Psychological and psychosocial interventions for cannabis cessation in adults: A systematic review

Figures & data

Box 1. Electronic databases

• MEDLINE

• EMBASE

• Cochrane Controlled Trials Register (CCTR)

• Health Technology Assessment (HTA) database

• Database of Abstracts of Reviews of Effects (DARE)

• Cochrane Systematic Reviews Database (CDSR)

• NHS Economic Evaluation Database (NHS EED)

• PsycInfo

• Web of Science Conference Proceedings Citation Index (WoS CPCI-S, WoS CPCP-SSH)

• ClinicalTrials.gov

• metaRegister of Controlled Trials (mRCT)

Box 2. Inclusion exclusion criteria

Inclusion criteria	Exclusion criteria
(1)  RCT design	(1)  Based within the criminal justice setting (e.g. parole or prison)
(2)  Included, in the majority (i.e. over 50%), adults aged 18 years or over who were users of cannabis	(2)  Involved providing interventions to an individual other than the regular cannabis user (e.g. partner or parent)
(3)  Tested a psychological or psychosocial intervention against comparator(s) (excluding pharmacological comparators)	(3)  Undertaken within a sub-specific population (i.e. indigenous communities or HIV positive individuals)
(4)  Provided data relating to individuals’ cannabis usage (where studies involved participants with multiple drug dependencies, studies were included if they reported cannabis use outcomes for the cannabis using population)	(4)  Aimed to treat the participant’s psychological condition rather than their cannabis use in “dually diagnosed” patients (i.e. patients with both a psychiatric condition and cannabis dependence)
(5)  Published in a peer-reviewed journal	(5)  Delivered the intervention, or a component of the intervention, within an inpatient setting (i.e. study participants are resident within a ward or treatment facility) (6)  Written in languages other than English

Figure 1. Study selection process – Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram.

