Cannabis Treatment: Why you should bother - Eurad

In the early days of Drug and Alcohol Findings, commentators asked whether we should cover research on cannabis treatment might reply along the lines of, 'Why bother? We have more than enough patients with problems with serious drugs like heroin.' The demand to treat was seen as arising from the pathologising of what in many societies is both normal and in some eyes desirable youth development: trying new experiences, challenging conventions, exposing the hypocrisy of alcohol-laden adults. And among adults, better they smoke calming joints than drink disinhibiting alcohol.

Those views retain some validity for the vast majority of cannabis users ... but this has become, and/or become seen more clearly as, a drug with a problem tail which justifies therapeutic intervention, distinguishable from the less problematic body. Among young adults treatment numbers in England are rising as heroin falls way, and now more 18–24s seek treatment for cannabis than for heroin use problems – not, according to the National Treatment Agency for Substance Misuse, because more are using the drug, but perhaps because services relieved of some of the recent pressure of opiate user numbers are giving more priority to cannabis, and because stronger strains of the drug are creating more problems. Among the under-18s cannabis dominates at around 13,000 in treatment in recent years, having steadily increased until tailing off slightly in 2010/11.

Though the crime reduction justification for treating adult heroin and crack users is not so clear among young cannabis users, still immediate impacts plus the longer term benefits of forestalling further problems has been calculated to more than justify the costs of treating under-18 patients, among whom cannabis is the major player.

But what kind of treatment and for how long and how intensively? Unlike heroin and cocaine, cannabis and its users have been seen as sufficiently amenable to intervention to warrant trying brief interventions along the lines established for risky but not dependent drinkers. In some studies these work just as well as more intensive treatment, but when the patients are heavily dependent, and the most difficult cases are not filtered out by the research, longer and more individualised therapies can have the advantage. These studies on adults might not translate to adolescents, for whom approaches which address family, school and other factors in the child's environment are considered most appropriate for what are often multiply troubled youngsters.

These are some of the issues thrown up by a set of patients and a set of interventions rather different from those associated with the drugs treatment in Britain normally focuses on. If current trends continue, understanding the findings of these and other studies will become yet more important to British treatment services.

Last revised 29 June 2012

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