will use this technology in conjunction with state-of-the-art EMA methods to study the impact of reduced cannabis use on key functional outcomes. Our central hypothesis is that reductions in frequency and quantity of cannabis use will lead to positive changes in cannabis users' mental health, physical activity, working memory, health-related quality of life, and driving behavior. The rationale for this research is that it will provide the first and only real-time data concerning the potential impact of reductions in cannabis use on functional outcomes. As such, the findings from the present research will directly inform ongoing efforts to include reductions in illicit drug use as a valid, clinically-meaningful outcome measure in clinical trials of pharmacotherapies for the treatment of substance use disorders.

近 2000 万美国人报告过去一个月吸食大麻，大量吸食大麻的人数有所增加 自 2007 年以来，美国增加了近 60%。大量使用大麻与教育程度较低有关， 身体活动减少，成瘾率、失业率和神经心理缺陷增加。 我们实验室和其他人的研究表明，大麻的使用也与心理健康状况的改善有关 症状以及自杀性和非自杀性自残。此外，大麻是最严重的非法药物 与毒驾和交通事故有关，包括致命事故。虽然有证据表明 持续的禁欲可以改善前使用者的功能结果，程度 单独减少大麻使用（即在没有持续戒断的情况下）可能与 目前尚不清楚功能结果的积极变化。这是文献中的一个关键空白，因为许多 对大麻和其他药物的临床干预与吸食大麻的频率和数量的减少有关 使用，但未能对总体戒烟率产生影响。本研究的总体目标是 使用生态瞬时评估（EMA），一种实时、自然的数据收集方法，前瞻性地 研究减少大麻使用对大麻重度使用者功能结果的影响。 EMA 地址 通过增强生态有效性、最小化记忆来克服传统评估技术的一些局限性 偏见，并能够检查背景对参与者行为的影响。应急管理 (CM) 将用于促进减少大麻使用频率和数量。 CM 是强化 行为疗法在短期内减少非法药物使用非常有效。此外，我们 最近开发了一种利用移动技术和最新发展的新颖方法 大麻测试使大麻的 CM 更加便携和可行。我们已经对这种方法进行了试点测试 重度大麻使用者并发现这是减少大麻使用的可接受且可行的方法。这 目前的研究将结合使用该技术和最先进的 EMA 方法来研究其影响 减少大麻使用对关键功能结果的影响。我们的中心假设是频率的降低 大麻的使用量和数量将导致大麻使用者的心理健康、身体活动、 工作记忆、与健康相关的生活质量和驾驶行为。这项研究的理由是它将 提供第一个也是唯一一个关于减少大麻使用对人的潜在影响的实时数据 功能结果。因此，本研究的结果将直接为正在进行的努力提供信息 将减少非法药物使用作为临床试验中有效的、有临床意义的结果衡量标准 用于治疗物质使用障碍的药物疗法。