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Motivations et stratégies lors d’arrêt spontané de la consommation de cannabis : quel impact sur les rechutes ?

Motivations for cannabis cessation, coping and adaptation strategies, and perceived benefits: Impact on cannabis use relapse and abstinence

Doi : 10.1016/j.encep.2013.03.008 

E. Chauchard  , A. Septfons, H. Chabrol

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Résumé

Introduction

L’arrêt du cannabis sans aide thérapeutique a été peu étudié. L’objectif de cette étude était de comparer les motivations, les stratégies d’adaptation et de coping et les bénéfices perçus lors de l’arrêt du cannabis, entre les participants abstinents et ceux qui ont rechuté, dans un contexte d’arrêt spontané.

Méthode

Soixante-trois participants dont 51 % de femmes et d’âge moyen 28,5 (±5,10), ont été recrutés sur Internet. Ils étaient des consommateurs réguliers de cannabis, non demandeurs de soins. Ils ont complété le Cannabis Quit Questionnaire, le Brief Cope et un questionnaire évaluant les bénéfices perçus de l’arrêt.

Résultats

Cinquante-trois pour cent des participants déclaraient avoir repris une consommation de cannabis suite à la tentative d’arrêt étudiée. Les participants abstinents montraient un niveau plus élevé de motivations orientées sur l’impact négatif de la consommation de cannabis sur la santé, sur sa propre image et sur son image sociale, ainsi que vers le renforcement négatif et les problèmes sociaux. Durant l’arrêt ils s’appuyaient significativement plus sur leur environnement social (famille, amis) et étaient moins consommateurs d’autres substances que les participants qui rechutaient.

Discussion

Certaines motivations, stratégies d’adaptation et de coping (environnementales et cognitives) spécifiques et le soutien social sont utilisées lors des arrêts spontanés de la consommation du cannabis et pourraient influencer le maintien de l’abstinence. Cette étude présente un intérêt à la fois pour les programmes de prévention et de soins.

Summary

Objectives

While cannabis has been recognized as the most illicit drug use in the world, few studies focusing on cannabis self-change and cannabis relapse or abstinence in adult non-treatment samples have been conducted. The first aim of this study was to understand cannabis self-change motives, coping and adaptation strategies and evaluating perceived benefits from cannabis cessation. The second aim was to compare, in a convenience sample of non-treatment-seeking adult cannabis smokers, motivations to quit smoking cannabis, coping and adaptive strategies, as well as perceived benefit from cessation between cannabis abstinent and participants who relapse.

Method

Sixty-three participants (31 men and 32 women) who attempted to quit cannabis in a non-controlled environment without medical help and were enrolled. They completed the Marijuana Quit Questionnaire (MJQQ), a self-report questionnaire collecting information in three areas: sociodemographic characteristics, cannabis use history (including any associated problems), and participants’ characteristics regarding their “most difficult” (self-defined) attempt to quit in a non-controlled environment. For this study the index quit attempt was characterized in two areas: reasons for quitting marijuana, coping strategies used while quitting. Two additional questionnaires were added to the MJQQ; the Brief Cope, and a questionnaire assessing perceived benefit of the cannabis quit attempt. The participants were on average 28.5 years old (±5.1), and started using cannabis on average at 15.8 years (±2.8). Seventy-four percent (n=45) of the participants met the DSM-IV criteria for cannabis dependence before cannabis cessation. T-tests were used to compare abstainers and participants who relapsed after the quit attempt.

Results

Realizing that cannabis induces disabling cognitive disorders such as affection of memory, concentration and attention were reported by 71% of the participant as a motivation for quitting cannabis use. Then, being more energetic (reported by 68%) and more active during the day (62%), being able to control their life (67%), proving themselves they could quit (60%), saving money (60%), as well being less worried about their health (57%) were also reported as motivations to quit cannabis use. Different coping and adaptation strategies were also reported. First, environmental strategies such as disposing of both cannabis (71%) and equipment to smoke (71%), no longer going to places where cannabis is smoked (33%) or lifestyle changes (68%) were used to cope with cannabis cessation. Then cognitive strategies such as motivation, willingness (71%), self-control and having a positive perception of the situation (68%) were also reported. Regarding coping strategies, participants accepted and learned how to live with the new situation (68%), and social support from family (32%) and friends (30%) were reported. Perceived benefits were linked with motivations for cannabis cessation. Thus, participants reported having more energy (75%), being more active (73%), less tired (70%) and recovering memory (57%) after cannabis cessation. Fifty-two percent of participants relapsed after the quit attempt. Abstainers had significantly higher scores on two subscales: the “negative impact of cannabis use on one's health and on self and social image” (t(61)=−3.84; P<0.001; d=−0.76) and “negative reinforcement (e.g. seeking relief for specific physical symptoms or social problems caused by cannabis)” (t(61)=3.56; P=0.01; d=−0.51) than non-anstainers. Non-abstainers reported significantly less social support from family (t(61)=−3.85; P<0.001, d=−0.76) and friends (t(61)=−2.22; P=00.03, d=−0.51) than abstainers.

Conclusion

This study underlines different aspects of cannabis cessation, self-change, relapse, and abstinence. Social and family support, as well as social network appears to be of prime importance in relapses and prevention programs for cannabis use. New perspectives for research on cannabis cessation self-change and relapses are thus highlighted, notably regarding factors that could predict relapse or success in cessation of smoking cannabis. Research on cannabis self-change and relapse are warranted for both prevention and therapeutic programs.


Mots clés : Cannabis, Arrêt spontané, Dépendance, Rechute, Abstinence

Keywords : Cannabis cessation, Self-change, Relapse, Abstinence, Dependence


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© 2013  L’Encéphale, Paris. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 39 - N° 6

P. 385-392 - décembre 2013 Retour au numéro
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