The relationship between motivations for cannabis consumption and problematic use
DOI:
https://doi.org/10.20882/adicciones.1221Keywords:
Patient-centered care, Cannabis, Motivations for cannabis use, Problematic cannabis useAbstract
Introduction. Systematic screening of problematic cannabis use does not include the motivations that lead to consumption, although from a person-centered perspective this is fundamental. The present study explores the motivations for cannabis use in adults and its relationship with cannabis use patterns and problematic use. Method. Adult cannabis users (previous 60 days) were recruited in the province of Barcelona (n = 468). Information on their sociodemographic data, cannabis use pattern, Cannabis Abuse Screening Test (CAST) and the main motivation for use were collected. Motivations were categorized a posteriori according to the Marijuana Motives Measures (MMM). A descriptive and inferential analysis was carried out to link the motivations to sociodemographic variables, consumption pattern and probability of suffering problematic cannabis use (CAST). Results. Using cannabis to heighten positive feelings (35%), out of habit (29%) and to cope with negative feelings (25%) were the most frequent motivations. In comparison to other motivations, coping is related to a greater quantity of cannabis used (4 vs 3 joints per day, p = 0.005), higher probability of problematic cannabis use (77% vs 64%, p = 0.05), and greater social vulnerability (unemployment 56% vs 37%, p = 0.001; and low educational level 14% vs 8%, p = 0.042). Conclusions. Coping as a motivation for cannabis use is present in one out of four users and is a marker of social vulnerability, greater quantity of cannabis used and higher risk of problematic use. Patient-centered care together with preventive (emotional and social education) and clinical strategies (psychotherapy) can be useful for this population at higher risk.References
Anderson, P., Berridge, V., Conrod, P., Dudley, R., Hellman, M., Lachenmeier, D., … Gual, A. (2017). Reframing the science and policy of nicotine, illegal drugs and alcohol – conclusions of the ALICE RAP Project. F1000Research, 6, 289. doi:10.12688/f1000research.10860.1.
Anderson, P., Braddick, F., Reynolds, J. y Gual, A. (2012). Alcohol policy in Europe - Evidence from the AMPHORA. Recuperado de http://amphoraproject.net/view.php?id_cont=45.
Baker, T. B., Piper, M. E., McCarthy, D. E., Majeskie, M. R. y Fiore, M. C. (2004). Addiction motivation reformulated: An affective processing model of negative reinforcement. Psychological Review, 111, 33–51. doi:10.1037/0033-295X.111.1.33.
Barrio, P. y Gual, A. (2016). Patient-centered care interventions for the management of alcohol use disorders: a systematic review of randomized controlled trials. Patient Preference and Adherence, 10, 1823–1845. doi:10.2147/PPA.S109641.
Bashford, J., Flett, R. y Copeland, J. (2010). The Cannabis Use Problems Identification Test (CUPIT): Development, reliability, concurrent and predictive validity among adolescents and adults. Addiction, 105, 615–625. doi:10.1111/j.1360-0443.2009.02859.x.
Benschop, A., Liebregts, N., van der Pol, P., Schaap, R., Buisman, R., van Laar, M., … Korf, D. J. (2015). Reliability and validity of the Marijuana Motives Measure among young adult frequent cannabis users and associations with cannabis dependence. Addictive Behaviors, 40, 91–95. doi:10.1016/j.addbeh.2014.09.003.
Blankers, M., Frijns, T., Belackova, V., Rossi, C., Svensson, B., Trautmann, F. y van Laar, M. (2014). Predicting Cannabis Abuse Screening Test (CAST) Scores: A recursive partitioning analysis using survey data from Czech Republic, Italy, the Netherlands and Sweden. PLoS ONE, 9, e108298. doi:10.1371/journal.pone.0108298.
Blevins, C. E., Banes, K. E., Stephens, R. S., Walker, D. D. y Roffman, R. A. (2016). Change in motives among frequent cannabis-using adolescents: Predicting treatment outcomes. Drug and Alcohol Dependence, 167, 175–181. doi:10.1016/j.drugalcdep.2016.08.018.
Bonsack, C., Montagrin, Y., Gibellini, S., Favrod, J., Besson, J. y Conus, P. (2008). Practice of a motivational intervention for cannabis users with psychosis. Schweizer Archiv fur Neurologie und Psychiatrie, 159, 378–385.
