Treatment of Cannabis Withdrawal Syndrome Using Cognitive-Behavioral Therapy and Relapse Prevention for Cannabis Dependence

Abstract

Cannabis is the most frequently used illegal substance in the United States and Europe. There is a dramatic increase in the demand for treatment for cannabis dependence. The majority of marijuana-dependent individuals who enter treatment have difficulty in achieving and maintaining abstinence from cannabis partly due to the cannabis withdrawal syndrome. Onset of most symptoms occurs during the 1st week of abstinence and returns to baseline by the end of the 2nd week of abstinence. In our view, many cannabis users actually self-medicate for anxiety and depressive subclinical syndromes (i.e., anxiety, irritability, negative mood, physical symptoms, and decreased appetite). We now report a treatment study of 26 regular cannabis-dependent users with 12-week cognitive-behavioral therapy weekly sessions for the treatment of marijuana dependence. We also report a cognitive-behavioral relapse prevention group treatment of 12 regular cannabis-dependent users who quit smoking cannabis. Six members of the relapse prevention group were also treated with holistic pulsing relaxation treatment for 3 months to ease physical and emotional pain. Results showed a high rate of 50% dropout from the 12-week treatment program. Secondly, 10 of the 26 participants (38%) have remained abstinent after 2 months of treatment indicated by negative urine samples for cannabis. Thirdly, 5 members of the relapse prevention group (42%) have remained cannabis free after 6 months of treatment. We suggest that weekly sessions of group cognitive-behavioral and motivational enhancement therapy may be useful for treatment of marijuana dependence and relapse prevention for cannabis use. Holistic pulsing may be useful as adjunct treatment for relapse prevention for cannabis dependence.

KEYWORDS:

• cannabis
• cannabis withdrawal syndrome
• cognitive-behavioral therapy

The treatment study was funded by a grant from the Israeli Anti-Drug Authority (Dr. Rachel Bar-Hamburger). We would like to thank the participants in our study and the therapists from the holistic pulsing treatment center in Tel Aviv, Tamir, and Shlomit Kadmiel in particular.