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Marijuana Use Trends and Treatment

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UCSB Alcohol & Drug Program

on 30 April 2018

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Transcript of Marijuana Use Trends and Treatment

A
D
Marijuana Use In College
Assessment and Treatment
Safety Myths
Trusting
Experience
A few distinctions...
The
Bud
Blog
Mild
Infrequent users who do not meet criteria for dependence
Moderate
Regular use, but not necessarily disordered use. May at times fail to meet obligations, use when its dangerous, use more than they intended to but not all three
Heavy
THC
Use a glass pipe
User experiences
euphoric high

Bud of the hemp plant

THC concentration of 20%

Smoked by lighting joint, pipe, or bong


Overdose "impossible"

THC Extract from Bud using CO2 or Butane

THC concentration of 80%

Smoked using a torch, a metal nail, and a glass pipe

Some have experienced blackouts
>once per week
3 times per week
Meet criteria for substance use disorder.
4 or more
times per week
Heavy +
Persistent Use
longitudinal study of 947 marijuana users ages 18 to 38
Warning Signs & Assessment
Smoking
Dabbing

At comparable levels of persistence, cannabis and alcohol
dependence were similarly linked to downward
mobility, antisocial behavior in the workplace, relationship
conflict, and traffic conviction

Findings were unchanged after we controlled
for all potential confounders.
Tolerance, Time and money spent acquiring and using increases, Desire to cut down/unsuccessful attempts to cut down, Cravings, Failure to fulfill major obligations, giving up important social , occupational, or recreational activities, Physically hazardous use, Ignores physical or psychological problems, Withdrawal

DSM-5 Criteria
for Cannibus Use Disorder
Mild: 2-3 Sx
Moderate: 4-5 Sx
Severe: 6 or more Sx

Reasons for using
Social, anxiety, sleep,
depression, boredom,
relaxation, food tastes better, likes the feeling, to cope, enhances life, to celebrate or reward
Negative
Consequences
Cough, lower motivation, academic issues, memory, DUI, sleep issues, decreased physical activity, anxiety, depression
Barriers to Change
Social group, dependence, fear, self medicating, withdrawal,
low motivation, self confidence
1-10 Scale
Goals for the future
Coping skills
Pros vs Cons of use
Motivation for
Change
Treatment
Trends
Moaks/Chops/Mowls
The combination of mj and tobacco used in a bong. bowl is cleared in one hit.

About 1/4th of a cigarette is used, commonly

Often the person is addicted to the tobacco and would like to stop using the tobacco but continue using mj
Negative Consequences
It is common for students who smoke daily, even several times per day, to not have experienced any negative consequences
DSM-5 Criteria
Its common for students who smoke regularly to not meet criteria for a cannabis use disorder (or meet criteria for mild) and for them to meet most baseline assessments of functioning
Motivation
Its very common for students who smoke regularly to list off reasons why cutting back or quitting would be positive but also state that they have little to no motivation to do so
What Else Do
We Know
MJ makes a lot of mediocre aspects of life more palatable
Use increase tends to sneak up on people
Daily use on campus is normalized
When presented with alternative activities that are more meaningful,
research tell us that people will choose the more meaningful activity

The UCSB Alcohol & Drug Program strives to create a safe, healthy, and learning-conducive environment through the promotion of healthy choices concerning the use of alcohol, tobacco, and other drugs. The program emphasizes the elimination of harmful use, high-risk behavior, and related violence
Our Mission & Scope
Harm Reduction Model
https://alcohol.sa.ucsb.edu/docs/default-source/default-document-library/cudit-r-cannabis-use-disorders-identification-test.pdf?sfvrsn=0
Harm Reduction Model
Individualized
Approach
"Mj & You"

Outpatient
Medication assisted outpatient
Intensive Outpatient
Inpatient Detox
Residential Care
Motivational interviewing is a counseling
method that helps people resolve ambivalent
feelings and insecurities to find the internal
motivation they need to change their behavior
M.I. appropriate interventions
Reason for using vs Negative consequences
Motivation for change vs barriers to change
Ambivalence and moments of conflict, not necessarily using criteria or diagnosis
Values, goals, and expectations
Stages of change guide intervention
Vignette
Annie, female, second year, age19 has been smoking daily since 10th grade comes to session because she has recently started dabbing 2-3x a week and a friend has expressed concern.
Normally, she goes through periods of heavy use, 3x or more per day and times of light use, 1x every 3 days. She isn't sure what the makes her smoke more or less.
Her GPA is 3.3 and she wants to go to Law School. She has close friends who do not smoke but her roommates do daily.
She Has noticed a change in her tolerance and wonders if she needs to back off after having very paranoid thoughts after her last dab.
Tools
MARS take home assessment
Intake interview
Weekly tracking sheet

Assessment
Scope
DSM-V diagnosis, R/O, and co-occuring disorders
Harm Reduction continuum
Reasons for using/ pattern of use
Consequences
Motivation for change
Barriers to change
Stage of Change
Treatment
To better understand pattern of use, student will utilize a tracking sheet
Student will set usage goals for the week
Counselor will provide psychoeducation on dabbing and health related risks
Counselor will continue to assess paranoid thoughts to R/O other mental health diagnosis
Vignette
James, male age 22 seeks support for daily chronic mj use. He is at risk for not qualifying for graduation due to failing several classes his senior year. He is coming in at his parent's request after they found an ounce of mj in his backpack. James began smoking when he moved to UCSB as a freshman in the dorms and started smoking daily his junior year.

His longest period of abstinence is 13 days while on vacation with his parents. He had withdrawal symptoms for 4 days. He reports using mj daily to sleep, concentrate, relax, and for recreational use. He currently smokes 3-5x per day, about 3 grams.

He often drives while high, attends class high, and studies high. He has lost touch with the friends he had his first two years of school and now spends time mostly with other student who like to smoke as much as he does.

James has no plans for after college, does not report having any passions, and has not been romantically interested in anyone in about a year.
Other Behaviors
Amount of money being spent
Amount in oz per week smoked
Edibles and dabs
Triggers
Middle phase goals?
Full transcript