Table 1. Characteristics of included studies

Study (country, mode of recruitment)	Interventions (Number of sessions)	Number of cannabis users	Inclusion criteria: age	Mean age at BL (range)	Level of cannabis use/dependence^a	Mean cannabis use at BL
Babor et al. (2004) and Litt et al. (2005) (USA, voluntary and referral)	– CBT/MET/CaseM (9) – MET (2) – Wait-list	450	≥18	36 (18–62)	High use: DSM-IV cannabis dependence; cannabis used ≥40 out of 90 d	27 d/month
Budney et al. (2011) and Budney (2013) (USA, voluntary)	– CBT/MET/voucher (9) – Computer CBT/MET + brief therapist + voucher (9) – MET (2)	45	18–65	35 (range NR)	High use: DSM-IV cannabis abuse or dependence and used cannabis ≥40 of previous 90 d	NR
Budney et al. (2006) (USA, voluntary and referral)	– CBT (14) – CBT/vouchers (14) – Vouchers	60	≥18	33 (range NR)	High use: Met DSM-IV cannabis dependence and used cannabis in past 30 d	26 d/month
Budney et al. (2000) and Moore and Budney (2003) (USA, voluntary)	– CBT/MET (14) – MET (4) – CBT/MET/vouchers (14)	60	≥18	32 (range NR)	High use: DSM-III-R classification for cannabis dependence; cannabis use in previous 30 d	23 d/month
Copeland et al. (2001) (Australia, voluntary)	– CBT (6) – MI (1) – Wait-list	229	≥18	32 (range NR)	High use: DSM-IV cannabis dependence	NR
De Dios et al. (2012) (USA, voluntary)	– MI/meditation (2) – AO	39	18–29	23 (range NR)	Low use: ≥3 times past month	18 d/month
Fernandes et al. (2010) (Brazil, voluntary)	– tele-Brief MI (1) – Written cannabis information	1744	NR	25 (11-NR)	NR	NR
Fischer et al. (2012, 2013) (Canada, voluntary)	– Brief MI (1) – Written cannabis information – Therapist general health MI (1) – Written general health information	134	18–28	20 (range NR)	Low use: Used for >1 year, at least 12 of past 30 d	24 d/month
Gates et al. (2012) (Australia, voluntary)	– tele-CBT/MI (4) – Wait-list	160	≥16	36 (range NR)	Low use: ≥1 use cannabis in last month	NR
Gmel et al. (2013) (Switzerland, voluntary)	– Brief MI (1) – AO	378	19–20	20 (19–20)	NR	7–9 d/month
Hoch et al. (2014) (Germany, referral)	– CBT/MET/PPS (10) – Wait-list	385	≥16	27 (16–63)	Low use: ≥9 d/month	20 d/month
Hoch et al. (2008, 2012) (Germany, voluntary and referral)	– CBT/MET/PPS (10) – Wait-list	122	≥16	24 (16–44)	High use: DSM-IV cannabis dependence/abuse 89%	NR
Humeniuk et al. (2012) (Worldwide, referral)	– Brief MI (1) – Wait-list	395	16–62	31 (range NR)	NR	NR
Jungerman et al. (2007) (Brazil, NR)	– CBT/MI/RP (4) (3mth) – CBT/MI/RP (4) (1mth) – Wait-list	160	≥18	32 (18–58)	Low use: ≥13 d/month	26–28 d/month
Kadden et al. (2007) and Litt et al. (2008) (USA, voluntary)	– CBT/MET (9) – CaseM (9) – CBT/MET/vouchers (9) – Vouchers	240	≥18	33 (range NR)	High use: DSM-IV cannabis dependence	NR
Lee et al. (2013) (USA, referral)	– Brief MI (1) – AO	212	18–25	20 (range NR)	Low use: ≥5 d/month	16–17 d/month
Lee et al. (2010) (USA, referral)	– Web-based-personalised feedback (1) – AO	341	17–19	18 (range NR)	Low use: any use	3 d/month
Litt et al. (2013) (USA, voluntary)	– CBT/MET/vouchers(homework) (9) – CBT/MET/vouchers (abstinence) (9) – CaseM (9)	215	≥18	33 (range NR)	High use: DSM-IV cannabis dependence	24 d/month
Rooke et al. (2013) (Worldwide, voluntary)	– Web-based CBT/MI (6) – Web-based written cannabis information	230	≥18	31 (range NR)	Low use: ≥1 d/month	21 d/month
Sobell et al. (2009) (Canada, voluntary and referral)	– CBT/MI (4) (group) – CBT/MI (4) (individual)	17	≥18	32 (range NR)	Low use: “not severe dependence”	27 d/month
Stein et al. (2011) (USA, voluntary)	– MI (2) – AO	332	18–24	21 (range NR)	Low use: ≥1 d/month	17 d/month
Stephens et al. (2007) (USA, voluntary)	– MI/personalised feedback (1) – Cannabis education (1) – Wait-list	188	≥18	32 (18–57)	High use: ≥15 d/month	26 d/month
Stephens et al. (2000), Lozano et al. (2006), and DeMarce et al. (2005) (USA, voluntary)	– CBT/RP/social support (14) – MI (2) – Wait-list	291	≥18	34 (range NR)	High use: DSM-III-R cannabis dependence	25 d/month
Stephens et al. (1994) (USA, voluntary)	– CBT/RP (10) – Social support group (10)	212	≥18	32 (18–65)	High use: ≥17 d/month	27 d/month
Tossmann et al. (2011) (Germany, voluntary)	– Web-based counselling – Wait-list	1292	NR	25 (range NR)	High use: “any use”, 92% DSM-IV cannabis dependent at BL	NR

^aLevel of cannabis use/dependence was classified as follows: “high use”: ≥80% of participants met DSM or ICD criteria for cannabis dependence or abuse and/or inclusion criteria specified that all participants used cannabis on at least 50% days over a specified time period.

AO, Assessment Only; ASI, Addiction Severity Index; BL, Baseline; CaseM-9, nine session Case Management; CBT, cognitive behavioural therapy; CBT-(N), CBT with N number of sessions; DSM, Diagnostic and Statistical Manual of Mental Disorders; MET, motivational enhancement therapy; MET-(N), motivational enhancement therapy with N number of sessions; MI, motivational interviewing; PPS, psychosocial problem solving; RP, relapse prevention; tele-brief MI-1, one session telephone delivered brief motivational intervention.

