Computer-assisted behavioral therapy and contingency management for cannabis use disorder

Area of Science:

• Behavioral science
• Psychiatry
• Health services research

Background:

• Computer-assisted behavioral treatments offer a promising avenue for improving access and affordability of substance use disorder (SUD) care.
• Existing evidence-based treatments for cannabis use disorder (CUD) include motivational enhancement therapy (MET), cognitive-behavioral therapy (CBT), and contingency management (CM).

Purpose of the Study:

• To assess the efficacy of a computer-assisted, multicomponent treatment (MET/CBT/CM) for CUD compared to a brief intervention and a therapist-delivered version.
• To conduct an initial cost comparison between computer-delivered and therapist-delivered treatments.

Main Methods:

• Seventy-five adult participants with CUD were randomized into three groups: brief MET only (BRIEF), therapist-delivered MET/CBT/CM (THERAPIST), or computer-delivered MET/CBT/CM (COMPUTER).
• Continuous cannabis abstinence, abstinence rates, and reduction in days of use were measured.
• Therapist costs per case were calculated for THERAPIST and COMPUTER conditions.

Main Results:

• Both THERAPIST and COMPUTER conditions resulted in longer durations of continuous cannabis abstinence than BRIEF (p < .05).
• No significant difference in abstinence duration was found between THERAPIST and COMPUTER conditions.
• COMPUTER averaged approximately $130 less per case in therapist costs than THERAPIST (p < .05), offsetting most contingency management costs.

Conclusions:

• Computer-assisted delivery of multicomponent treatment for CUD is as effective as therapist-delivered care in promoting abstinence.
• Computer-assisted treatment significantly reduces costs compared to therapist-delivered care, potentially improving treatment accessibility.
• Further research in larger clinical trials is needed to confirm these maintenance and cost-effectiveness findings.