Attempts to stop or reduce daily cannabis use: An intensive natural history study

Abstract

We attempted to replicate and add to our prior study of attempts to stop or reduce cannabis use among daily cannabis users trying to change on their own, by observing a larger sample and adding further clinically relevant outcomes. Daily users (n = 193) who intended to stop or reduce sometime in the next 3 months called an Interactive Voice Response system each morning for 3 months to report on cannabis use, attempts to stop or reduce, withdrawal symptoms, and so forth, on the prior day. This study replicated our prior findings that (a) cannabis users trying to change make many, and often rapid, transitions among use as usual, reduction, and abstinence; (b) reduction attempts are more common than abstinence attempts; (c) quit and reduction attempts are short-lived and few participants achieve long-term abstinence; (d) alcohol and drug use are not greater on abstinence days; and (e) few users seek treatment. Novel findings included (f) a greater number of days of abstinence or intentional reduction predicted a greater decline in cannabis dependence, (g) most users do not prepare before their quit attempt, (h) coping outcomes during abstinence predict increased duration of abstinence, (i) tobacco use is less common on days of abstinence, and (j) withdrawal symptoms occur even with short quit attempts. Replication tests in more generalizable samples and of longer duration are indicated. Further natural history studies are likely to provide information to help improve the content of psychological treatments for cannabis use. (PsycINFO Database Record

Figure 1

Participant Flow Chart. All percents are of those in the preceding box.

Figure 2

Use status of “average” participants; i.e., the 11 participants nearest the median number of days of abstinence or reduction for the entire sample. Black = day of intentional abstinence (i.e., quit attempt), gray = day of intentional reduction, dotted = day of usual use (including unintentional abstinence or reduction), X = day with missing data.