Despite its widespread use, relatively few cannabis users present to treatment, with only 31,980 episodes of care provided for primary cannabis use problems in 2006-07 (AIHW, 2008). Study on the barriers to cannabis treatment has highlighted the importance of providing additional outpatient treatments that are specific to cannabis (Treloar et al., 2007). Partly based on the success that telephone counselling has shown for people with tobacco related problems (see Stead et al 2008 Cochrane Review) and this desire for alternative treatments, the Cannabis Information and Helpline (CIH) was launched by Lifeline Australia in collaboration with the National Cannabis Prevention and Information Centre.
However, to date no Australian data exists on the effectiveness of a brief intervention based on the telephone in assisting individuals to reduce their cannabis use. The Helpline offers the opportunity to research the efficacy of different brief interventions that may address several barriers to conventional cannabis treatments.
This study aimed to recruit 120 participants who phoned the Cannabis Information and Helpline requesting assistance in reducing their own cannabis use. Treatment effectiveness was assessed by reduction in cannabis use and general improvements in quality of life. Participants were randomised into two groups: immediate treatment or three-months delayed treatment. Treatment was four sessions of cognitive-behavioural and motivational enhancement therapy. Treatment delivery was meant to be flexible, in that successful patients would continue to learn new skills during each session, whereas unsuccessful participants would undergo motivational interviewing and problem-solving techniques in an effort to address their lack of improvement. Participants were interviewed pre-treatment, immediately post-treatment, and at one- and three-months post-treatment.
The treatment was delivered by Cannabis Information and Helpline counsellors. All counsellors received two full-days of training. Counselling calls were monitored randomly to assess treatment fidelity.
The brief intervention was a four session intervention utilising a directive model that assists participants in recognising the benefits of change and are developing coping skills that work towards a reduction of cannabis use and prevention of relapse. Participants were first assessed at baseline and provided information to the researcher that was then forwarded to the counsellors at the Helpline. As is typical with interventions based on motivational interviewing, participants received feedback from their initial baseline assessment in the form of a Participant Case File (PCF). The PCF was also used as a case management tool to help counsellors maintain continuity between treatment sessions. Immediately following the baseline assessment, the participants were randomly placed into one of two groups; those who began the intervention immediately and those who were asked to wait three months before beginning the intervention (the ‘control’ group).
Following the completion of the four sessions (or after four weeks from baseline assessment for those in the ‘control’ group), each participant was asked to provide the researcher with information on their cannabis use, as well as their physical and mental health via phone interview. Finally, participants completed a second phone interview three months from the original baseline assessment date.
The intervention was delivered to 160 individuals. Those allocated to the telephone intervention reported greater confidence in reducing their cannabis at post-treatment, which in turn led to achieving a significantly greater number of abstinent days at the three month follow-up assessment compared to the control participants (intervention participants reported an average of 20.7 days of abstinence in the 28 days prior to follow-up compared to 15.5 days reported by control participants). At the three month follow-up, 22.8% of the intervention participants reported clinically significant improvement from baseline levels of cannabis use and related problems compared to 13.6% of the control participants.
Findings were presented to several drug and alcohol conferences, and published in the journal Addiction as detailed below. In addition, further detail can be found at the UNSW library holdings of doctoral student theses (unsworks:10861 http://handle.unsw.edu.au/1959.4/52191).
Papers:
Presentations:
Gates, P., Copeland, J., Norberg, M. (2012) Randomised Controlled Trial of a Brief Cannabis Intervention, Paper presented to the National Cannabis Prevention and Information Centre Conference, 19-21 September, Brisbane, Australia
Gates, P., Copeland, J., Norberg, M. (2011)Randomised controlled trial of a brief cannabis intervention delivered by telephone.Paper presented at the 73rd Annual Meeting of the College on Problems of Drug Dependence (CPDD), 18-23 June, Florida, USA
Gates, P., Norberg, M., Copeland, J. (2010) A randomised controlled trial of a brief cannabis intervention delivered by telephone, Paper presented at the National Drug and Alcohol Research Centre Seminar Series, 11 November, National Drug and Alcohol Research Centre, Sydney, Australia
Gates, P.,Copeland, J., Norberg, M., Digiusto, E. (2010) Randomised control trial of a brief cannabis intervention delivered by telephone. Paper presented at the Australasian Professional Society on Alcohol and Other Drugs (APSAD) Conference, 28 November–1 December, Canberra, Australia
Gates, P.,Copeland, J., Norberg, M., Digiusto, E. (2010) Randomised Controlled Trial of a Brief Cannabis Intervention Delivered by Telephone. Panel discussion presented at the Australasian Professional Society on Alcohol and other Drugs, 28 November, Canberra, Australia
Posters:
Gates, P., Copeland, J., Norberg, M., Digiusto, E. (2011) Randomised Controlled Trial of a Brief Cannabis Intervention Delivered by Telephone, Poster presentation at the College of Problems of Drug Dependence, June 18-23, Florida, USA
Gates, P., Copeland, J., Norberg, M., Digiusto, E. (2011) Randomised controlled trial of a brief cannabis intervention delivered by telephone. Poster presented atthe Post-Graduate Student Conference, 10 September, University of New South Wales
Gates, P.,Copeland, J., Norberg, M., Digiusto, E. (2011)Randomised controlled trial of a brief cannabis intervention delivered by telephone. Poster presented at the Advances in Public Health and Health Services Research at UNSW Research Symposium, 5 August, Sydney Australia.
Gates, P., Copeland, J., Norberg, M., Digiusto, E. (2010) Randomised Controlled Trial of a Brief Cannabis Intervention Delivered by Telephone. Poster presentation at the Australasian Professional Society on Alcohol and other Drugs, 28 November-1 December, Canberra, Australia
Gates, P., Copeland, J., Norberg, M., Digiusto, E. (2010) Randomised Controlled Trial of a Brief Cannabis Intervention Delivered by Telephone, Poster presentation at the Advances in Public Health and Health Services Research, 7 May, University of New South Wales, Sydney, Australia
Gates, P., Copeland, J., Norberg, M., Digiusto E. (2010) Randomised control trial of a brief cannabis intervention delivered by telephone. Poster presented at the National Drug and Alcohol Research Centre Annual Symposium, 10 August, Sydney, Australia