13 - Engaging Young Probation-Referred Marijuana-Abusing Individuals in Treatment

Summary

For the past several years, our group has been working on developing effective treatments for young adults who are referred for treatment of marijuana abuse and dependence through the legal system, as well as other criminal justice populations. This chapter provides a brief overview of the rationale for the treatments we have developed, summarizes the initial small trial we conducted to evaluate these approaches (Sinha et al., 2003), and describes how results from that study are informing our ongoing work in this area.

Why Target Young Adult Marijuana Users?

Marijuana is the most commonly used illicit substance in the USA, with approximately 5.5 million regular weekly users (see Anthony et al., 1994; and Anthony's chapter in this volume). Moreover, marijuana use among adolescents and young adults has increased dramatically in recent years (Johnson et al., 1996). This is significant because longitudinal epidemiological studies have consistently identified marijuana as a gateway drug for progression to use of other illicit substances among young adults (Kandel & Yamaguchi, 1993; Kandel et al., 1992). The segment with the highest prevalence of marijuana use is the 18–25 age range, where 48% report lifetime use, 23% report use in the last year, and 11% report marijuana use in the last month, with higher rates among males than females (Kandel et al., 1997).

Frequent marijuana use during young adulthood significantly increases the risk of lifetime experiences with other illicit drugs, greater involvement in drugs, greater involvement in drugs, earlier onset of cocaine and opioid use, health problems, depression, and involvement with the legal system (Kandel & Davies, 1996; Kandel et al., 1992).