Table 2. Results at post-treatment

			Post treatment difference between groups^b
Study % DSM^a mean Age (range)	Intervention N sessions (N attended) Duration	Control N sessions (N attended) Duration	% Abstinent	Days use	Joints per day	Periods use per day	Severity of dependence	Dependence symptoms	Cannabis problems
CBT versus wait-list
Babor et al. (2004) 100% 36 (18–62)	CBT/MET/CaseM 9 (6.5) 12 weeks	Waitlist	Sig p = NR	Sig p = NR d = 1.14	Sig p = NR d = 0.43	Sig p = NR d = 0.91		Sig^g p = NR d = 0.9	Sig^j p = NR
Copeland et al. (2001)	CBT	Waitlist	No data
Hoch et al. (2014) NR 27 (16–63)	CBT/MET/PPS 10 (NR) 12 weeks	Waitlist	Sig p < 0.001		Sig^c p < 0.001		Sig^d p < 0.001 d = −0.6 (95% CI −1.2, 0.2)	Sig p < 0.001 d = −0.9 (95% CI −1.1, −0.5)	Sig^k p < 0.001 d = −0.7 (95% CI −1.3, 0.2)
Hoch et al. (2012) 89% 24 (16–44)	CBT/MET/PPS 10 (NR) 5–8 weeks	Waitlist	Sig p < 0.01		Sig^c p = 0.008		Sig^f p < 0.001 d = −1.58
Jungerman et al. (2007) NR 32 (18–58)	CBT/MI/RP 4 (NR) 12 week	Waitlist		Sig p = 0.0002	Sig p = 0.005	Sig p = 0.004	Not sig^f p = 0.292	Sig^h p = 0.018	Not sig^j p = 0.16
Stephens et al. (2000) 98% 34 (≥18)	CBT/RP/SSG (group) 14 (8.4) 18 week	Waitlist	Sig p < 0.001	Sig p < 0.001		Sig p < 0.001		Sig^i p < 0.001	Sig p < 0.001
CBT/psychotherapy versus brief MI
Babor et al. (2004) 100% 36 (18–62)	CBT/MET/CaseM 9 (6.5) 12 weeks	MET 2 (1.6) 5 weeks	Sig p = NR	Sig p = NR d = 0.52	Not sig p = NR	Sig p = NR d = 0.4		Sig^g p = NR d = 0.52	Sig^j p = NR
Budney et al. (2000) 100% 32 (≥18)	CBT/MET 14 (NR) 14 weeks	MET 4 (NR) 14 weeks	Not sig p = NR	Not sig p = NR			Not sig^f p = NR		Not sig^l p = NR
Copeland et al. (2001)	CBT	MI	No data
Stephens et al. (2000) 98% 34 (≥18)	CBT/RP/SSG (group) 14 (8.4) 18 weeks	MI (indiv.) 2 (NR) 4 weeks	Not sig p = NR	Not sig p = NR		Not sig p = NR		Not sig^i p = NR	Not sig p = NR
CBT versus other interventions
Jungerman et al. (2007) NR 32 (18–58)	CBT/MI/RP over 12 weeks 4 (NR) 12 week	CBT/MI/RP over 4 weeks 4 (NR) 4 weeks		Not sig p = 0.671	Not sig p = 0.937	Not sig p = 0.301	Sig^f p = 0.012	Sig^h p = 0.035	Sig^j p = 0.02
Kadden et al. (2007) 100% 33 (≥18)	CBT/MET 9 (5.2) 9 weeks	CaseM 9 (5.2) 9 weeks		Not sig p = NR	Not sig p = NR		Not sig^f p = NR		Not sig^j p = NR
Sobell et al. (2009) Non-severe only 32 (≥18)	CBT/MI (indiv) 4 (NR) NR	CBT/MI (group) 4 (NR) NR		Not sig p = 0.07
Stephens et al. (1994) NR 32 (18–65)	CBT/RP (group) 10 (7.6) 12 weeks	SSG (group) 10 (7.6) 12 weeks	Not sig p < 0.10	Not sig p = NR					Not sig^m p = NR
Telephone or web-based CBT or counselling versus wait-list or other
