Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-25T23:07:27.706Z Has data issue: false hasContentIssue false

Chapter 24 - Treating Cannabis Use in Schizophrenia and Other Psychotic Disorders

from Part VII - Cannabinoids and Schizophrenia: Aetiopathology and Treatment Implications

Published online by Cambridge University Press:  12 May 2023

By
Alexandria S. Coles ,
Ashley E. Kivlichan ,
David J. Castle  and
Tony P. George
Edited by
Deepak Cyril D'Souza ,
David Castle  and
Sir Robin Murray
Deepak Cyril D'Souza
Affiliation:
Staff Psychiatrist, VA Connecticut Healthcare System; Professor of Psychiatry, Yale University School of Medicine
David Castle
Affiliation:
University of Tasmania, Australia
Sir Robin Murray
Affiliation:
Honorary Consultant Psychiatrist, Psychosis Service at the South London and Maudsley NHS Trust; Professor of Psychiatric Research at the Institute of Psychiatry
Get access

Summary

As is abundantly clear from other chapters in this book, cannabis misuse is a serious problem in people with schizophrenia and psychotic disorders, with rates of problematic cannabis use (e.g., cannabis use disorder) ~25% compared to ~3% in the general population. Cannabis misuse in people with schizophrenia is associated with symptom exacerbation, acute hospitalization, poorer psychosocial outcomes, and reduced quality-of-life. The mechanisms for this common co-morbidity are poorly understood, but may relate to self-medication, shared biological and/or genetic vulnerability, and social and environmental factors. Moreover, the potency of the cannabis consumed, along with dose and frequency of use, may contribute to psychosis risk and poorer clinical course. Reducing the burden of cannabis use in these patients depends on effective engagement and developing novel intervention targets. Behavioural treatments studied to date suggest modest evidence supporting motivational, cognitive-behavioural, and contingency management interventions in reducing cannabis use in psychotic patients. Moreover, amongst pharmacological interventions studied, clozapine may reduce cannabis use in people with schizophrenia, with lesser evidence for other second-generation anti-psychotic drugs, such as olanzapine and ziprasidone. Use of long-acting injectable antipsychotics (LAIs) might be relevant in people whose adherence is poor. Novel treatments such as brain stimulation and smart-phone/web-based interventions should be rigorously evaluated in future studies.

Keywords

schizophreniapsychosiscannabiscannabis use disordertreatmentbehavioural therapypharmacotherapy
Type
Chapter
Information
Marijuana and Madness , pp. 246 - 266
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abdel-Baki, A., Thibault, D., Medrano, S., et al. (2020). Long-acting antipsychotic medication as first-line treatment of first-episode psychosis with comorbid substance use disorder. Early Interv Psychiatry, 14, 69–79.CrossRefGoogle ScholarPubMed
Adamson, S., Kay-Lambkin, F., Baker, A., et al. (2010). An improved brief measure of cannabis misuse: The cannabis use disorders identification test – revised (CUDIT-R). Drug Alcohol Depend, 110, 137–143.Google Scholar
Allsop, D., Copeland, J., Linteris, N., et al. (2014). Nabiximols as an agonist replacement therapy during cannabis withdrawal: A randomized clinical trial. JAMA Psychiatry, 71, 281–291.CrossRefGoogle ScholarPubMed
Arsalan, A., Iqbal, Z., Tariq, M., et al. (2019). Association of smoked cannabis with treatment resistance in schizophrenia. Psychiatry Res, 278, 242–247.Google Scholar
Baker, A., Bucci,, S., Lewin, T. J., et al. (2006). Cognitive-behavioural therapy for substance use disorders in people with psychotic disorders: Randomised controlled trial. Br J Psychiatry, 188, 439–448.CrossRefGoogle ScholarPubMed
