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. 2016 Sep:60:197-202.
doi: 10.1016/j.addbeh.2016.04.014. Epub 2016 Apr 22.

Gender differences in cannabis use disorder treatment: Change readiness and taking steps predict worse cannabis outcomes for women

Brian J Sherman  1 , Nathaniel L Baker  2 , Aimee L McRae-Clark  3
Affiliations

Gender differences in cannabis use disorder treatment: Change readiness and taking steps predict worse cannabis outcomes for women

Brian J Sherman et al. Addict Behav. 2016 Sep.

Abstract

Introduction: Gender differences in cannabis use and cannabis use disorder have been established. Regarding treatment, some evidence suggests that women are less responsive, though the mechanisms are not well understood. Motivation to change and self-efficacy are associated with better outcomes overall, and may help explain gender differences in cannabis use outcomes.

Methods: A secondary data analysis of a double-blind placebo controlled trial of buspirone treatment for cannabis dependence (N=175) was conducted. Self-report assessments of motivation to change, self-efficacy, and other clinical correlates were completed at baseline, and cannabis use was measured throughout the study.

Results: There was a significant interaction between gender and taking steps on abstinence. Counter to hypothesis, higher taking steps reduced likelihood of achieving abstinence among women; there was no association among men. Subsequently, taking steps was associated with self-efficacy and quantity of use among men, and cannabis related problems among women. There was a significant interaction between gender and readiness to change on creatinine adjusted cannabinoid levels. Change readiness was positively associated with cannabinoid levels among women, but not men.

Conclusions: Motivation to change and initiation of change behavior predict worse cannabis outcomes in women. Men and women differ in what motivates change behavior. Social desirability, neurobiology, and treatment type may impact these effects. Gender differences in cannabis use and treatment responsiveness must be considered in future studies.

Keywords: Cannabis; Gender; Motivation; Sex differences; Taking steps; Treatment.

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Conflict of interest statement

Conflict of Interest: All authors declare they have no conflict of interest.

Figures

Figure 1
Figure 1
Proportions of negative UCTs by gender and SOCRATES – Taking Steps. Note: Estimated marginal means represented in figure reflect interaction of gender by Taking Steps on proportion of negative UCTs. SOCRATES – Taking Steps median split was used to illustrate interaction. Women low in Taking Steps had greater proportion of negative UCTs (M = .11, SE = .15) than women high in Taking Steps (M = .01, SE = .01); OR = .08(.02-.37), p = .001, while among men there was no significant difference by level of Taking Steps [low M = .08, SE = .09 vs. high M = .07, SE = .08; OR = .91(.37-2.24), p = .84]. Proportion neg. UCTs reflects the number of negative urine cannabinoid tests over the total number of UCTs during the study period, adjusted for non-independence.
Figure 2
Figure 2
Creatinine adjusted cannabinoid levels by gender and readiness to change. Note: Figure 2 illustrates estimated marginal means for creatinine adjusted cannabinoid levels for men and women across high and low levels of readiness to change. Median split was applied to demonstrate the interaction. Women high on readiness to change had higher creatinine adjusted cannabinoid levels during treatment (M = 1.3, SE = .21) than women low on readiness (M = .43, SE = .31; b = .35, se = .08, p = .000), while this association was not significant among men (high M = .94, SE = .12 vs. low M = 1.1, SE = .22; b = -.08, se = .07, p = .20).
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