Community Based Cannabis Cessation Program

Examining a Community Based Intervention for Cannabis Smoking Cessation in Norway - an Observational Study

The study examined a community based cannabis cessation program in Norway (CCP). The CCP uses a combination of cognitive therapy and psychoeducation and covers the normal withdrawal period for cannabis smoking cessation (up to 8 weeks), comprising ~15 individual sessions. From 2005 onwards, the CCP was implemented as a low-threshold community-based program in several Norwegian municipalities, e.g., Kristiansand, Fredrikstad and Oslo. The study had an observational one-group pre- / post test design. Outcomes was changes in cannabis use, mental distress, well-being, social network and sense of coherence (SoC) measured post-intervention (T2) and at a 3 months follow-up (T3).

Study Overview

• Status: Completed
• Conditions: Cannabis Use
• Intervention / Treatment: Behavioral: Cannabis cessation Program

• Study Type: Observational
• Enrollment (Actual): 102

Contacts and Locations

Study Locations

• Norway
  • Fredrikstad, Norway
    • Social Services, Fredrikstad Municipality
  • Kristiansand, Norway
    • Kristiansand Municipality, Cannabis Cessation Program
  • Oslo, Norway
    • City Centre Outreach Service, Agency for Social and Welfare Services

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years and older (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: N/A
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

The target group was individuals who engaged in regular or daily cannabis use, and who were motivated to quit cannabis.

Description

Inclusion Criteria:

• Severity of Dependence Scale (SDS) score ≥4

Exclusion Criteria:

• polydrug use where cannabis was not the predominating substance of use
• psychiatric comorbidity that was perceived as too severe to handle at the community-based centers

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

HAP - group; The target group was individuals who engaged in regular or daily cannabis use, and who were motivated to quit cannabis. The formal inclusion criteria was a Severity of Dependence Scale (SDS) score ≥4 and being ≥16 years old. Exclusion criteria was polydrug use where cannabis was not the predominating substance of use and psychiatric comorbidity that was perceived as too severe to handle at the community-based centers .

Behavioral: Cannabis cessation Program; Lundqvist and Ericsson developed the 'Cannabis Cessation Program' (CCP, Nordic abbreviation: HAP) in Sweden in the 1990s. The method uses a combination of cognitive therapy and psychoeducation and covers the normal withdrawal period for cannabis smoking cessation (up to 8 weeks), comprising ~15 individual sessions. It describes a medical, a psychological, and a social phase, in which the participant is helped to recognize and address typical problems related to each phase, e.g., physical and psychological withdrawal problems. The overarching aim of the program is to help cannabis users to reorganize thinking patterns that developed while they were using cannabis and increase their social and psychological coping skills in relation to quitting cannabis use. The CCP manual has been translated into eight languages, e.g., Norwegian.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cannabis use	Days with cannabis use last 30 days	Changes from baseline to post-treatment and follow-up, on average 5 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mental distress	The Hopkins Symptom Checklist (HSCL) 25-item version was used to measure mental distress. Each of the 25 items was scored on a 4-point scale (1-4). An average score was computed, indicating a global severity index of mental distress (GSI), where higher scores indicated greater distress. Clinical cut-off = 1.75	Changes from baseline to post-treatment and follow-up, on average 5 months
Well-being	The Outcome Rating Scale (ORS) was used to assess well-being. The scale has four visual analogue items on personal, interpersonal, social, and general well-being, and each item are scored from 0 = bad up to 10 = good. The items are then summed (range 0-40) and a score <25 indicated scores expected in a clinical population.	Changes from baseline to post-treatment and follow-up, on average 5 months
Social network	Number of current friends with and without problematic substance use	Changes from baseline to post-treatment and follow-up, on average 5 months
Sense of Coherence (SoC)	The Sense of Coherence questionnaire, 29 item version, measures the degree to which the subject feels that he or she has a sense of control over their own lives (manageability - 10 items), that life has meaning (8 items) and that their social life is understandable (comprehensibility - 11 items). Responses to items are scored on a seven-point semantic differential scale. Scores are summed (ranges from 29 - 203) and higher scores indicated a stronger SoC	Changes from baseline to post-treatment and follow-up, on average 5 months

Collaborators and Investigators

• Sponsor: Sorlandet Hospital HF
• Collaborators: City of Oslo; Municipality of Kristiansand; Norway Centre for Addiction Research
• Investigators: Principal Investigator: John-Kåre Vederhus, PhD, Addiction Unit, Sørlandet Hospital, Kristiansand

Publications and helpful links

General Publications

• Vederhus JK, Rørendal M, Skårdal M, Næss MO, Clausen T, Kristensen Ø. Successful outcomes with low-threshold intervention for cannabis use disorders in Norway - an observational study. PLoS One. 2022 Jun 16;17(6):e0269988. doi: 10.1371/journal.pone.0269988. eCollection 2022.

Study record dates

Study Major Dates

• Study Start (Actual): June 2, 2013
• Primary Completion (Actual): January 31, 2017
• Study Completion (Actual): January 31, 2017

Study Registration Dates

• First Submitted: July 12, 2021
• First Submitted That Met QC Criteria: July 24, 2021
• First Posted (Actual): August 4, 2021

Study Record Updates

• Last Update Posted (Actual): August 4, 2021
• Last Update Submitted That Met QC Criteria: July 24, 2021
• Last Verified: July 1, 2021

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders; Chemically-Induced Disorders; Substance-Related Disorders; Marijuana Abuse
• Other Study ID Numbers: 005004

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Yes
• IPD Plan Description: Study protocol will be shared upon request. Anonymous data will be shared upon reasonable request
• IPD Sharing Time Frame: Upon request
• IPD Sharing Access Criteria: Upon request
• IPD Sharing Supporting Information Type: Study Protocol

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No