Barrowclough, C., Haddock, G., Tarrier, N., et al. (2001). Randomized controlled trial of motivational interviewing, cognitive behavior therapy, and family intervention for patients with comorbid schizophrenia and substance use disorders. Am J Psychiatry, 158, 1706–1713.CrossRefGoogle ScholarPubMed
Barrowclough, C., Marshall, M., Gregg, L., et al. (2014). A phase-specific psychological therapy for people with problematic cannabis use following a first episode of psychosis: A randomized controlled trial. Psychol Med, 44, 2749–2761.Google Scholar
Bellamoli, E., Manganotti, P., Schwartz, R. P., et al. (2014). rTMS in the treatment of drug addiction: An update about human studies. Behav Neurol, 2014, 815215.CrossRefGoogle ScholarPubMed
Bersani, G., Orlandi, V., Kotzalidis, G. D., et al. (2002). Cannabis and schizophrenia: Impact on onset, course, psychopathology and outcomes. Eur Arch Psychiatry Clin Neurosci, 252, 86–92.CrossRefGoogle ScholarPubMed
Bloomfield, M. A., Morgan, C. J., Kapur, S., et al. (2014). The link between dopamine function and apathy in cannabis users: An [18F]-DOPA PET imaging study. Psychopharmacology (Berl), 231, 2251–2259.CrossRefGoogle ScholarPubMed
Bonsack, C., Gibellini Manetti, S., Favrod, J., et al. (2011) Motivational intervention to reduce cannabis use in young people with psychosis: A randomized controlled trial. Psychother Psychosom, 80, 287–297.CrossRefGoogle ScholarPubMed
Borgan, F., Kokkinou, M., and Howes, O. (2021). The cannabinoid CB1 receptor in schizophrenia. Biol Psychiatry Cogn Neurosci Neuroimaging, 6, 646–659.Google ScholarPubMed
Brunette, M. F., Dawson, R., O’Keefe, C. D., et al. (2011). A randomized trial of clozapine vs. other antipsychotics for cannabis use disorder in patients with schizophrenia. J Dual Diagnosis, 7, 50–63.Google Scholar
Bucci, S., Baker, A., Halpin, S. A., et al. (2010). Intervention for cannabis use in young people at ultra high risk for psychosis and in early psychosis. Mental Health Subst Use, 3, 66–73.CrossRefGoogle Scholar
Budney, A. J., Moore, B. A., Rocha, H. L., et al. (2006). Clinical trial of abstinence-based vouchers and cognitive-behavioral therapy for cannabis dependence. J Consult Clin Psychol, 74, 307–316.CrossRefGoogle ScholarPubMed
Carpenter, K. M., McDowell, D., Brooks, D. J., et al. (2009). A preliminary trial: Double-blind comparison of nefazodone, bupropion-SR, and placebo in the treatment of cannabis dependence. Am J Addict, 18, 53–64.Google Scholar
Carroll, K. M., Easton, C. J., Nich, C., et al. (2006). The use of contingency management and motivational/skills-building therapy to treat young adults with marijuana dependence. J Consult Clin Psychol, 74, 955–966.Google Scholar
Coles, A. S., Knezevic, D., George, T. P., et al. (2021). Long-acting injectable antipsychotic treatment in schizophrenia and co-occurring substance use disorders. Front Psychiatry, 12, 808002.Google Scholar
Coles, A. S., Kozak, K., and George, T. P. (2018). A review of brain stimulation for treatment of substance use disorders. Am J Addict, 27, 71–91.Google Scholar
Coles, A. S., Sasiadek, J., and George, T. P. (2019) Pharmacotherapies for co-occurring substance use and bipolar disorders: A systematic review. Bipolar Dis, 21, 595–610.CrossRefGoogle ScholarPubMed
Compton, M. T., Furman, A. C., and Kaslow, N. J. (2004). Lower negative symptom scores among cannabis-dependent patients with schizophrenia-spectrum disorders: Preliminary evidence from an African American first-episode sample. Schizophr Res, 71, 61–64.CrossRefGoogle ScholarPubMed
Cooper, Z. D., Foltin, R. W., Hart, C. L., et al. (2013). A human laboratory study investigating the effects of quetiapine on marijuana withdrawal and relapse in daily marijuana smokers. Addict Biol, 18, 993–1002.CrossRefGoogle ScholarPubMed
