Evidence-Based Strategies to Reduce High-Risk Cannabis Use

Calender Posted on: March 21, 2022clock Time to read: 2 minutes

Excessive cannabis use can cause harm to all aspects of a person’s life, from their career and finances to their health and relationships with others. Though the media often portrays it as harmless, cannabis, or – as it’s often referred to – marijuana, has been found to cause a variety of adverse outcomes, including impaired driving, increased risk of stroke and testicular cancer, and brain changes that can affect learning and memory.  Studies show a consistent link between cannabis use and mental illnesses producing psychosis.

Despite these findings, 33 U.S. states, along with countries including Canada and Uruguay, have legalized marijuana for medical use. 18 of those states also allow recreational use. But a look at what happens when the use of cannabis becomes more extensive suggests that the drug can and does have downsides, including acute injuries and illnesses.  

After nicotine and alcohol, cannabis is the most commonly used addictive drug, and its use among young people is widespread. In 2018, more than 11 million young adults reported using cannabis in the past year, and in 2019, the CDC reported that 37% of U.S. high school students reported that they had used cannabis at some point. 22% of U.S. high school students reported use in the past 30 days. With the growing popularity of vaping devices, teens have started vaping THC concentrates. Nearly 4% of 12th graders report that they vape THC daily. Past-year vaping of cannabis remained steady in 2020, following large increases in the behavior in 2018 and 2019. 

Cannabis concentrates and edibles are an increasing concern. Concentrates can have THC levels as high as 70%. Edibles pose their own unique risks as they are processed differently in the body. This can result in a delayed “high,” prompting the user to ingest more than is suggested on the packaging, which can result in overdose.

 

In addition, the number of young people who believe regular cannabis use is risky is decreasing, despite a number of studies that show cannabis interferes with learning and memory, which increases the risk of poor grades and dropping out of school. Research also shows that regular cannabis use by teens reduces IQ levels and test scores. Some studies even suggest an association between cannabis use and cases of violence. However, cannabis advocates tend to downplay marijuana’s negative effects on public health and safety. 

 

A considerable body of evidence highlights the fact that not only should individuals be targeted by interventions and preventative measures, but also populations. Reduction strategies targeted at the individual as well as the population-at-large can prevent cannabis-related harm, have a protective effect on vulnerable populations, and reduce the overall level of cannabis problems.

Cannabis-reduction strategies for individuals

There are many popular cannabis-reduction strategies for individuals who struggle to control their use of marijuana. Evidence-based practices, in particular, are recommended when seeking to reduce cannabis use, including brief interventions, personalized feedback, and the use of text messaging services. 

We include all three evidence-based strategies in our cannabis reduction and education course, Cannabis-Wise

  • Brief Interventions

In a recent study, researchers found that online cannabis interventions benefit from specific and targeted interventions, also known as brief interventions, to promote cannabis-related behavioral change among youths. These targeted interventions may include structured cannabis-use modules, daily feedback, peer support for increased adherence to the program, user-centered design, and input from key stakeholders such as families and local service providers. 

Cannabis-Wise includes brief interventions through the verified eCHECKUP TO GO system. 

  • Personalized Feedback

Another study has identified that driving after cannabis use (DACU) is a significant public health concern and represents one of the riskiest cannabis-related behaviors. Years of research have demonstrated that cannabis use impairs a person’s driving ability, but many college students report that they believe cannabis use does not impair their driving abilities. This study found that the use of a mobile phone-based intervention with personalized feedback and text messaging follow-ups increased perceptions of the dangerousness of DACU and caused changed perceptions among college students. 

Cannabis-Wise includes personalized feedback throughout the duration of the course to increase student participation and engagement. 

  • Use of Text Messaging Services

A third study found that an automated text-delivered intervention messaging that focused on close peer relations was successful in reducing cannabis use urges to use, memory problems, and relationship problems due to cannabis use. Moreover, data from the sample indicated that participants believed the intervention texts helped them reduce or manage their cannabis use. They also reported that these texts increased their understanding of the negative relational effects associated with ongoing cannabis use.


