Cannabis abuse is prevalent among young people in Pakistan, despite its association with significant psychopathology. Current treatment models to reduce cannabis use have been purported to have variable effectiveness and lack cultural adaptability. Consequently, this study assessed if an indigenously adapted community reinforcement approach (IA-CRA) compared to placebo would have a beneficial impact on individuals attaining abstinence and additionally positively impact depressive and anxiety symptoms and quality of life. A single-blind randomized controlled trial of IA-CRA (n = 60) and control group (n = 60) was conducted for 120 individuals fulfilling criteria for cannabis misuse. The IA-CRA group demonstrated significant high rates of abstinence compared to treatment as usual (86.4% vs. 11.9%, χ2 = 63.60, p < .001) with this finding persisting at 36-week follow-up (89.7% vs. 23.5%, χ2 = 63.60, p < 0.001). Reduced depressive (F = 7.27, p < .001, ηp2 = .24), anxiety F = 7.66, p < .001, ηp2 = .52), stress-related symptoms (F = 7.66, p < .001, ηp2 = .62), and improved quality of life (F = 20.45, p < .001, ηp2 = .43) were demonstrated at study end with these findings maintained at 9-month follow-up (p < .001). This study demonstrates that a brief trial of IA-CRA can support individuals attain abstinence regarding cannabis use and have a modest ameliorative effects for depressive and anxiety symptoms, with these beneficial effects maintained for at least 36 weeks’ post-intervention.
Trial Registration: NCT04513756. Registered 13 August 2020. US National Institute of Health