Copeland, J., Swift, W., Roffman, R., et al. (2001). A randomized controlled trial of brief cognitive-behavioral interventions for cannabis use disorder. J Subst Abuse Treat, 21, 55–64; discussion 65–66.Google Scholar
D’Souza, D. C., Abi-Saab, W. M., Madonick, S., et al. (2005). Delta-9-tetrahydrocannabinol effects in schizophrenia: Implications for cognition, psychosis, and addiction. Biol Psychiatry, 57, 594–608.Google Scholar
D’Souza, D. C., Cortes-Briones, J., Creatura, G., et al. (2019). Efficacy and safety of a fatty acid amide hydrolase inhibitor (PF-04457845) in the treatment of cannabis withdrawal and dependence in men: A double-blind, placebo-controlled, parallel-group, phase 2a single-site randomized trial. Lancet Psychiatry, 6, 35–45.Google Scholar
Diana, M., Raij, T., Melis, M., et al. (2017). Rehabilitating the addicted brain with transcranial magnetic stimulation. Nat Rev Neurosci, 18, 685–693.Google Scholar
Drake, R. E., and Mueser, K. T. (2001). Managing comorbid schizophrenia and substance abuse. Curr Psychiat Rep, 3, 418–422.Google Scholar
Drake, R. E., O’Neal, E. L., and Wallach, M. A. (2008). A systematic review of psychosocial interventions for people with co-occurring severe mental and substance use disorders. J Subst Abuse Treat, 34, 123–138.CrossRefGoogle ScholarPubMed
Dunlop, K., Hanlon, C. A., and Downar, J. (2017). Noninvasive brain stimulation treatments for addiction and major depression. Ann NY Acad Sci, 1394, 31–54.Google Scholar
Eack, S. M., Hogarty, S. S., Greenwald, D. P., et al. (2015). Cognitive enhancement therapy in substance misusing schizophrenia: Results of an 18-month feasibility trial. Schizophr Res, 161, 478–483.Google Scholar
Edwards, J., Elkins, K., Hinton, M., et al. (2006). Randomized controlled trial of a cannabis-focused intervention for young people with first-episode psychosis. Acta Psychiatr Scand, 114, 109–117.CrossRefGoogle ScholarPubMed
Feil, J., and Zangen, A. (2010). Brain stimulation in the study and treatment of addiction. Neurosci Biobehav Rev, 34, 559–574.Google Scholar
Gates, P. J., Norberg, M. M., Copeland, J., et al. (2012). Randomized controlled trial of a novel cannabis use intervention delivered by telephone. Addiction, 107, 2149–2158.Google Scholar
George, T. P., Hill, K. P., and Vaccarino, F. J. (2018). Cannabis legalization and psychiatric disorders: Caveat H-emptor. Can J Psychiatry, 63, 447–450.CrossRefGoogle Scholar
Gilbert, D. G., Rabinovich, N. E., and McDaniel, J. T. (2020). Nicotine patch for cannabis withdrawal symptom relief: A randomized controlled trial. Psychopharmacology (Berl), 237, 1507–1519.Google Scholar
Gorelick, D. A., Zangen, A., and George, M. S. (2014). Transcranial magnetic stimulation in the treatment of substance addiction. Ann NY Acad Sci, 1327, 79–93.Google Scholar
Gray, K. M., Carpenter, M. J., Baker, N. L., et al. (2012). A double-blind, randomized controlled trial of N-acetylcysteine in cannabis-dependent adolescents. Am J Psychiatry, 169, 805–812.CrossRefGoogle ScholarPubMed
Gray, K. M., Sonne, S. C., McClure, E. A., et al. (2017). A randomized placebo-controlled trial of N-acetylcysteine for cannabis use disorder in adults. Drug Alcohol Depend, 177, 249–257.Google Scholar
Gray, K. M., Watson, N. L., Carpenter, M. J., et al. (2010). N-acetylcysteine (NAC) in young marijuana users: An open-label pilot study. Am J Addict, 19, 187–189.Google Scholar
Green, A. I. (2007). Treatment of schizophrenia and comorbid substance abuse: Pharmacological approaches. J Clin Psychiatry, 67, S31–S35.Google Scholar
Green, A. I., Burgess, E. S., Dawson, R., et al. (2003). Alcohol and cannabis use in schizophrenia: Effects of clozapine vs. risperidone. Schizophr Res, 60, 81–85.Google Scholar
Green, M. F. (2016). Impact of cognitive and social cognitive impairment on functional outcomes in patients with schizophrenia. J Clin Psychiatry, 77, 8–11.Google Scholar
