1. Clinically significant improvements in function
Kathleen M Carrroll PhD, Yale University
Supported by
NIDA DA NIDA P50 DA009241
NIDA U10 DA015831
NIDA DA041661
MTP Research Group

2. Clinically significant outcomes
‘Safe’ levels of use
Short versus long term consequences
Defining ‘success’, responder
Feel and function
Cannabis dependence symptoms
Cannabis-related problems
Craving and withdrawal symptoms, sleep quality
ASI days of problems (floor effects for composites?)
Quality of life (Brezing et al, 2018)

3. MTP (JCCP, 2004): N=450 outpatient cannabis dependent individuals, 3 sites

4. MTP: Change in DSM-IV Dependence symptoms by treatment

5. DSM-IV Abuse Symptoms by time

6. Abstinent versus improved (no DSM dependence symptoms) versus not improved, past 90 days

7. Marijuana Problems Scale-MTP

8. Young probation referred marijuana users, N=136
Average age 21 (range 18-25)
90% male
60% African American, 13% Latin American
50% did not complete high school
51% unemployed
Average 5 previous arrests
Average total months incarceration=9

9. Treatment conditions
CBT/MET
TAU CM
Attendance +
abstinence No

10. Retention: Percent completing treatment
Carroll et al, JCCP, 2006

11. “CM response” outcome: Completing treatment and submission of 1 or more marijuana free urine specimens
Carroll et al, JCCP, 2006

12. Point-prevalence (marijuana-free urines specimens at 6 month follow-up)
Carroll et al, JCCP, 2006

13. Marijuana Problem Scale by group

14. Cannabis tx datasets, N=264 (90% fup)
Instrument
Pretx
Weekly
Posttx
F-up
1, 3, 6
Baseline Screening Form x
Attitudes & Expectations
SCID-Axis I
X canabis only
SCID-Axis II
CPI-So
Perceived Stress Scale
Reasons for Quitting
Marijuana Problems Scale
Marijuana Withdrawal Questionnaire  x x 
Marijuana Craving Questionnaire
Urine monitoring
ASI Pre Post F-up
TLFB
Beck Depression Inv.
Brief Symptom Inv.
Potential outcomes
“Problem free functioning”
Change in DSM symptoms count
Reduction in cannabis-related consequences, problems
Quality of life

15. How many days were you paid for working in the past 28?
DOMAIN
ITEM
Medical Status
* How many days in the past 28 have you been hospitalized overnight for physical medical problems?
How many days in the past 28 have you had any medical problems that were serious enough to keep you home from work or interfere with things you wanted to do?
Employment Status
How many days were you paid for working in the past 28?
* How many days have you experienced employment problems in the past 28?
Legal Status
* In the past 28 days, how many times have you been arrested and charged with criminal offenses like shoplifting or vandalism, parole or probation violations, drug charges, prostitution, contempt of court, forgery, weapons offenses, burglary, larceny, breaking and entering, robbery, assault, arson, rape, homicide, or manslaughter?
*In the past 28 days, how many times have you been charged with disorderly conduct, vagrancy, public intoxication, driving while intoxicated, or major driving violations?
* How many days have you spent in prison in the past 28?
How many days did you engage in illegal activities for profit in the past 28?
How much money did you receive from illegal sources in the past 28 days? (Will be recoded to YES/NO to indicate receipt of any money from illegal sources)
Family/Social Relationships
* Do you live with anyone who has a drug problem?
* How many close friends do you have?
In the past 28 days, have you had significant periods during which you had serious conflicts with the following people (mother, father, siblings, partner/spouse, children, other significant family, close friends, neighbors, co-workers)?
How many days in the past 28 have you had serious conflicts with your family?
* How many days in the past 28 have you had serious conflicts with other people?
Psychological Problems
* How many times in the past 28 days have you received inpatient or outpatient treatment for any psychological or emotional problems?
In the past 28 days, have you had significant periods during which you had any of the following problems: 1 – serious depression, 2 – serious anxiety or tension, 3 – seeing or hearing things that were not there, 4 – trouble understanding, concentrating, remembering, 5 – trouble controlling violent behavior, 6 – serious thoughts of suicide, 7 – suicide attempts, 8 – been prescribed medications for any psychological/emotional problems? (Will be recoded to a count of the number of “yes” responses)
How many days in the past 28 have you had any such psychological or emotional problems?