Zaharakis N, Coatsworth JD, Riggs NR, et al. Treating young adult cannabis use disorder with text message-delivered peer network counseling. Contemp Clin Trials. 2024;144:107635. doi:10.1016/j.cct.2024.107635
This article provides an overview and preliminary report of a two-arm, multi-site RCT for young adults with cannabis use disorder living in locations where recreational use is legal or illegal. The study aimed to test the efficacy of a novel peer network counseling intervention delivered via text message (PNC-txt) using biometrically confirmed THC levels, self-report and reported consequences of use. In addition, this study examined if the expected changes in cannabis use could be attributed to a change in peer network health and whether this differed based on participants’ sex or location. Finally, this trial assessed the effects of PNC-txt’s ability to reduce stress, cravings, and risky behaviors and how that related to cannabis reduction over time. Participants (n=1078) were recruited from Colorado (legal) and Tennessee (illegal) and randomized to either PNC-txt or a waitlist control condition. PNC-txt prompts users to engage in pre-programmed text conversations. Users were texted 4 days per week, over four weeks, with around ten prompts per session. Users respond to targeted prompts using programmed responses. Messages aim to work on four areas: improving attitudes, self-efficacy, peer network health, and developing action plans. In addition to these texts, participants were sent surveys every other day to collect information on cannabis use, craving, emotional state, stress, and mood. From the initial 1078 participants, 878 completed the 6-month follow-up assessment, providing an adequately powered sample for the planned analyses. Given the promising efficacy displayed in previous pilot studies, future work will hopefully show similar efficacy. Given this, additional work surrounding the implementation of this novel cannabis use disorder mobile health intervention would be pertinent.