Guillin, O., Abi-Dargham, A., and Laruelle, M. (2007). Neurobiology of dopamine in schizophrenia. Int Rev Neurobiol, 78, 1–39.Google Scholar
Haddock, G., Barrowclough, C., Tarrier, C., et al. (2003). Cognitive-behavioural therapy and motivational intervention for schizophrenia and substance misuse: 18-month outcomes of a randomised controlled trial. Br J Psychiatry, 183, 418–426.CrossRefGoogle ScholarPubMed
Hajizadeh, M. (2016). Legalizing and regulating marijuana in Canada: Review of potential economic, social, and health impacts. Int J Health Policy Manag, 5, 453–456.CrossRefGoogle ScholarPubMed
Haney, M., Cooper, Z. D., Bedi, G., et al. (2013). Nabilone decreases marijuana withdrawal and a laboratory measure of marijuana relapse. Neuropsychopharmacology, 38, 1557–1565.Google Scholar
Haney, M., Hart, C. L., Vosburg, S. K., et al. (2010). Effects of baclofen and mirtazapine on a laboratory model of marijuana withdrawal and relapse. Psychopharmacology (Berl), 211, 233–244.Google Scholar
Haney, M., Ramesh, D, Glass, A, et al. (2015). Naltrexone maintenance decreases cannabis self-administration and subjective effects in daily cannabis smokers. Neuropsychopharmacology, 40, 2489–2498.CrossRefGoogle ScholarPubMed
Hanlon, C. A., Dowdle, L. T., and Henderson, J. S. (2018). Modulating neural circuits with transcranial magnetic stimulation: Implications for addiction treatment development. Pharmacol Rev, 70, 661–683.Google Scholar
Hasin, D. S. (2018). U.S. epidemiology of cannabis use and associated problems. Neuropsychopharmacology, 43, 195–212.CrossRefGoogle ScholarPubMed
Hendriks, V., van der Schee, E., and Blanken, P. (2011). Treatment of adolescents with a cannabis use disorder: Main findings of a randomized controlled trial comparing multidimensional family therapy and cognitive behavioral therapy in The Netherlands. Drug Alcohol Depend, 119, 64–71.CrossRefGoogle ScholarPubMed
Hill, K. P., Toto, L. H., Lukas, S. E., et al. (2013). Cognitive behavioral therapy and the nicotine transdermal patch for dual nicotine and cannabis dependence: A pilot study. Am J Addict, 22, 233–238.CrossRefGoogle ScholarPubMed
Hjorthøj, C. R., Orlovska, S., Fohlmann, A., et al. (2013). Psychiatric treatment following participation in the CapOpus randomized trial for patients with comorbid cannabis use disorder and psychosis. Schizophr Res, 151, 191–196.Google Scholar
Hoch, E., Noack, R., Henker, J., et al. (2012). Efficacy of a targeted cognitive-behavioral treatment program for cannabis use disorders (CANDIS). Eur Neuropsychopharmacol, 22, 267–280.CrossRefGoogle ScholarPubMed
Ikeda, T., Kobayashi, S., and Morimoto, C. (2019). Effects of repetitive transcranial magnetic stimulation on ER stress-related genes and glutamate, gamma-aminobutyric acid and glycine transporter genes in mouse brain. Biochem Biophys Rep, 17, 10–16.Google Scholar
James, W., Preston, N., Koh, G., et al. (2004). A group intervention which assists patients with dual diagnosis reduce their drug use: A randomized controlled trial. Psychol Med, 34, 983–990.Google Scholar
Johnston, J., Lintzeris, N., Allsop, D. J., et al. (2014). Lithium carbonate in the management of cannabis withdrawal: A randomized placebo-controlled trial in an inpatient setting. Psychopharmacology (Berl), 231, 4623–4636.CrossRefGoogle Scholar
Kadden, R. M., Litt, M. D., Kabela-Cormier, E., et al. (2007). Abstinence rates following behavioral treatments for marijuana dependence. Addict Behav, 32, 1220–1236.Google Scholar
Kavanagh, D. J., Young, R., White, A., et al. (2004). A brief motivational intervention for substance misuse in recent-onset psychosis. Drug Alcohol Rev, 23, 151–155.Google Scholar