Buckner, J. D., Walukevich, K. A., Zvolensky, M. J. y Gallagher, M. W. (2017). Emotion regulation and coping motives serially affect cannabis cessation problems among dually diagnosed outpatients. Psychology of Addictive Behaviors, 31, 839–845. doi:10.1037/adb0000310.
Bujarski, S. J., Norberg, M. M. y Copeland, J. (2012). The association between distress tolerance and cannabis use-related problems: The mediating and moderating roles of coping motives and gender. Addictive Behaviors, 37, 1181–1184. doi:10.1016/j.addbeh.2012.05.014.
Chatters, R., Cooper, K., Day, E., Knight, M., Lagundoye, O., Wong, R. y Kaltenthaler, E. (2016). Psychological and psychosocial interventions for cannabis cessation in adults: A systematic review. Addiction Research & Theory, 24, 93–110. doi:10.3109/16066359.2015.1073719.
Cooper, K., Chatters, R., Kaltenthaler, E. y Wong, R. (2015). Psychological and psychosocial interventions for cannabis cessation in adults: a systematic review short report. Health Technology Assessment, 19, 1–130. doi:10.3310/hta19560.
Cooper, M. L., Kuntsche, E., Levitt, A., Barber, L. L. y Wolf, S. (2015). Motivational models of substance use. (K. J. Sher, Ed.) (Vol. 1). Oxford University Press. doi:10.1093/oxfordhb/9780199381678.013.017.
Delegación del Gobierno para el Plan Nacional sobre Drogas. (2009). Consumo problemático de cánnabis en estudiantes españoles de 14-18 años: Validación de escalas. Madrid: Ministerio de Sanidad, Servicios Sociales e Igualdad. Recuperado de http://www.pnsd.msssi.gob.es/profesionales/publicaciones/catalogo/bibliotecaDigital/publicaciones/pdf/ConsProblematico_cannabis.pdf.
Delegación del Gobierno para el Plan Nacional sobre Drogas. (2013). Encuesta estatal sobre el uso de drogas en enseñanzas secundarias (ESTUDES) 2012-2013, España. Madrid: Ministerio de Sanidad, Servicios Sociales e Igualdad. Recuperado de http://www.pnsd.msssi.gob.es/noticiasEventos/dossier/pdf/ESTUDES2012_2013.pdf.
Delegación del Gobierno para Plan Nacional sobre Drogas. (2015). Encuesta sobre alcohol y drogas en España (EDADES) 2013/14. Madrid: Ministerio de Sanidad Sevicios Sociales e Igualdad. Recuperado de http://www.pnsd.msssi.gob.es/profesionales/sistemasInformacion/sistemaInformacion/pdf/EDADES2013.pdf.
Ecker, A. H. y Buckner, J. D. (2014). Cannabis use behaviors and social anxiety: The roles of perceived descriptive and injunctive social norms. Journal of Studies on Alcohol and Drugs, 75, 74–82.
Fox, C. L., Towe, S. L., Stephens, R. S., Walker, D. D. y Roffman, R. A. (2011). Motives for cannabis use in high-risk adolescent users. Psychology of Addictive Behaviors, 25, 492–500. doi:10.1037/a0024331.
Garland, E. L. y Howard, M. O. (2018). Mindfulness-based treatment of addiction: current state of the field and envisioning the next wave of research. Addiction Science & Clinical Practice, 13, 14. doi:10.1186/s13722-018-0115-3.
Hall, W. y Degenhardt, L. (2014). The adverse health effects of chronic cannabis use. Drug Testing and Analysis, 6, 39–45. doi:10.1002/dta.1506.
Hernández-Serrano, O., Espada, J. P. y Guillén-Riquelme, A. (2016). Relación entre conducta prosocial, resolución de problemas y consumo de drogas en adolescentes. Anales de Psicología, 32, 609-616. doi:10.6018/analesps.32.2.204941.
Johnson, K., Mullin, J. L., Marshall, E. C., Bonn-Miller, M. O. y Zvolensky, M. (2010). Exploring the mediational role of coping motives for marijuana use in terms of the relation between anxiety sensitivity and marijuana dependence. American Journal on Addictions, 19, 277–282. doi:10.1111/j.1521-0391.2010.00041.x.
