[The treatment of cannabis dependence: Clinical work, psychotherapy and evidence]

Identifying compulsive consumption of marijuana in association with another mental disorder (attentional defcit disorder, bipolar disorder, depression or psychosis) presents the challenge of clarifying validated therapeutic strategies, especially within the teen population, in which it shows the highest prevalence. The ever-increasing prevalence and the need for regional treatments, demand that we approach this health matter as a public health issue. The ideological con?icts related to the necessary decriminalization of consumption and the current debate on the medical use of marijuana often confuse the urgent need to establish effective therapeutic strategies for the population affected by this mental disorder. Family therapy and community reinforcement are one of the most effcient interventions, other than the traditional individual and group therapies. Contingent, motivational and cognitive-behavioral tailored interventions appear to be most effcient and recommendable. Aerobic exercise and the use of mobile technology also show effectiveness. The administration of medications such as gabepentin, the aminoacid n-acetyl cysteine (NAC) and the cannabinoid cannabidiol (CBD) appear to be very promising. Usual medications, such as valproic acid, quetiapine and bupropion, increase craving, therefore intensifying the need for consumption and thus yielding overall negative results.