Kolliakou, A., Castle, D., Sallis, H., et al. (2012). Reasons for cannabis use in first-episode psychosis: Does strength of endorsement change over 12 months? Eur Psychiatry, 30, 152–159.CrossRefGoogle Scholar
Koskinen, J., Lohonen, J., Koponen, H., et al. (2010). Rates of cannabis use disorders in clinical samples of patients with schizophrenia: A meta-analysis. Schizophr Bull, 36, 1115–1124.Google Scholar
Kozak, K., Barr, M. S., and George, T. P. (2017). Traits and biomarkers for addiction risk in schizophrenia. Curr Addict Rep, 4, 14–24.Google Scholar
Kozak, K., Lowe, D. J. E., Sanches, M., et al. (2021). Effects of repetitive transcranial magnetic stimulation (rTMS) on cannabis use and cognitive function in achizophrenia. Brain Stimulation, under review.Google Scholar
Krebs, P., Norcross, J. C., Nicholson, J. M., et al. (2018). Stages of change and psychotherapy outcomes: A review and meta-analysis. J Clin Psychol, 74, 1964–1979.Google Scholar
Levin, F., Mariani, J., Brooks, D. J., et al. (2011). Dronabinol for the treatment of cannabis dependence: A randomized, double-blind, placebo-controlled trial. Drug Alcohol Depend, 116, 142–150.Google Scholar
Levin, F., Mariani, J, Brooks, D. J., et al. (2013). A randomized, double-blind, placebo-controlled trial of venlafaxine extended-release for co-occurring cannabis dependence and depressive disorders. Am J Addict, 108, 1084–1094.Google Scholar
Levin, F., Mariani, J. J., Pavlicova, M., et al. (2016). Dronabinol and lofexidine for cannabis use disorder: A randomized, double-blind, placebo-controlled trial. Drug Alcohol Depend, 159, 53–60.Google Scholar
Levin, F., McDowell, D., Evans, S. M., et al. (2004). Pharmacotherapy for marijuana dependence: A double-blind, placebo-controlled pilot study of divalproex sodium. Am J Addict, 13, 21–32.Google Scholar
Lintzeris, N., Bhardwaj, A., Mills, L., et al. (2019). Nabiximols for the treatment of cannabis dependence: A randomized clinical trial. JAMA Intern Med, 179, 1242–1253.Google Scholar
Litt, M. D., Kadden, R. M., Tennen, H., et al. (2020). Individualized assessment and treatment program (IATP) for cannabis use disorder: Randomized controlled trial with and without contingency management. Psychol Addict Behav, 34, 40–51.Google Scholar
Longenecker, J. M., Bagby, R. M., McKenzie, K. J., et al. (2021). Cross-cutting symptom domains predict functioning in psychotic disorders. J Clin Psychiatry, 82, 20m13288.Google Scholar
Lowe, D. J. E., Sasiadek, J. D., Coles, A. S., et al. (2019). Cannabis and mental illness: A review. Eur Arch Psychiat Clin Neurosci, 269, 107–120.Google Scholar
Machielsen, M., Beduin, A. S., Dekker, N., et al. (2012). Differences in craving for cannabis between schizophrenia patients using risperidone, olanzapine or clozapine. J Psychopharmacol, 26, 89–95.Google Scholar
Machielsen, M. W. J., Veltman, D. J., van den Brink, W., et al. (2014). The effect of clozapine and risperidone on attentional bias in patients with schizophrenia and a cannabis use disorder: An FMRI study. J Psychopharmacol, 28, 633–642.Google Scholar
Madigan, K., Brennan, D., Lawlor, E., et al. (2013). A multi-center, randomized controlled trial of a group psychological intervention for psychosis with comorbid cannabis dependence over the early course of illness. Schizophr Res, 143, 138–142.CrossRefGoogle ScholarPubMed
Mahoney, J. J., 3rd, Hanlon, C. A., Marshalek, P. J., et al. (2020). Transcranial magnetic stimulation, deep brain stimulation, and other forms of neuromodulation for substance use disorders: Review of modalities and implications for treatment. J Neurol Sci, 418, 117149.CrossRefGoogle ScholarPubMed
Marijuana Treatment Project Research Group. (2004). Brief treatments for cannabis dependence: Findings from a randomized multisite trial. J Consult Clin Psychol, 72, 455–466.Google Scholar
