ASPOFAFF :: Journal - Volume 2 :: Volume 2 - Issue 1 :: Vol 2 - Iss 1 - Short Communication - Integrating a group intervention for cannabis use within psychiatric care for bipolar disorders


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ASPOFAFF :: Journal - Volume 2 :: Volume 2 - Issue 1 :: Vol 2 - Iss 1 - Short Communication - Integrating a group intervention for cannabis use within psychiatric care for bipolar disorders

Vol 2 - Iss 1 - Short Communication - Integrating a group intervention for cannabis use within psychiatric care for bipolar disorders #81

Integrating a group intervention for cannabis use within psychiatric care for bipolar disorders

Béatrice Weber Rouget, Patrick Bourgeois & Jean-Michel Aubry

Commonly regarded for decades as an innocuous drug, cannabis is nowadays more and more considered as detrimental, particularly when used by vulnerable populations, such as adolescents and persons with somatic or psychiatric pathology. Growing evidence highlights that this substance can and does produce dependence and more attention is now being directed toward the urge to develop treatment protocols for cannabis consumers. This need remains still unmet (Dennis & al 2002; Copeland 2004), as little is known about how to treat effectively individuals who are abusing this drug (Steinberg & al 1997).

Clear data is also lacking regarding specific associations between psychiatric disorder and cannabis dependence. According to several studies, the presence of a psychiatric disorder increases the likelihood of developing alcohol and drugs dependence. On the other hand, as shown in some researches, substance abuse/dependence may have direct (initiation and aggravation) and indirect effects (treatment compliance) on the mental illness (Regier & al 1990; Strakowski & al 1998; Arseneault & al 2004; Henquet & al 2005).

Concerning bipolar disorders, high rates of substance misuse are reported. In fact, when compared to bipolar illness, no other Axis I disorder shows as high a prevalence of substance abuse (Tohen & al 1999). The reasons for this strong association are unknown. Moreover, bipolar patients seem to present some patterns of drug use, with high rates of cannabis and stimulants (Brown & al 2001).

Aware of these patterns and concerned with the problematic issue of substance abuse adverse effects on mental illness, as mental health professionals, we can no longer treat effectively bipolar disorders while ignoring in some of our patients a cannabis abuse comorbid condition.

As it seems to be very difficult to attract people with mental illness into separate specific treatment units for their substances use problems and that individuals addicted to cannabis are reportedly more ambivalent with regard to change and often inexperienced in relation to substance abuse treatment (Steinberg & al 1997), we decided to follow the guidelines of integrating interventions focusing on cannabis abuse within standard psychiatric care (Baker & al 2002) offered to patients consulting in our evaluation and treatment program for bipolar disorders.

We will briefly describe our group treatment module aimed at managing cannabis use within safety levels and based on education, motivational interviewing and cannabis consumption daily record. Our impressions to date about the clinical feasibility of this integrated intervention within more standard psychiatric care of our bipolar patients will be reported.

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