Marijuana Rehab Aftercare and Relapse Prevention

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What is Marijuana Rehab Aftercare?

Aftercare is a treatment intervention that is utilized after rehab and is essential to achieving the ultimate goal of any treatment program for marijuana addiction— remaining sober and preventing relapse. 
What is Marijuana Rehab Aftercare?

Is Marijuana Aftercare Rehab Necessary?

Rehab is often seen as an important initial step in treatment of marijuana addiction. It is helpful as it offers an opportunity to put an end problematic marijuana use.

Aftercare refers to a set of protracted interventions offered after the initial phase of treatment that aim to prevent relapse and encourage drug- free lifestyle.

  • The need for aftercare following treatment has been reported to be high among those who've completed residential detox for their drug use.
  • Depending on the requirement of an individual, aftercare can continue for a short duration or as long as needed.

Research has shown that aftercare for marijuana addiction in form of Cognitive Behavioral Therapy (CBT) (offered in conjunction with Motivation Enhancement Therapy) reduces:

  • Number of days of drug use.
  • Frequency of use on those days.
  • The symptoms of substance dependence.
  • Longer term problems related to marijuana use.

Similarly, a treatment strategy known as contingency management (CM) has also been shown to significantly:

  • Increase the proportion of days abstinent from marijuana.
  • Lower rates of relapse over 12-month observation period.

The Benefit of Marijuana Relapse Prevention

As with the other substance use disorders, marijuana dependency is commonly conceptualized as a ‘chronic-relapsing’ disorder.

  • On average, adults with an average daily marijuana use of more than a decade have entered treatment programs six or more times.
  • Treatment outcomes for adolescent and young adult marijuana users show post-treatment abstinence rates at less than 15 percent.

Learn more Find marijuana addiction treatment and aftercare options

Some of the commonly reported contributors to relapse with marijuana use following abstinence are:

  • Co-morbid depression and anxiety.
  • Co-occurring use of other drugs.
  • Craving.
  • Easy accessibility.
  • Environmental cues.
  • History of conduct disorder.
  • Low self-esteem.
  • Peer pressure.
  • Perceived difficulty in abstaining.
  • Stress.

Relapse prevention measures are aimed at maintaining sobriety, delaying imminent relapses and preventing subsequent relapse.

  • It is aimed at consolidating the gains made during rehab and further building on them to sustain long-term recovery.
  • Research, for long, has suggested that men attending the relapse prevention sessions for marijuana use are more likely to report reduced use without problems.
  • Later research has also supported engagement in aftercare as a predictor of marijuana abstinence at follow-up among adolescents.

Marijuana Abuse is a Chronic Condition

Marijuana addiction develops over years with a host of biological, psychological and environmental factors contributing to its development.

A lot of parallels can be drawn between marijuana addiction treatment and other chronic medical conditions such as hypertension.

  • Like other chronic medical disorders, hereditary factors play an important role in addiction to marijuana.
  • Role of personal responsibility, frequently associated with exacerbating the effects of marijuana, has been well established for chronic medical disorders like hypertension as well.
    • Emergence of both these conditions is shaped by a host of personal choices such as salt intake and cigarette smoking among those vulnerable to developing hypertension, and experimentation among those who are vulnerable to becoming addicted to the effects of marijuana or other intoxicating substances.
  • The search for a ‘cure’ of chronic medical disorders remains a much desired but as yet unattained target.
    • However, effective treatment options are available for the management of marijuana addiction like other chronic medical disorders.

Further, marijuana addiction shares similarities with other chronic medical disorders because therapeutic adherence plays a key role in treatment outcome for both the conditions.

  • The challenge of poor treatment retention observed with marijuana addiction is observed with hypertension as well with less than 40 percent being fully adherent to the treatment.

Further, recurrence of symptoms among those in treatment is not uncommon among those with chronic medical conditions as observed among 50% to 70% of adult patients with hypertension.

  • These rates are comparable to the findings among those seeking treatment for marijuana addiction.
  • The chronic, relapsing nature of addiction is reflected in the fact that more than half the individuals entering publicly funded addiction programs require multiple episodes of treatment over several years to achieve and sustain recovery.
  • Relapse should not be viewed as absolute treatment failure. Rather, it is best seen as a temporary stumbling block and positioned as an opportunity or new starting point from which to revisit the management plan and work on the areas that require further attention in order to resume one's recovery.

Continuing Care Options

Continuing care for marijuana addiction refers to the extension of treatment beyond the initial phase. Counseling and support is continued throughout, with an aim to prevent relapse and encourage drug- free lifestyle.

Counseling Interventions/ Group Therapy

  • Cognitive Behavioral Therapy (CBT):

    CBT—administered to individuals as well as in group settings—has been found to be effective for marijuana addiction treatment.

    A randomized controlled trial of CBT and Motivational Enhancement (MET) by The Marijuana Treatment Project Research Group found significantly greater long-term abstinence and greater reductions in frequency of marijuana use with a combination of CBT and MET offered over nine weekly sessions.

    Copeland and colleagues also compared six sessions of CBT with delayed treatment control (DTC) and found greater rates of abstinence in the CBT group as compared to the DTC group.

