While the legal status of cannabis is receiving much attention within international organizations, it should not obscure an important issue: the need to strengthen and improve prevention and treatment services for cannabis use disorders in the face of a significant increase in treatment demand.
In just a few years, cannabis markets have undergone an unprecedented evolution that has resulted in an increase in treatment demand for cannabis use disorders as the primary drug of concern. This increase has also had a significant impact on patterns of use (polydrug use, heavy chronic use, use of synthetic cannabinoids), resulting in potentially grave physical, mental and social problems. Therefore, irrespective of the debates on how best to control the use of marijuana through legal channels, we believe that there is an urgent need to efficiently address the needs of people for whom cannabis use is becoming a real problem.
Improving treatment and prevention
As is well known, these problems are more serious when cannabis consumption starts at an early age to progress into long-term, chronic use. A coherent health response should therefore prevent early use, especially among young people; prevent the transition to chronic use; reduce the harm related to heavy and chronic use; and lastly; provide adequate support and care to people with problematic use.
As an addiction treatment service provider and an active participant in the monitoring of international drug policies, Dianova has sought to better understand the issues related to the evolution of cannabis legislation. To this end, our organization carried out a Study on the Regulation and Legalization of the Therapeutic and Recreational Uses of Cannabis and their Addiction, Social and Health-Related Risks. This study served as a basis for updating the organisation’s position paper on substance use disorders and on cannabis policies in particular. The study underlined in its conclusions that there is a need to develop and implement programmes that are better tailored to the needs of people, which is often not the case at present.
For this reason, Dianova organized a series of webinars on how to improve these prevention and treatment programmes in order to gather first-hand information from various relevant stakeholders. The first of these webinars was held with several members of the Dianova network, the second with members of the European Federation of Therapeutic Communities (EFTC) and a third is planned for a side event to be held on the margins of the United Nations Commission on Narcotic Drugs on April 15 (see flyer). The experience drawn from these seminars has shown them to be extremely valuable in understanding the needs of the sector and sharing effective practices.
With regard to prevention (primary and secondary), we believe that the Commission should call for the implementation of science-based practices, including school programmes aimed at debunking myths about cannabis, refining young people’s perception marijuana-related risks, and developing their social and self-care skills. We also deem that more emphasis should be put on the lack of effectiveness of the approaches aimed at informing the target population of the risks associated with cannabis use.
On the treatment side, we believe that dedicated services need to take more account of the diversity of use across different users’ profiles – for example the use of cannabis as an anaesthetic – a diversity that is often disregarded in treatment interventions.
Similarly, we note that many specialized programmes primarily target adolescents and may not be adapted to the needs of young adults and adults. Therefore, we believe it is essential to strengthen the provision of services for this population.
Finally, based on our experience, it appears important to give priority to the choices of the people concerned with regard to programmes and services, and we stress the need to:
- Take into account the different patterns of cannabis use and the role played by cannabis use;
- Ensure adequate management of co-occurring mental health problems, including through partnerships with specialized outpatient services;
- Involve families in the intervention, and for younger adolescents, improve their families’ parenting skills;
- Pay attention to multiple uses, or even multiple addictions: we have noted in particular the aggravation of problems when cannabis use is associated with compulsive gambling;
- In the case of cannabis use, recommend responsible consumption, particularly among adults with or likely to have mental health problems;
Finally, we ask the Commission on Narcotic Drugs and its members to broaden the debate on cannabis beyond its legal aspects in order to meet these needs. To this end, it is essential to promote research and partnerships to improve and adapt science-based prevention and treatment practices, while ensuring adequate implementation and funding of these services.
Sources (documents and websites)
Study on the Regulation and Legalization of the Therapeutic and Recreational Uses of Cannabis and their Addiction, Social and Health-Related Risks – Dianova International (2020)
Position paper on addiction and cannabis policies – Dianova International (2021)
Disease Resistant, GMO Cannabis – Cannabis Tech
Prevent and treat problematic cannabis use – webinar, Dianova International