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2000万美国人报告说，在过去的一个月里，他们使用了大麻，而大量吸食大麻的人数有所增加 自2007年以来，美国的这一比例增长了近60%。大量使用大麻与较低的教育程度有关， 体力活动减少，上瘾、失业和神经心理缺陷率增加。 我们实验室和其他实验室的研究表明，大麻的使用也与精神健康的提高有关 自杀性和非自杀性自伤的症状。此外，大麻是最严重的非法药物。 与麻醉驾驶和交通事故有关，包括致命事故。虽然有证据表明 持续戒酒可导致前使用者功能结果的改善，程度上 单独减少大麻使用(即，在没有持续戒断的情况下)可能与以下哪些因素有关 功能结果的积极变化目前尚不清楚。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减少大麻的频率和数量有关 使用，但不能达到对总体禁酒率的影响。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，以前瞻性地 研究减少大麻使用对大量吸食大麻者的功能结果的影响。EMA地址 传统评估技术通过提高生态有效性、最大限度地减少内存而存在的几个局限性 偏见，并能够检查环境对参与者行为的影响。应急管理 (Cm)将用于促进减少大麻的使用频率和数量。CM是一种密集的 在短期内减少非法药物使用的非常有效的行为疗法。此外，我们 最近开发了一种新的方法，利用移动技术和最近的发展 大麻测试，使大麻的CM更便携和可行。我们已经对此方法进行了试点测试 毒品和犯罪问题办公室对大量吸食大麻的人进行了调查，发现这是一种可以接受和可行的减少吸食大麻的方法。这个 目前的研究将使用这项技术结合最先进的EMA方法来研究影响 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 而大麻使用量将导致大麻使用者的心理健康、体力活动、 工作记忆、与健康相关的生活质量和驾驶行为。这项研究的基本原理是它将 提供第一次也是唯一一次实时数据，说明减少大麻使用对 功能结果。因此，本研究的结论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一项有效的、具有临床意义的结果衡量标准 治疗物质使用障碍的药物疗法。