    Similarly, a randomized controlled trial of group CBT found a significant reduction in:

    • Days of use of marijuana.
    • Number of uses per day, dependence symptoms.
    • Problems related to use over a 16-month follow-up.
  • The studies assessing effectiveness of CBT for marijuana use among adolescents and young adults have shown somewhat less distinct, but nonetheless positive effects.

    Dennis and colleagues compared five treatment models for their effectiveness among adolescents.

    • These included MET-CBT 5 (2 individual and 3 group sessions), MET-CBT 12 (2 individual and 10 group sessions), MET-CBT 12 plus family support network (6 parent education group sessions, 4 home visits, and case management), the community reinforcement approach (10 individual sessions and 4 parent sessions), and multidimensional family therapy (12 to 15 family systems-focused sessions).
    • While significant differences in treatment outcomes were not observed between the varied therapeutic approaches, all five interventions decreased drug use and symptoms of dependence.

12-Step Facilitation Treatment

The 12-step model outlines a specific, self-help style of recovery program for addiction. It is a set of guiding principles that chart a course of action for addressing addiction.

  • The recovery is sought in physical, mental, emotional and spiritual domains as one works through the steps.

    One admits to being powerless over drugs and/or alcohol.

    Members are encouraged to share their process of recovery and associated problems with others in meetings.

    One is also encouraged to identify a more experienced member of the group as a sponsor to guide through the recovery process.

Such programs have been found to complement the benefits of professional addiction treatment.

  • While the description of possibilities of 12-step self-help program for marijuana addiction in medical literature dates back more than two decades, there is limited information on its utilization and effectiveness for marijuana addiction.

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Follow-up Medical Care

Use of marijuana, particular when excessive and/or prolonged, can lead to various adverse physical health consequences.

    • These include respiratory problems such as chronic bronchitis and pneumonia.
    • Cardiovascular problems, especially among older adults with ischemic heart disease, hypertension, and stroke.
    • It is likely that prolonged marijuana smoking could be a risk factor for lung cancer, although this findings remains to be established unequivocally.
    • Also, marijuana use has been identified as a known risk factor for development of psychoses.
  • These adverse physical and mental health effects associated with marijuana use warrant regular medical follow-ups during the aftercare.

    • Marijuana can adversely impact the developing brain of adolescents and lead to adverse educational outcomes.
    • Also cannabis is commonly described as a ‘gateway drug’ and hence those with history of marijuana use need to be screened for possible use of other drugs during aftercare.

Sober Living / Therapeutic Community

Therapeutic communities offer a long stay facility to recovering individuals who have quit drug use and look forward to a drug free life. The duration of exposure to the therapeutic milieu of the community is one of the most important predictors of the successful outcome.

  • These communities offer a substitute family and a therapeutic structure that tries to strike a balance between therapy, autonomy and democracy.

    • One learns through the social interactions and management of potential crisis situations. Successful accomplishments help build the self-esteem and self-efficacy of the residents.
    • One passes through various phases during the stay in the therapeutic community.

A recent review on effectiveness of therapeutic community programs for drug (including marijuana) users by Vanderplasschen and colleagues has reported that therapeutic community is associated with:

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  • Longer time to relapse.
  • Reduced rates for recidivism (including re-arrest and re-incarceration rates).

Therapeutic community has been found to be beneficial for those having co-occurring, or dual diagnosis of a psychiatric disorder along with drug use as well as in prison settings.

Contingency Management

  • Contingency management (CM):

    CM is an intervention aimed at preventing or reducing drug use by making tangible rewards contingent on drug-free behavior. It has been found to be an effective add-on behavioral intervention for prevention of relapse to marijuana use.

Research trials of CM offered alone as well in combination with MET-CBT have reported greater abstinence rates for marijuana, confirmed by toxicology screening (e.g. urine testing).

  • The results sustained better for the combined CM and MET-CBT during post-treatment phase.
  • Initial reports from research studies find it to be promising for adolescents abusing marijuana as well as those with co-occurring marijuana use and severe mental disorders.
  • Additionally, it has been found to improve therapeutic adherence among those referred by the criminal justice system.

If you or someone you love has been trying to quit marijuana and needs help, our treatment support team can provide more information – call us at 1-888-993-3112Who Answers?.

Supporting Family and Friends With Marijuana Recovery

Living with a marijuana user and dealing with the process of recovery can be challenging for the family as well as friends. To be sure, the adverse consequences associated with addiction extend way beyond the user and impact significant others in drug user’s life.

There are self-help support groups for the family members and friends of drug users. You can also be of great help in the process of recovery of your loved one.

  • Understanding marijuana addiction and treatment shall help you deal better with the ups and downs of the process of recovery and remain engaged with the recovering individual.
  • You can support sobriety by offering emotional support and helping your loved one deal with stressful situations that could possibly lead to relapse.
  • You can also motivate your loved one to remain active with the aftercare process, as retention in treatment is one of the best predictors of successful outcome. You can also help them search for appropriate aftercare options.

Family and friends need to be aware of their own psychological and emotional needs and discuss their feelings with others. To know more about how you can be of help in recovery process of your loved one call us at 1-888-993-3112Who Answers? to speak with one of our treatment support team members.



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