Communication Skills for Cannabis Use

(STAC Trial)

Overseen By Ty Tristao, BA

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Washington

Disqualifiers: Non-English speakers, No Zoom access

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 6

Duration: 6 weeks

40 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Cannabis Conversation Skills for Families (CCSF)?

Psychotherapeutic strategies used for other substance use disorders can be effective for cannabis dependence, and family engagement adds substantial value, especially among adolescents. Combination therapies that include motivational interventions and teach coping skills have shown effectiveness in treating cannabis dependence. ^{1 2 3 4 5}

Is the Communication Skills for Cannabis Use treatment safe for humans?

Safety issues are a major concern for the use of cannabis and cannabinoid medications, and while there is some information from studies of recreational use, the effects can differ widely. Standardized, quality-controlled cannabinoid products have safety profiles available, but caution is advised as clinical experience is still in the early stages, and long-term safety monitoring is needed. ^{6 7 8 9 10}

How is the Cannabis Conversation Skills for Families (CCSF) treatment different from other treatments for cannabis use?

The Cannabis Conversation Skills for Families (CCSF) treatment is unique because it focuses on improving communication skills within families to address cannabis use, rather than relying solely on traditional methods like education or public health measures. This approach emphasizes creating a supportive environment for discussing cannabis use and its risks, which can be more effective in preventing misuse, especially among adolescents. ^{11 12 13 14 15}

What is the purpose of this trial?

The objectives of this research is to (1) create a family intervention and provider manual to train family members of young people with psychosis (YP-P) who are heavy cannabis users new communication skills to motivate change in the YP-P's cannabis use, (2) pre-test the intervention with 10 family member participants and adapt the intervention based on their recommendations, and (3) evaluate the feasibility and acceptability of the intervention in a randomized pilot trial (n=40). The investigators anticipate that the intervention will improve family participants' communication skills, decrease expressed emotion and caregiver burden. The investigators anticipate that improvements in communication skills, expressed emotion and caregiver burden will lead to decreases in the cannabis use of their YP-P.

Research Team

Denise Walker, Ph.D.

Principal Investigator

University of Washington

Eligibility Criteria

This trial is for adults aged 18 or older who have a young family member with psychosis and heavy cannabis use. Participants must be in close contact (at least 10 hours per week) with their loved one, who should be receiving treatment for first-episode psychosis and using cannabis frequently.

Inclusion Criteria

I spend 10+ hours weekly with a loved one who has early psychosis.

Has a loved one who is both in CSC treatment for FEP and has used cannabis on at least 9 days in the past 30

Exclusion Criteria

I cannot read or speak English well enough for study materials.

Do not have access to Zoom

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention Development

Development of a family intervention informed by a Stakeholder Advisory Board and pre-testing with 10 family member participants

4 weeks

Treatment

Family members receive training in communication skills to support reduced cannabis use in young adults with psychosis

6 weeks

6 sessions (90 minutes each) held weekly via Zoom

Follow-up

Participants are monitored for safety and effectiveness after treatment

3 months

Treatment Details

Interventions

• Cannabis Conversation Skills for Families (CCSF)

Trial Overview The study tests a new intervention called Cannabis Conversation Skills for Families (CCSF), designed to help families communicate better about cannabis use with young people experiencing psychosis. The goal is to improve communication skills, reduce emotional stress, and lessen caregiver burden.

Participant Groups

Group I: Cannabis Conversation Skills for Families (CCSF) Experimental Treatment 1 Intervention

The purpose of the intervention is to train family members in communication skills that may increase contemplation of change in their loved one with first episode psychosis to reduce cannabis use, decrease conflict surrounding these discussions, and provide skills to understand when and how to approach their loved one about cannabis use and encourage treatment. Six sessions (90 minutes each) will be held weekly in a closed group format via Zoom, with the same therapist leading each group. Group size will be 3-8 participants, with an average wait time of 4 weeks. Assessments will occur at baseline, post-treatment, and at a 3-month follow-up.

Group II: Treatment as Usual (TAU) Control Active Control 1 Intervention

In this project, treatment as usual will consist of psychoeducation on cannabis and its impacts on psychosis and family services otherwise provided to participants through their participation in the coordinated specialty care program at which their loved one is enrolled. The investigators will track what each family receives and characterize the content and dose in analysis.

Who Is Running the Clinical Trial?

