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Please note that the information on this page is based on the EMCDDA Annual report 2011: the state of the drugs problem in Europe. Most statistical data relate to the year 2009 (or the last year available).


Annual report 2011: the state of the drugs problem in Europe

Published: 15 November 2011


Treatment provision

In Europe, cannabis treatment includes a broad range of measures including Internet-based treatment, counselling and structured psychosocial interventions, and treatment in residential settings. There is also a frequent overlap between selective and indicated prevention and treatment interventions (see 'Responding — an overview').

Cannabis treatment is mainly provided in specialist outpatient facilities, and services specifically targeting cannabis-related problems are now available in more than half of the Member States. For example, more than 300 youth counselling centres have been set up across France to cater primarily for the needs of young users with cannabis problems. In Germany, alongside several specific cannabis programmes, 161 counselling centres have adopted the programme 'Realize it', which requires clients to set goals for controlling consumption, and addresses individual and environmental factors associated with their cannabis use. The intervention is delivered in five sessions over a period of 10 weeks to up to 1 400 cannabis users per year. In Hungary, the large majority (80 %) of cannabis clients attend preventive-consulting services. These services are provided by accredited organisations.

Germany and the Netherlands have been particularly active in the development of cannabis programmes. Cannabis problems are commonly associated with other substance or psychosocial problems, and this is reflected in the types of programme available to cannabis users. For example, the Amsterdam Medical Centre has developed a family motivational intervention for young cannabis users with schizophrenia and their parents (Dutch Reitox national report, 2009). A randomised controlled trial has shown positive results for this intervention. After three months, the young people involved in the trial reported reduced cannabis use and craving, while the parents reported reduced stress and improved well-being. Cases involving the co-occurrence of cannabis use and psychiatric problems, such as psychosis or depression, require integrated approaches between specialised treatment providers and mental health centres. In practice, however, treatment of dual diagnoses is still often handled sequentially and cooperation between care providers remains difficult.

A recent German study predicts increasing numbers seeking treatment for problems related to cannabis use in future years, especially among male adolescents and young adults. Currently, estimates of the proportion of drug users reached by drug facilities in Germany show that, although specialised addiction services are able to reach between 45 % and 60 % of users with opioid dependence, only between 4 % and 8 % of cannabis users estimated to be in need of treatment are reached. In some cases, Internet-based interventions, which are now available in three Member States, may provide further treatment options to cannabis users who seek support but who are reluctant to approach traditional treatment services.

Recent studies on treatment of cannabis users

Treatment evaluation studies are still scarce in comparison with those for other illicit drugs, in spite of the increasing demand for cannabis treatment. Research is nevertheless increasing in Europe, with studies currently being conducted in Germany, Denmark, Spain, France and the Netherlands.

A number of these studies confirm that psychosocial interventions can have positive results with cannabis users. This is the case, for example, for multidimensional family therapy, a comprehensive family-based outpatient intervention targeting adolescents with drug use and behaviour problems (Liddle et al., 2009), which reported success in reducing levels of drug consumption. Conclusions from a comparison with other available treatments in a cross-country multisite trial were, however, unclear. This has prompted the EMCDDA to commission a meta-analysis of European and American studies.

Other psychosocial interventions that are currently being evaluated include psycho-education (based on behavioural therapeutic and motivational interviewing elements) and relapse prevention, brief interventions, contingency management and various types of cognitive behavioural therapy.

Research is also being conducted on pharmacological products that may support psychosocial interventions (Vandrey and Haney, 2009). In this area, the three principal lines of research currently being followed investigate the possibilities of using pharmaceuticals to help reduce cannabis withdrawal symptoms, craving or use (Marshall, K. et al., 2011).

Bibliographic references

Liddle, H.A., Rowe, C.L., Dakof, G.A., Henderson, C.E. and Greenbaum, P.E. (2009), 'Multidimensional family therapy for young adolescent substance abuse: twelve-month outcomes of a randomized controlled trial', Journal of Consulting and Clinical Psychology 77(1), pp. 12-25.

Marshall, K.S., Gowing, L. and Ali, L. (2011), 'Pharmacotherapies for cannabis withdrawal', Cochrane Database of Systematic Reviews, Issue 1.

Vandrey, R. and Haney, M. (2009), 'Pharmacotherapy for cannabis dependence: how close are we?', CNS Drugs 23(7), pp. 543-53.

About the EMCDDA

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is the reference point on drugs and drug addiction information in Europe. Inaugurated in Lisbon in 1995, it is one of the EU's decentralised agencies. Read more >>

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Page last updated: Friday, 28 October 2011