Gates et al. (2012) NR 36 (≥16)	tele-CBT/MI 4 (3.3) 3 weeks	Waitlist		Not sig p = 0.054	Sig^d p = 0.017		Sig^e p < 0.001		Sig^k p < 0.001
Rooke et al. (2013) NR 31 (≥18)	CBT/MI 6 (3.5) 6 weeks	Written cannabis information	Not sig p = 0.10	Sig p = 0.02 d = 0.30 (CI NR)			Not sig^e p = 0.49 d = 0.10 (CI NR)
Tossmann et al. (2011)	Web-based counselling	Waitlist	No data
Brief MI versus wait-list/AO
Babor et al. (2004) 100% 36 (18–62)	MET 2 (1.6) 5 weeks	Waitlist	Not sig p = 0.10	Sig p = NR d = 0.59 (CI NR)	Sig p = NR d = 0.29 (CI NR)	Sig p = NR d = 0.6 (CI NR)		Sig^g p = NR d = 0.33 (CI NR)	Not sig^j p = NR
Copeland et al. (2001)	MI	Waitlist	No data
De Dios et al. (2012) 23 (18–29), female	MI/meditation 2 (2) 2 weeks	AO	Not sig p = NR	Sig p = 0.015
Gmel et al. (2013)	Brief MI (group)	AO	No data
Humeniuk et al. (2012)	Brief MI	Waitlist	No data
Lee et al. (2013)	Brief MI	AO	No data
Lee et al. (2010)	Web-based personalised feedback	AO	No data
Stein et al. (2011) 40% 21 (18–24), female	MI 2 (1.7) 4 weeks	AO	Not sig p = 0.174
Stephens et al. (2007) NR 32 (18–57)	MI/personalised feedback 1 (1) 1 week	Waitlist		Sig p < 0.05		Sig p < 0.05		Sig^g p < 0.05	Not sig^j p = NR
Stephens et al. (2000) 98% 34 (≥18)	MI 2 (NR) 4 weeks	Waitlist	Sig p < 0.001	Sig p < 0.001		Sig p < 0.001		Sig^i p < 0.001	Sig p < 0.001
Brief MI versus other interventions
Fernandes et al. (2010)	Tele-brief MI	Written cannabis information	No data
Fischer et al. (2012)	Brief MI	Cannabis education	No data
Stephens et al. (2007) NR 32 (18–57)	MI/personalised feedback 1 (1) 1 week	Cannabis education		Sig p < 0.05		Sig p < 0.05		Sig^g p < 0.05	Not sig^j p = NR
Contingency management versus other
Budney et al. (2000) 100% 32 (≥18)	CBT + V 14 (NR) 14 weeks	CBT or MET (NR) 14 weeks	Sig p < 0.02	Not sig p = 0.12			Sig^f p = NR		Not sig^l p = NR
	CBT 14 (NR) 14 weeks	MET 4 (NR) 14 weeks	Not sig p = NR
Budney et al. (2006) 100% 33 (≥18)	V n/a (n/a) 14 weeks	CBT 14 (8.8) 14 weeks	Sig^o p = 0.02 OR = 6.0 (95% CI 1.7–21.0)^p		Sig p < 0.05
	CBT + V 14 (9.6) 14 weeks	CBT 14 (8.8) 14 weeks	Sig^o p = 0.20 OR = 4.1 (95% CI 1.2–14.4)^p
	V n/a (n/a) 14 weeks	CBT + Voucher 14 (9.6) 14 weeks	Not sig p = 0.32
	All groups			Not sig p = 0.71				Not sig^j p = NR
Budney et al. (2011) 100% 35 (18–61)	CompCBT + V and CBT + V	MET 9 (NR) 4 weeks	Sig p < 0.05
	CompCBT + V 2 (NR) 12 weeks	CBT + V 9 (NR) 12 weeks	Not sig p > 0.05
	All groups						Not sig^f p = NR
Litt et al. (2013) 100% 33 (≥18)	CBT/MET/V (abstinence)9 (5.5) 2 months	CaseM 9 (6) 2 months
	CBT/MET/V (abstinence)9 (5.5) 2 months	CBT/MET/V (homework)9 (5.7) 2 months	Sig p < 0.03