Mason, B., Cream, R., Godell, V., et al. (2012). A proof-of-concept randomized controlled study of gabapentin: Effects on cannabis use, withdrawal and executive function deficits in cannabis-dependent adults. Neuropsychopharmacology, 37, 1689–1698.Google Scholar
McLellan, A. T., Kushner, H., Metzger, D., et al. (1992). The fifth edition of the addiction severity index. J Subst Abus Treat, 9, 199–213.Google Scholar
McRae-Clark, A. L., Baker, N. L., Gray, K. M., et al. (2015). Buspirone treatment of cannabis dependence: A randomized, placebo-controlled trial. Drug Alcohol Depend, 156, 29–37.Google Scholar
McRae-Clark, A. L., Baker, N. L., Gray, K. M., et al. (2016). Vilazodone for cannabis dependence: A randomized, controlled pilot trial. Am J Addict, 25, 69–75.Google Scholar
McRae-Clark, A., Carter, R. E., Killeen, T. K., et al. (2009). A placebo-controlled trial of buspirone for the treatment of cannabis dependence. Drug Alcohol Depend, 105, 132–138.CrossRefGoogle Scholar
McRae-Clark, A., Carter, R. E., Killeen, T. K., et al. (2010). A placebo-controlled trial of atomoxetine in marijuna-dependent individuals with attention deficit hyperactivity disorder. Am J Addict, 19, 481–489.Google Scholar
Miranda, R., Jr., Treloar, H., Blanchard, A., et al. (2017). Topiramate and motivational enhancement therapy for cannabis use among youth: A randomized placebo-controlled pilot study. Addict Biol, 22, 779–790.Google Scholar
Moretti, J., Poh, E. Z., and Rodger, J. (2020). rTMS-induced changes in glutamatergic and dopaminergic systems: Relevance to cocaine and methamphetamine use disorders. Front Neurosci, 14, 137.Google Scholar
Notzon, D. P., Kelly, M. A., Choi, C. J., et al. (2018). Open-label pilot study of injectable naltrexone for cannabis dependence. Am J Drug Alcohol Abuse, 44, 619–627.Google Scholar
Penetar, D. M., Looby, A. R., Ryan, E. T., et al. (2012). Bupropion reduces some of the symptoms of marihuana withdrawal in chronic marihuana users: A pilot study. Subst Abuse, 6, 63–71.Google Scholar
Potvin, S., Stip, E., Lipp, O., et al. (2006). Quetiapine in patients with comorbid schizophrenia-spectrum and substance use disorders: An open-label trial. Curr Med Res Opin, 22, 1277–1285.CrossRefGoogle ScholarPubMed
Rabin, R. A., Barr, M. S., Herman, Y., et al. (2017). Effects of extended cannabis abstinence on neurocognitive outcomes in cannabis dependent schizophrenia patients versus non-psychiatric controls. Neuropsychopharmacology, 42, 2259–2271.Google Scholar
Rabin, R. A., and George, T. P. (2017). Understanding the link between cannabinoids and psychosis. Clin Pharmacol Therap, 101, 197–199.CrossRefGoogle ScholarPubMed
Rabin, R. A., Kozak, K., Herman, Y., et al. (2018). A method to achieve short-term cannabis abstinence in cannabis-dependent patients with schizophrenia and non-psychiatric controls. Schizophr Res, 194, 47–54.Google Scholar
Rabin, R. A., Zakzanis, K. K., and George, T. P. (2011). The effects of cannabis use on neurocognition in schizophrenia: A meta-analysis. Schizophr Res, 128, 111–116.Google Scholar
Rooke, S., Copeland, J., Norberg, M., et al. (2013). Effectiveness of a self-guided web-based cannabis treatment program: Randomized controlled trial. J Med Internet Res, 15, e26.Google Scholar
Roten, A. T., Baker, N. L., and Gray, K. M. (2013). Marijuana craving trajectories in an adolescent marijuana cessation pharmacotherapy trial. Addict Behav, 38, 1788–1791.Google Scholar
Salling, M. C., and Martinez, D. (2016). Brain stimulation in addiction. Neuropsychopharmacology, 41, 2798–2809.Google Scholar
Schnell, T., Koethe, D., Krasnianski, A., et al. (2014). Ziprasidone versus clozapine in the treatment of dually diagnosed (DD) patients with schizophrenia and cannabis use disorders: A randomized study. Am J Addict, 23, 308–312.CrossRefGoogle ScholarPubMed