Cannabis-reduction strategies for communities and populations

There are also many community- and population-based protective factors that can play a role in preventing high-risk cannabis use. 

Parental use and beliefs about cannabis use are strong influences on youth behavior. For example, youth whose parents have never used cannabis are about three times less likely to use it than youth whose parents have used cannabis. Similarly, youth whose parents do not believe marijuana use is risky, are approximately 1.5 times more likely to use it when compared with youth whose parents hold more negative beliefs regarding marijuana use. 

Families can play a significant protective role in preventing youth cannabis use by fostering a supportive family environment while monitoring or prohibiting youth marijuana use. Positive family factors such as identifying with one’s parents/caregiver, maternal affection, and perceived parental trust have been found to play a protective role in preventing youth cannabis use. No tolerance rules around marijuana use and greater parental oversight are also associated with a decrease in cannabis use.

Schools can provide opportunities for cannabis education, prevention, and reduction strategies. Authoritative school environments, characterized by fair disciplinary practices and mutual respect between teachers and students,  have shown lower levels of cannabis use among students. Less predictable environments where rules are neither clearly articulated nor consistently enforced tend to have higher rates of cannabis use and abuse. 

It is also vital to consider students’ relationships to the school environment in understanding cannabis use risk. The level of connection that students feel to their school, fellow students, and classes are associated with their marijuana use: a student who feels a sense of belonging and connectedness at school will be less likely to use or abuse marijuana, compared to a student who does not feel the same sense of belonging. 

Community-level risk factors are also essential to consider, such as the availability of the product (either medically, recreationally, or illegally), product marketing (primarily relevant in states where marijuana is legal at the state or local level for non-medical use), community disorganization, economic deprivation, and more. For each of these community-level risk factors, the opposite should be considered an important protective factor that can reduce or prevent high-risk marijuana use.

 

Tools for cannabis-use reduction

When an individual wants to reduce cannabis use but needs some motivation or someone to hold them accountable, there are a range of apps and online or in-person support groups that exist.  These groups can empower individuals to set goals, intentions, and identify reasons not to use them. They can also help track success in decreasing use.

There are also impactful online prevention programs that can offer much-needed support and feedback. 3rd Millennium Classrooms’ cannabis prevention course is a successful evidence-based intervention tool that can help students learn about their underlying motivations for using cannabis and learn to control their use.


Cannabis Wise is designed to challenge cannabis expectancies and reduce high-risk behavior. Fully-researched, evidence-based information allows students to objectively view cannabis use – and abuse. Personalized feedback is integrated throughout the course, primarily through the verified eCHECKUP TO GO intervention, which tailors the course experience to each student and ensures a high level of interaction and engagement.

Resources:

Beneria, A., Santesteban-Echarri, O., Daigre, C., Tremain, H., Ramos-Quiroga, J. A., McGorry, P. D., & Alvarez-Jimenez, M. (2021). Online interventions for cannabis use among adolescents and young adults: Systematic review and meta-analysis. Early intervention in psychiatry, 10.1111/eip.13226. Advance online publication. https://doi.org/10.1111/eip.13226

Teeters, J. B., King, S. A., & Hubbard, S. M. (2021). A mobile phone-based brief intervention with personalized feedback and interactive text messaging is associated with changes in driving after cannabis use cognitions in a proof-of-concept pilot trial. Experimental and clinical psychopharmacology, 29(2), 203–209. https://doi.org/10.1037/pha0000442

 Mason, M. J., Zaharakis, N. M., Moore, M., Brown, A., Garcia, C., Seibers, A., & Stephens, C. (2018). Who responds best to text-delivered cannabis use disorder treatment? A randomized clinical trial with young adults. Psychology of addictive behaviors: journal of the Society of Psychologists in Addictive Behaviors, 32(7), 699–709. https://doi.org/10.1037/adb0000403