University of Washington

Lead Sponsor

Trials

1,858

Recruited

2,023,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Findings from Research

Only about 20% of individuals undergoing treatment for cannabis dependence achieve long-term abstinence, highlighting the need for more effective and accessible treatment options.

Psychotherapeutic strategies, especially combination therapies that include motivational interventions and behavioral skills training, have shown larger effect sizes for cannabis dependence compared to other substance use disorders, indicating their potential effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

State of the art treatments for cannabis dependence. Danovitch, I., Gorelick, DA.[2021]

The digital intervention ICan, which incorporates motivational interviewing and cognitive behavioral therapy, was more effective than standard educational information in reducing the amount of cannabis used over a 3-month period, showing a significant reduction in grams used (P=0.009).

However, by the 6-month follow-up, both the ICan and control groups showed similar reductions in the number of cannabis use days, indicating that while ICan had initial benefits, its long-term effectiveness in reducing frequency of use was not significantly different from the control group.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A guided digital intervention to reduce cannabis use: The ICan randomized controlled trial. Olthof, MIA., Goudriaan, AE., van Laar, MW., et al.[2023]

Adding medical cannabis to prescription opioids for chronic pain patients showed very low certainty evidence of reducing opioid use, with no significant impact on pain relief or sleep disturbance based on five randomized trials and twelve observational studies.

However, the addition of cannabis was associated with an increased risk of nausea and vomiting, indicating potential adverse effects that need to be considered when evaluating its use in chronic pain management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Opioid-sparing effects of medical cannabis or cannabinoids for chronic pain: a systematic review and meta-analysis of randomised and observational studies. Noori, A., Miroshnychenko, A., Shergill, Y., et al.[2022]

The safety of cannabis and cannabinoid medications is a significant concern, and while some safety information can be drawn from recreational use studies, medical and recreational users may experience different effects.

There is a pressing need for long-term safety monitoring of cannabinoid use in patients, as clinical experience is still developing, which will help inform both therapeutic decisions and public policy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Safety issues concerning the medical use of cannabis and cannabinoids. Ware, MA., Tawfik, VL.[2019]

References

1. United States pubmed.ncbi.nlm.nih.gov

State of the art treatments for cannabis dependence. [2021]

2. England pubmed.ncbi.nlm.nih.gov

A guided digital intervention to reduce cannabis use: The ICan randomized controlled trial. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Exclusive Therapeutic Use of Cannabis in a Large Sample of Daily Cannabis Users in France: A Cross-Sectional Survey. [2023]

4. England pubmed.ncbi.nlm.nih.gov

Opioid-sparing effects of medical cannabis or cannabinoids for chronic pain: a systematic review and meta-analysis of randomised and observational studies. [2022]

5. Germany pubmed.ncbi.nlm.nih.gov

Cannabis use among recently treated cancer patients: perceptions and experiences. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

Making informed choices about cannabis use during pregnancy and lactation: A qualitative study of information use. [2023]

7. England pubmed.ncbi.nlm.nih.gov

Canadian educational resources about cannabis use and fertility, pregnancy and breast feeding: a scoping review protocol. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

Safety issues concerning the medical use of cannabis and cannabinoids. [2019]

9. Netherlands pubmed.ncbi.nlm.nih.gov

Self-Reported Medical and Nonmedical Cannabis Use: Results from the 2018 Behavioral Risk Factor Surveillance System in 14 States. [2023]

10. United States pubmed.ncbi.nlm.nih.gov

Dispensary Staff Perceptions About the Benefits, Risks, and Safety of Cannabis for Medical Purposes. [2023]

11. Germany pubmed.ncbi.nlm.nih.gov

Associations of childhood sociability and responsibility with cannabis use trajectories during adolescence: results from a prospective population-based birth cohort study. [2022]

12. England pubmed.ncbi.nlm.nih.gov

Psychometric properties of the CAST and SDS scales in young adult cannabis users. [2019]

13. England pubmed.ncbi.nlm.nih.gov

Assessment of cannabis use disorders: a systematic review of screening and diagnostic instruments. [2018]

14. England pubmed.ncbi.nlm.nih.gov

Counselling adolescents and parents about cannabis: A primer for health professionals. [2021]

15. Australia pubmed.ncbi.nlm.nih.gov

Cannabis and brain function. [2019]