Schwilke, E. W., Gulberg, R. G., Darwin, W. D., et al. (2011). Differentiating new cannabis use from residual urinary cannabinoid excretion in chronic, daily cannabis users. Addiction, 106, 499–506.Google Scholar
Sheridan Rains, L., Marston, L., Hinton, M., et al. (2019). Clinical and cost-effectiveness of contingency management for cannabis use in early psychosis: The CIRCLE randomised clinical trial. BMC Med, 17, 161.Google Scholar
Sherman, B. J., Baker, N. L., and McRae-Clark, A. L. (2017). Effect of oxytocin pretreatment on cannabis outcomes in a brief motivational intervention. Psychiatry Res, 249, 318–320.CrossRefGoogle Scholar
Sigmon, S. C., and Higgins, S. T. (2006). Voucher-based contingent reinforcement of marijuana abstinence among individuals with serious mental illness. J Subst Abuse Treat, 30, 291–295.Google Scholar
Sigmon, S. C., Steingard, S., Badger, G. J., et al. (2000). Contingent reinforcement of marijuana abstinence among individuals with serious mental illness: A feasibility study. Exp Clin Psychopharmacol, 8, 509–517.Google Scholar
Sinadinovic, K., Johansson, M., Johansson, A. S., et al. (2020). Guided web-based treatment program for reducing cannabis use: A randomized controlled trial. Addict Sci Clin Pract, 15, 9.CrossRefGoogle ScholarPubMed
Slavet, J. D., Stein, L. A. R., Colby, S. M., et al. (2006). The marijuana ladder: Measuring motivation to change marijuana use in incarcerated adolescents. Drug Alcohol Depend, 83, 42–48.Google Scholar
Spencer, C., Castle, D., and Michie, P. T. (2002). Motivations that maintain substance use among individuals with psychotic disorders. Schizophr Bull, 28, 233–247.Google Scholar
Stephens, R. S., Babor, T. F., Kadden, R., et al. (2004). Brief treatments for cannabis dependence: Findings from a randomized multisite trial. J Consult Clin Psychol, 72, 455–466.Google Scholar
Stephens, R. S., Roffman, R. A., and Curtin, L. (2000). Comparison of extended versus brief treatments for marijuana use. J Consult Clin Psychol, 68, 898–908.CrossRefGoogle ScholarPubMed
Stephens, R. S., Roffman, R. A., and Simpson, E. E. (1994). Treating adult marijuana dependence: A test of the relapse prevention model. J Consult Clin Psychol, 62, 92–99.Google Scholar
Szerman, N., Basurte-Villamor, I., Vega, P., et al. (2020). Once-monthly long-acting injectable aripiprazole for the treatment of patients with schizophrenia and co-occurring substance use disorders: A multicentre, observational study. Drugs Real World Outcomes, 7, 75–83.Google Scholar
Tang, S. M., Ansarian, A., and Courtney, D. B. (2017). Clozapine treatment and cannabis use in adolescents with psychotic disorders: A retrospective cohort chart review. J Can Acad Child Adolesc Psychiatry, 26, 51–58.Google Scholar
Tatar, O., Abdel-Baki, A., Tra, C., et al. (2021). Technology-based psychological interventions for young adults with early psychosis and cannabis use disorder: Qualitative study of patient and clinician perspectives. JMIR Form Res, 5, e26562.Google Scholar
Trigo, J. M., Soliman, A., Quilty, L. C., et al. (2018). Nabiximols combined with motivational enhancement/cognitive behavioral therapy for the treatment of cannabis dependence: A pilot randomized clinical trial. PLoS ONE, 13, e0190768.Google Scholar
Weinstein, A. M., Miller, H., Bluvstein, I., et al. (2014). Treatment of cannabis dependence using escitalopram in combination with cognitive-behavior therapy: A double-blind placebo-controlled study. Am J Drug Alcohol Abuse, 40, 16–22.Google Scholar
Zhang, J. J. Q., Fong, K. N. K., Ouyang, R. G., et al. (2019). Effects of repetitive transcranial magnetic stimulation (rTMS) on craving and substance consumption in patients with substance dependence: A systematic review and meta-analysis. Addiction, 114, 2137–2149.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×