AO, assessment only; CaseM, case management CBT, cognitive behavioural therapy; CBT + V, CBT plus voucher; CompCBT, computer CBT; CP, cannabis problems; CU, cannabis usage; MET, motivational enhancement therapy; MI, motivational interviewing; MtC, Motivation to change; NR, not reported; PPS, Psychosocial Problem Solving; RP, relapse prevention; SoD, Severity of Dependence; SSG, social support group; V, voucher (contingency management).

^a% meeting criteria for cannabis dependence via DSM-III or DSM-IV.

^bDefined as the first follow-up point after the end of treatment.

^cAmount per week.

^dAmount per day.

^eSDS.

^fASI.

^gDSM-IV.

^hDSM-III.

ⁱMDS.

^jMPS.

^kCPQ.

^lMCQ.

^mDAST.

ⁿRMPI.

^oContinuous abstinence.

^pAbstinence for 6 weeks or more.

Table 3. Results at follow-up

				Follow up difference between groups^b
Study % DSM^a mean Age (range)	Intervention (N attended) Duration	Control N sessions Duration	Follow-up from baseline	% Abstinent	Days use	Joints per day	Periods use per day	Severity of dependence	Dependence symptoms	Cannabis problems
CBT versus wait-list
Babor et al. (2004)	CBT/MET/CaseM	Waitlist		No data
Copeland et al. (2001) 96% 32 (≥18)	CBT 6 (4.2) 6 weeks	Waitlist	9 m	Sig p = 0.05	Not sig p = NR	Sig^c p = 0.02		Sig^d p < 0.001		Sig^k p < 0.001
Hoch et al. (2014)	CBT/MET/PPS	Waitlist		No data
Hoch et al. (2012)	CBT/MET/PPS	Waitlist		No data
Jungerman et al. (2007)	CBT/MI/RP	Waitlist		No data
Stephens et al. (2000)	CBT/RP/SSG	Waitlist		No data
CBT/psychotherapy versus brief MI
Babor et al. (2004) 100% 36 (18–62)	CBT/MET/CaseM 9 (6.5) 12 weeks	MET 2 (1.6) 12 weeks	9 m 15 m	Not sig p = NR Sig p < 0.001	Sig p < 0.001 d = 0.37 Sig p = NR d = 0.22	Not sig p = NR Not sig p = NR	Sig p < 0.01		Sig p < 0.01 d = 0.31	Not sig^j p = NR Not sig^j p = NR
Budney et al. (2000)	CBT/MET	MET		No data
Copeland et al. (2001) 96% 32 (≥18)	CBT 6 (4.2) 6 weeks	MI 1 (NR) 6 weeks	9 m	Not sig p = 0.6	Not sig p = NR	Not sig^c p = 0.3		Sig^d p = 0.04		Not sig^k p = 0.08
Stephens et al. (2000) 98% 34 (≥18)	CBT/RP/SSG (group) 14 (8.4) 18 weeks	MI (indiv.) 2 (NR) 18 weeks	16 m	Not sig p = NR	Not sig p = NR		Not sig p = NR		Not sig^i p = NR	Not sig p = NR
CBT versus other interventions
Jungerman et al. (2007)	CBT/MI/RP over 12 weeks	CBT/MI/RP over 4 weeks		No data
Kadden et al. (2007) 100% 33 (≥18)	CBT/MET 9 (5.2) 9 weeks	CaseM 9 (5.2) 9 weeks	14 m		Not sig p = NR	Not sig p = NR		Not sig^f p = NR		Not sig^j p = NR
Sobell et al. (2009) Non-severe only 32 (≥18)	CBT/MI (indiv) 4 (NR) NR	CBT/MI (group) 4 (NR) NR		12 m	Not sig p = 0.86
Stephens et al. (1994) NR 32 (18–65)	CBT/RP (group) 10 (7.6) 12 weeks	SSG (group) 10 (7.6) 12 weeks	15 m	Not sig p = NR	Not sig p = NR					Not sig^l p = NR
Telephone or web-based CBT or counselling versus wait-list or other
Gates et al. (2012) NR 36 (≥16)	tele-CBT/MI 4 (3.3) 3 weeks	Waitlist	3 m		Not sig p = 0.057	Not sig^c p = 0.340		Sig^d p = 0.001		Sig^k p = 0.006
Rooke et al. (2013) NR 31 (≥18)	CBT/MI 6 (3.5) 6 weeks	Written cannabis information	3 m	Not sig 0.06 d = 0.25	Sig p = 0.02 d = 0.33			Not sig^e p = 0.001
Tossmann et al. (2011) 92% 25 (NR)	Web-based counselling NR 7 weeks	Waitlist	3 m		Sig p < 0.001
Brief MI versus wait-list/AO
Babor et al. (2004)	MET	Waitlist		No data
