September 4, 2001

The results are partially in: treatment for chronic, heavy users of marijuana is effective. In fact, the longer the treatment - up to nine weeks - the more effective it is.

Now the question to be answered is: What will be more helpful to heavy users who want to become abstinent - focusing treatment on their life problems, on their motivation, or on their lack of coping skills?

Scientists at the Health Center are addressing these questions in a research program titled Marijuana Treatment Project-2. The project, funded by the National Institute of Drug Abuse, builds upon what was learned from the original Marijuana Treatment Project, a three-year, $1.5 million study of the most effective treatments for adults who are dependent on cannabis.

Ronald Kadden, a psychologist and professor of psychiatry at the Health Center is the study's principal investigator.

"The focus of the new five-year study is to look at methods to induce abstinence in chronic cannabis abusers," says Kadden. "These methods include a variety of interventions - counseling, monitoring, and even incentives - and weekly visits to the Health Center."

Chronic pot smokers are those smoking several joints almost every day, and getting high for at least several hours each time they use. The average participant in the first marijuana treatment project smoked three joints each day and was high for about six hours per day.

Chronic pot abusers range across the social spectrum, Kadden says. Participants have included businessmen, lawyers and teachers, executives and white collars of all sorts, tradesmen and blue collar men and women, and people who are unemployed.

"Chronic marijuana smokers - who are dependent on pot - are higher functioning on average than alcoholics or drug addicts," says Kadden. "They're not functioning as well as they could be in their jobs, and they're surely not living up to their potential, but they are less likely to be unemployed or impoverished than many heroin addicts or acute alcoholics."

Things aren't going as well as they might for the chronic pot user, and in many cases that's because they're high when they should be sober and paying attention to living, says Elise Kabela, a Health Center researcher and Marijuana

Treatment Project-2 investigator. They often have relationship problems, Kabela says, as

well as low energy, and they are given to

procrastination.

"They do less of the things they would have done if they weren't high on pot," she says.

Chronic pot smokers fall into limbo when it comes to quitting smoking. There are a variety of reasons. One of the most important reasons springs from their belief that there is no such thing as cannabis dependence, a belief that is contradicted by facts and by medical science. Yet the myth persists.

Pot is addictive; the proof of that is seen in the signs of dependence among heavy users that mirror the classic withdrawal symptoms of alcohol or drug addiction. These include anxiety, irritability, restlessness, nausea and more.

Treatment for marijuana dependence differs from other addictive treatment because there are no medications involved. Motivation to quit smoking is paramount; treatment consists of counseling, support and providing information about both the problem and the recovery process. Part of the treatment is addressing and soothing the very real anxieties the chronic user is apt to feel and display.

"By the time they come to us, using marijuana is deeply entrenched in their lives," Kadden says. "They use it to deal with stressful situations, at work and at home and they realize it has become an impediment to the full enjoyment of life. In many cases, they are using it just to feel normal. They are ready to become abstinent from pot," he says. "We help them move from the theoretical to the practical."

Pat Keefe