Jones, D. E., Greenberg, M. y Crowley, M. (2015). Early social-emotional functioning and public health: The relationship between kindergarten social competence and future wellness. American Journal of Public Health, 105, 2283–2290. doi:10.2105/AJPH.2015.302630.
Korshak, S.J. y Delboy, S. (2013). Complementary modalities: Twelve-step programs and group psychotherapy for addiction treatment. Group, 37, 273-294. doi:10.13186/group.37.4.0273.
Lee, C. A., Derefinko, K. J., Davis, H. A., Milich, R. y Lynam, D. R. (2017). Cross-lagged relations between motives and substance use: Can use strengthen your motivation over time? Drug and Alcohol Dependence, 178, 544–550. doi:10.1016/j.drugalcdep.2017.05.027.
Legleye, S., Karila, L., Beck, F. y Reynaud, M. (2007). Validation of the CAST, a general population Cannabis Abuse Screening Test. Journal of Substance Use, 12, 233–242. doi:10.1080/14659890701476532.
Li, W., Howard, M. O., Garland, E. L., McGovern, P. y Lazar, M. (2017). Mindfulness treatment for substance misuse: A systematic review and meta-analysis. Journal of Substance Abuse Treatment, 75, 62–96. doi:10.1016/j.jsat.2017.01.008.
López-Pelayo, H., Batalla, A., Balcells, M. M., Colom, J. y Gual, A. (2015). Assessment of cannabis use disorders: A systematic review of screening and diagnostic instruments. Psychological Medicine, 45, 1121–1133. doi:10.1017/S0033291714002463.
López Pelayo, H., Miquel De Montagut, L., Casajuana Kögel, C. y Balcells Oliveró, M. (2018). Post-truth Cannabis use: Back to evidence-based medicine. Adicciones, 30, 237-242. doi:10.20882/adicciones.1095.
Lundahl, B. W., Kunz, C., Brownell, C., Tollefson, D. y Burke, B. L. (2010). A meta-analysis of motivational interviewing: Twenty-five years of empirical studies. Research on Social Work Practice, 20, 137–160. doi:10.1177/1049731509347850.
Lundahl, B. W., Moleni, T., Burke, B. L., Butters, R., Tollefson, D., Butler, C. y Rollnick, S. (2013). Motivational interviewing in medical care settings: A systematic review and meta-analysis of randomized controlled trials. Patient Education and Counseling, 93, 157–168. doi:10.1016/j.pec.2013.07.012.
Matalí Costa, J. L. (2015). Motius de consum de cànnabis dels adolescents amb trastorn dual: relació amb variables clíniques i conseqüències acadèmiques. Universitat Autònoma de Barcelona. Recuperado de http://www.tesisenred.net/bitstream/handle/10803/321107/jlmc1de1.pdf?sequence=1.
Matalí Costa, J., Simons, J., Pardo, M., Lleras, M., Pérez, A. y Andión, O. (2018). Spanish version validation of the Marihuana Motives Measure in a drug-consuming adolescent sample. Adicciones, 30, 282–291. doi:10.20882/adicciones.947.
Meier, P. S., Holmes, J., Angus, C., Ally, A. K., Meng, Y. y Brennan, A. (2016). Estimated effects of different alcohol taxation and price policies on health inequalities: A mathematical modelling study. PLoS Medicine, 13, e1001963. doi:10.1371/journal.pmed.1001963.
Mezquita, L., Ruiz-Valero, L., Martínez-Gómez, N., Ibáñez, M. I. y Ortet, G. (2019). Development and Validation of the Marijuana Motives Measure Short Form (MMM-SF). Adicciones, 31, 106-116 doi:10.20882/adicciones.979.
Miller, W. R. y Rollnick, S. (2013). Motivational interviewing : helping people change. Guilford Press. Recuperado de https://www.guilford.com/books/Motivational-Interviewing/Miller-Rollnick/9781609182274.
Moitra, E., Christopher, P. P., Anderson, B. J. y Stein, M. D. (2015). Coping-motivated marijuana use correlates with DSM-5 cannabis use disorder and psychological distress among emerging adults. Psychology of Addictive Behaviors, 29, 627–632. doi:10.1037/adb0000083.
