Brief Marijuana Dependence Counseling
These three examples illustrate several important questions commonly asked by people about
their marijuana use:
• Is it possible to be dependent on marijuana?
• Do I want to stop using because of what I’ve experienced?
• Can I succeed in stopping, given the challenges I’ve faced in the past?
The counseling approach presented in this manual addresses these issues among others. It comprises three key intervention components: motivational enhancement, cognitive behavioral skills training, and case management. Each session presents examples of how a counselor might introduce certain topics, facilitate the client’s resolution to stop using marijuana, provide skills training, and help the client access needed community supports.
Background
Before 1994, no published, controlled trials of treatment for marijuana use disorders existed, which is surprising because marijuana long has been the most frequently used illicit substance in the United States. Interest in treatment for people who use marijuana may have been lacking
because of myths that extensive marijuana use did not lead to dependence and that no adverse consequences were associated with misuse (Roffman et al. 1988; Stephens and Roffman 1993).
The relatively mild withdrawal symptoms associated with marijuana use may have led to a belief that dependence was unlikely and that people who needed treatment abused other substances
and their marijuana use was a secondary concern (e.g., Rainone et al. 1987). Similarly, most early reviews found few serious negative consequences associated with marijuana use (e.g., Hollister 1986; Wert and Raulin 1986a, 1986b). However, recent research shows that a significant number of adults are dependent on marijuana and experience negative consequences secondary to their use of marijuana.