1. Babson, et al., in progress Isabella Romero
The Impact of CBT-I on Cannabis Cessation Outcomes in Military Veterans
I decided to do my broader impacts presentation on a project that I am joining this summer as a volunteer research assistant. The title of this study is the Impact of CBT-I (Cognitive Behavioral Therapy for Insomnia) on Cannabis Cessation outcomes in military veterans
Babson, et al., in progress
Isabella Romero

2. Background
Rates of Cannabis Use Disorder (CUD) diagnoses significantly increased among veterans within the Veterans Affairs Health Care System from 2002 to 2009 (Bonn-Miller, Harris & Trafton, 2012):
Prevalence ~60%
Rates with no co-occuring substance use disorders %
Treatments for CUD do exist; relapse is high up to 70% (Moore & Budney, 2003)
Poor sleep quality = high risk factor for abusing cannabis and relapsing after attempting to quit cannabis in vets with CUD (Babson, Boden, Harris, Stickle, & Bonn-Miller, 2013)
A pharmaceutical sleep aid trial demonstrated improvement in sleep quality, reduction in craving for those quitting cannabis; may be good adjunct therapy (Vandrey, et al., 2011)
A cannabis use disorder is much like any other substance use disorder in that in order to be diagnosed, an individual must meet criteria for drug related dysfunctional thoughts and behaviors.
Nationwide study of all patient’s within the VA medical Health care system who encountered the VA during the year of 2002, 2008 and 2009.
Psychological therapies do exist however rates of relapse are high, up to 70% in an outpatient sample, much like the one ner campus, where individuals are recieivng therapy for substance use problems.
Relapse refers to using the same amount of the drug that was used before attempting to quit.
GAP: No research has examined a behavioral sleep therapy and the effects it has on cannabis outcomes

3. Objective
To examine the efficacy of Cognitive Behavioral therapy for Insomnia (CBT-I) alone or with an adjunctive mobile app (CBT-I-MA) on cannabis cessation, compared with a placebo therapy in military vets with CUD and Insomnia
The objective of the current study is to examine the efficacy of CBT-I either alone, or with the inclusion of an adjunct mobile app, compared with a placebo therapy on cannabis cessation outcomes in military veterans with CUD and Insomnia
Based off of an earlier pilot study by this P.I., this study seeks to examine the efficacy of
A incremental benefit of including an adjunct mobile app which will include components tracking cannabis use frequency,

4. Hypotheses
Veterans receiving CBT-I-MA or CBT-I (compared to a placebo)
1. will experience greater reductions in cannabis use frequency
1 b. Have greater point prevalence abstinence (PPA) over time.
2. Those receiving CBT-I-MA or CBT-I (versus placebo) will experience improved sleep quality;
2 b. group-based differences in cannabis outcomes over time explained by sleep quality over time.
3. Those who receive CBT-I-MA will evidence better cannabis cessation and sleep outcomes compared to those who receive CBT-I alone.

5. Method Randomly assign veterans to 3 groups:
CBT-I
CBT-I-MA
Placebo
Randomly assign veterans to 3 groups:
Assessments (at baseline, 2 wks, 4 wks, + 6 months post quit):
Abstinence
Relapse
Sleep quality (sleep diaries, ratings, time intervals, etc.)
168 Veterans

6. Significance
To inform clinical practice and policy on whether utilization of a behavioral sleep intervention is effective in reducing relapse and promoting abstinence in individuals with a CUD and sleep dysfunction
Also to determine the incremental benefits of including an adjunctive mobile phone app

7. References
Babson, K. A., Boden, M. T., Harris, A. H., Stickle, T. R., & Bonn-Miller, M. O. (2013). Poor sleep quality as a risk factor for lapse following a cannabis quit attempt. Journal of Substance Abuse Treatment, 44(4), 438–443.
Bonn-Miller, M. O., Harris, A. H. S., & Trafton, J. A. (2012). Prevalence of Cannabis Use Disorder diagnoses among veterans in 2002, 2008, and Psychological Services, 9(4), 404–416.
Bray, R. M., Fairbank, J. A., & Marsden, M. E. (1999). Stress and substance use among military women and men. The American Journal Of Drug And Alcohol Abuse, 25(2),
Moore, B. A., & Budney, A. J. (2003). Relapse in outpatient treatment for marijuana dependence. Journal Of Substance Abuse Treatment, 25(2),
Vandrey, R., Smith, M. T., McCann, U. D., Budney, A. J., & Curran, E. M. (2011). Sleep disturbance and the effects of extended-release zolpidem during cannabis withdrawal. Drug Alcohol Depend (1):38-44.

8. Questions?