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Table of Contents
Contents
1 Introduction 1
2 What is Cannabis? 5
The Geographical and Historical Origins of Cannabis 6
History of the Medicinal Use of Cannabis 7
Recent US History of Cannabis Use 9
Factors Influencing Cannabis Legalization in the United States 10
3 The Chemistry of Cannabis 13
Psychoactive Chemicals in Cannabis 13
Synthetic Cannabinoids 15
Cannabinoids and the Human Body 17
The Changing Chemistry of Cannabis and Synthetics 19
4 Cannabis Use in the United States 20
Potential Effects of Legalization of Cannabis in the United States 20
Risks and CUD 22
Risks Pertaining to Cannabis Delivery Methods and Potency 24
5 Cannabis, its Recreational Use, and its Effects 27
Recreational Use of Cannabis 29
Pregnancy 31
Highway Safety 33
Cognitive Impairment 33
6 Cannabis as Medicine and the User’s Experience 35
Multiple Sclerosis 36
Chronic Pain 36
Epilepsy 38
Cancer 38
Psychiatric Conditions 39
Medical Cannabis Patients Describe Their Experiences 39
Positive Experiences 40
Negative Experiences 41
Recommendations 41
Summary 41
7 A New Approach to Cannabis Screening 42
Universal Screening for Substance Use Disorders 42
Rationale for a Cannabis Screener 43
Cannabis Intervention Screener 44
Development of the CIS 45
Summary of CIS Evaluation Findings 46
Cannabis Use Vs. Misuse Vs. Abuse 48
Implications from CIS Study Findings 51
Orientation to Clinical Interventions Addressing Cannabis Use Disorder 53
Motivational Interviewing and Motivational Enhancement Therapy 53
Brief MI Interaction for Cannabis Misuse 54
Cognitive Behavioral Therapy 55
Intrapersonal Skills Training 57
CBT Introduction 58
The Structure of a Session Delivery: “Law of Thirds” 59
Session 1. Eliciting the Life Movie 64
Clinician Preparation 65
Session 1 Outline and Overview 66
Session 1 Protocol with Scripts 68
Session 1. Eliciting Life Movie and Change Plan Handouts 78
Treatment Information Sheet 79
Eliciting the Life Movie: MI Conversation 81
A Change Plan—Optional 84
Learning New Coping Strategies (Handout) 85
Session 2. Enhancing Awareness 89
Clinician Preparation 90
Session 2 Outline and Overview 91
Session 2 Protocol with Scripts 94
Session 2. Enhancing Situational Awareness Handouts 102
Review of Progress and Between-Session Challenges 103
Alcohol/Cannabis use Awareness Record 104
Alcohol/Cannabis use Awareness Record Example 105
Planning to Feel Good (Optional) 106
Session 3. Learning Assertiveness 107
Clinician Preparation 108
Session 3 Outline and Overview 109
Session 3 Protocol with Scripts 111
Session 3. Learning Assertiveness Handouts 120
Review of Progress and Between-Session Challenges 121
Communication Styles 122
Between-Session Challenge Assertiveness 124
Session 4. Supporting Recovery through Enhanced Social Supports 126
Enhancing Social Support 128
Session 4 Outline and Overview for Enhancing Social Support 129
Session 4 Protocol with Scripts 132
Session 5. Supporting Recovery through Healthy Replacement Activities 136
Clinician Preparation 137
Session 5 Outline and Overview for Enhancing Healthy Replacement Activities 138
Session 5 Protocol with Scripts 140
Session 5. Supporting Recovery Through Healthy Replacement Activities Handouts 143
Review of Progress and Between-Session Challenges 144
Social Support 145
My Social Atom 146
Plan for Seeking Support 147
Increasing Pleasant Activities 148
Engaging in Replacement Activities 149
Session 6. Problem Solving 150
Clinician Preparation 151
Session 6 Outline and Overview 152
Session 6 Protocol with Scripts 155
Session 6. Problem Solving Handouts 163
Review of Progress and Between-Session Challenges 164
Problem Solving 165
Session 7. Handling Urges, Cravings, and Discomfort (urge Surfing) 167
Clinician Preparation 168
Session 7 Outline and Overview 169
Session 7 Protocol with Scripts 172
Session 7. Handling Urges, Cravings, and Discomfort Handouts 186
Coping with Cravings and Discomfort 187
Daily Record of Urges to Use 189
Urge Surfing 190
Session 8. Making Important Life Decisions 192
Clinician Preparation 194
Session 8 Outline and Overview 195
Session 8 Protocol 197
Session 8. Making Important Life Decisions Handouts 201
Clinician’s Quick Reference to Session 8 202
MI Skills and Strategies 204
Readiness-to-Change Ruler 205
Values Exploration 206
My Values 208
Decision-Making Guide 209
Decision-Making Guide Example 211
Thinking About My Use Option 3 213
Session 9. Enhancing Self-awareness 214
Clinician Preparation 215
Session 9 Outline and Overview 216
Session Protocol 217
Session 9. Enhancing Self-Awareness Handouts 227
Clinician’s Quick Reference to Session 9 228
Alcohol/Cannabis Use Awareness Record 229
Alcohol/Cannabis Use Awareness Record (continued) 231
Alcohol/Cannabis Use Awareness Record Example 232
Future Self Letter 233
Relaxation Practice Exercise 234
Session 10. Mindfulness, Meditation, and Stepping Back 235
Clinician Preparation 238
Session 10 Outline and Overview 239
Session Protocol 240
Session 10. Mindfulness, Meditation, and Stepping Back Handouts 246
Clinician’s Quick Reference to Session 10 247
Mindfulness Meditation Instructions 248
Meditation Exercise: On the Riverbank 249
References 250
Index 267