Copeland et al. (2001) 96% 32 (≥18)	MI 1 (NR) 1 week	Waitlist	9 m	Sig p = 0.05	Not sig p = 0.09	Not sig^d p = 0.2		Sig^e p = 0.008		Sig^k p = 0.004
De Dios et al. (2012) NR 23 (18–29), female	MI/meditation 2 (2) 2 weeks	AO	3 m	Not sig p = NR	Sig p = 0.026
Gmel et al. (2013) NR 20 (19–20), male	Brief MI (group) 1 (NR) 1 week	AO	6 m		Not sig p = 0.342
Humeniuk et al. (2012) Low use only 31 (16–62)	Brief MI 1 (1) 1 week	Waitlist	3 m		Sig p < 0.05
Lee et al. (2013) NR 20 (18–25), students	Brief MI (in person or written) 1 (NR) 1 week	AO	3 m 6 m		Not sig p = NR RR = 0.96, 95% CI 0.80, 1.15 Not sig p = NR RR = 1.11, 95% CI 0.85, 1.43	Sig^c p < 0.05 RR = 0.76, 95% CI 0.60, 0.96				Not sig^n p < 0.10 RR = 0.9, 95% CI 0.76, 1.07 Not sig^n p = NR RR = 1.15, 95% CI 0.90, 1.47
Lee et al. (2010) NR 18 (17–19), students	Web-based personalised feedback 1 (NR) 1 week	AO	3 m 6 m		Not sig p = NR Not sig p = NR					Not sig^n p = NR Not sig^n p = NR
Stein et al. (2011) 40% 21 (18–24), female	MI 2 (1.7) 4 weeks	AO	3 m 6 m	Sig p = 0.010 Not sig p = 0.202
Stephens (2007)	MI/personalised feedback	Waitlist		No data
Stephens (2000)	MI	Waitlist		No data
Brief MI versus other interventions
Fernandes et al. (2010) NR 25 (11-NR)	Tele-brief MI 1 (NR) 1 week	Written cannabis information	6 m	Sig p < 0.05 OR = 1.6, 95% CI 1.2, 2.0
Fischer et al. (2012) NR 20 (18–28)	Brief MI 1 (NR) 1 week	Cannabis education	3 m 12 m		Not sig p = NR Not sig p = NR	Not sig p = NR Not sig p = NR
Stephens et al. (2007) NR 32 (18–57)	MI/personalised feedback 1 (1) 1 week	Cannabis education	6 m 12 m		Not sig p = 0.408 Sig p = 0.019		Not sig p = NR Not sig p = NR		Sig^g p = 0.019 Sig^g p = 0.049	Not sig^j p = NR Not sig^j p = NR
Contingency management versus other
Budney et al. (2000) 100% 32 (≥18)	CBT + V	CBT or MET		No data
Budney et al. (2006) 100% 33 (≥18)	CBT + V 14 (9.6), 14 weeksV	14 (8.8), 14 weeks CBT	12 m	Not sig p = 0.74		Sig p < 0.05
		CBT		Sig p = 0.04
	V	14 (9.6), 14 weeks CBT + V		Sig p < 0.05
	All groups			Sig p < 0.01	Not sig p = 0.31				Not sig^j p = NR
Budney et al. (2011) 100% 35 (18–61)	CompCBT + V	MET	9 m	No data
	CBT + V	MET		No data
	CBT + V	compCBT + V		No data
	All groups			p < 0.05
Kadden et al. (2007) 100% 33 (≥18)	All groups		14 m	Not sig p = NR	Not sig p = NR		Not sig^f p = NR	Not sig p = NR	Not sig p = NR
Litt et al. (2013) 100% 33 (≥18)	CBT/MET/V 9(5.5) 2 month	CaseM 9(6) 2 month	8 m	Not sig p = NR
	CBT/MET/V 9(5.5) 2 month	CBT/MET/V (homework) 9(5.7) 2 month		Not sig p = NR

AO, assessment only; CaseM, case management; CBT, cognitive behavioural therapy; CBT + V, CBT plus vouchers; CompCBT + V, Computer CBT plus vouchers; CP, cannabis problems; CU, cannabis usage; MET, motivational enhancement therapy; MI, motivational interviewing; MtC, Motivation to change; NR, not reported; PPS, Psychosocial Problem Solving; RP, relapse prevention; SoD, Severity of Dependence; SSG, social support group; V, Voucher (Contingency Management).

^a% meeting criteria for cannabis dependence via DSM-III or DSM-IV.

^bDefined as the final follow-up point.

^cAmount per week.

^dAmount per day.

^eSDS.

^fASI.

^gDSM-IV.

^hDSM-III.

ⁱMDS.

^jMPS.

^kCPQ.

^lMCQ.

^mDAST.

ⁿRMPI.

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