Mora, T. (2018). Acerca de la imposición sobre bebidas alcohólicas en España. Gaceta Sanitaria, 32, 176–180. doi:10.1016/j.gaceta.2017.10.017.
Observatorio Español de la Droga y las Toxicomanias. (2017). INFORME 2017: Alcohol, Tabaco y Drogas ilegales en España. Ministerio de Sanidad y Servicios Sociales.
Okaneku, J., Vearrier, D., McKeever, R. G., LaSala, G. S. y Greenberg, M. I. (2015). Change in perceived risk associated with marijuana use in the United States from 2002 to 2012. Clinical Toxicology, 53, 151–155. doi:10.3109/15563650.2015.1004581.
Patrick, M. E., Bray, B. C. y Berglund, P. A. (2016). Reasons for marijuana use among young adults and long-term associations with marijuana use and problems. Journal of Studies on Alcohol and Drugs, 77, 881-888. doi:10.15288/jsad.2016.77.881.
Patton, G. C., Coffey, C., Lynskey, M. T., Reid, S., Hemphill, S., Carlin, J. B. y Hall, W. (2007). Trajectories of adolescent alcohol and cannabis use into young adulthood. Addiction, 102, 607–615. doi:10.1111/j.1360-0443.2006.01728.x.
Payton, J. W., Wardlaw, D. M., Graczyk, P. A., Bloodworth, M. R., Tompsett, C. J. y Weissberg, R. P. (2000). Social and emotional learning: A framework for promoting mental health and reducing risk behavior in children and youth. Journal of School Health, 70, 179-185. doi:10.1111/j.1746-1561.2000.tb06468.x.
Ramaekers, J. G., Theunissen, E. L., de Brouwer, M., Toennes, S. W., Moeller, M. R. y Kauert, G. (2011). Tolerance and
cross-tolerance to neurocognitive effects of THC and alcohol in heavy cannabis users. Psychopharmacology, 214, 391–401. doi:10.1007/s00213-010-2042-1.
Simons, J., Correia, C. J., Carey, K. B. y Borsari, B. E. (1998). Validating a five-factor marijuana motives measure: Relations with use, problems, and alcohol motives. Journal of Counseling Psychology, 45, 265–273. doi:10.1037/0022-0167.45.3.265.
Socidrogalcohol. (2017). Estudio sociológico cualitativo sobre el consumo de alcohol y cannabis entre adolescentes y jóvenes. Recuperado de http://www.socidrogalcohol.org/phocadownload/Publicaciones/manuales-guias/estudiosociologico_cannabis_alcohol_def.pdf.
Villalbí, J. R., Suelves, J. M., Saltó, E. y Cabezas, C. (2011). Valoración de las encuestas a adolescentes sobre consumo de tabaco, alcohol y cannabis en España. Adicciones, 23, 11–16.
Volkow, N. D., Swanson, J. M., Evins, A. E., DeLisi, L. E., Meier, M. H., Gonzalez, R., … Baler, R. (2016). Effects of cannabis use on human behavior, including cognition, motivation, and psychosis: A review. JAMA Psychiatry, 73, 292-297. doi:10.1001/jamapsychiatry.2015.3278.
Walther, L., Gantner, A., Heinz, A. y Majic’, T. (2016). Evidence-based treatment options in cannabis dependency. Deutsches Arzteblatt International, 113, 653–659. doi:10.3238/arztebl.2016.0653.
Witkiewitz, K., Bowen, S., Harrop, E. N., Douglas, H., Enkema, M. y Sedgwick, C. (2014). Mindfulness-based treatment to prevent addictive behavior relapse: Theoretical models and hypothesized mechanisms of change. Substance Use and Misuse, 49, 513–524. doi:10.3109/10826084.2014.891845.
World Health Organization. (2016). The health and social effects of nonmedical cannabis use. WHO. Geneva: World Health Organization. Recuperado de http://who.int/substance_abuse/publications/msbcannabis.pdf?ua=1.
World Medical Association Declaration of Helsinki. (2013). Ethical principles for medical research involving human subjects. The Journal of the American Medical Association, 20, 2191–2194.
Yildiz, A., Vieta, E., Leucht, S. y Baldessarini, R. J. (2011). Efficacy of antimanic treatments: Meta-analysis of randomized, controlled trials. Neuropsychopharmacology, 36, 375–389. doi:10.1038/npp.2010.192.
