Preferences of Young Adults With Psychosis for Cannabis-Focused Harm Reduction Interventions: A Cross-Sectional Study: Préférences des jeunes adultes souffrant de psychose pour les interventions de réduction des méfaits axées sur le cannabis : une étude transversale

Stephanie Coronado-Montoya; Amal Abdel-Baki; David Crockford; José Côté; Simon Dubreucq; Alina Dyachenko; Benedikt Fischer; Tania Lecomte; Sophie L'Heureux; Clairélaine Ouellet-Plamondon; Marc-André Roy; Philip Tibbo; Marie Villeneuve; Didier Jutras-Aswad

doi:10.1177/07067437241242395

Preferences of Young Adults With Psychosis for Cannabis-Focused Harm Reduction Interventions: A Cross-Sectional Study: Préférences des jeunes adultes souffrant de psychose pour les interventions de réduction des méfaits axées sur le cannabis : une étude transversale

Can J Psychiatry. 2024 Apr 4:7067437241242395. doi: 10.1177/07067437241242395. Online ahead of print.

Authors

Stephanie Coronado-Montoya^{1

2}, Amal Abdel-Baki^{1

2

3}, David Crockford^{4

5}, José Côté^{2

6}, Simon Dubreucq^{1

2}, Alina Dyachenko², Benedikt Fischer^{7

8

9

10

11}, Tania Lecomte^{12

13}, Sophie L'Heureux^{14

15}, Clairélaine Ouellet-Plamondon^{1

2

3}, Marc-André Roy^{15

16

17}, Philip Tibbo¹⁸, Marie Villeneuve¹, Didier Jutras-Aswad^{1

2

3

19}

Affiliations

¹ Department of Psychiatry and Addiction, Université de Montréal, Montréal, Canada.
² Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, Canada.
³ Department of Psychiatry, Centre Hospitalier de l'Université de Montréal, Montréal, Canada.
⁴ Department of Psychiatry, University of Calgary, Calgary, Canada.
⁵ Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.
⁶ Faculty of Nursing, Université de Montréal, Montréal, Canada.
⁷ Centre for Applied Research in Addiction and Mental Health, Simon Fraser University, Vancouver, Canada.
⁸ Research & Graduate Studies Division, University of the Fraser Valley, Abbotsford, Canada.
⁹ Department of Psychiatry, University of Toronto, Toronto, Canada.
¹⁰ School of Population Health, University of Auckland, Auckland, New Zealand.
¹¹ Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil.
¹² Department of Psychology, University of Montréal, Montréal, Canada.
¹³ Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, Canada.
¹⁴ Clinique Notre-Dame des Victoires, Institut Universitaire en Santé Mentale, Centre Intégré Universitaire de Soins et Services Sociaux de la Capitale Nationale, Québec, Canada.
¹⁵ Department of Psychiatry and Neurosciences, Laval University, Québec, Canada.
¹⁶ Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec, Québec, Canada.
¹⁷ Centre de Recherche CERVO, Québec, Canada.
¹⁸ Department of Psychiatry, Dalhousie University, Halifax, Canada.
¹⁹ University Institute on Addictions, Montréal, Canada.

PMID: 38571478
DOI: 10.1177/07067437241242395

Abstract

Objectives: Cannabis use is common in people with early-phase psychosis (EP) and is associated with worse treatment outcomes. Few targeted interventions for cannabis use behaviour in this population exist, most focusing on abstinence, none focusing on harm reduction. Many people with EP will not seek treatment for their cannabis use with current therapeutic options. Understanding preferences for cannabis-focused harm reduction interventions may be key to improving outcomes. This study aimed to determine preferences of young adults with EP who use cannabis for cannabis-focused harm reduction interventions.

Methods: Eighty-nine young adults across Canada with EP interested in reducing cannabis-related harms were recruited. An online questionnaire combining conventional survey methodology and two unique discrete choice experiments (DCEs) was administered. One DCE focused on attributes of core harm reduction interventions (DCE 1) and the second on attributes of boosters (DCE 2). We analysed these using mixed ranked-ordered logistic regression models. Preference questions using conventional survey methodology were analysed using summary statistics.

Results: Preferred characteristics for cannabis-focused harm reduction interventions (DCE 1) were: shorter sessions (60 min vs. 10 min, odds ratio (OR): 0.72; P < 0.001); less frequent sessions (daily vs. monthly, OR: 0.68; P < 0.001); shorter interventions (3 months vs. 1 month, OR: 0.80; P < 0.01); technology-based interventions (vs. in-person, OR: 1.17; P < 0.05). Preferences for post-intervention boosters (DCE 2) included opting into boosters (vs. opting out, OR: 3.53; P < 0.001) and having shorter boosters (3 months vs. 1 month, OR: 0.79; P < 0.01). Nearly half of the participants preferred to reduce cannabis use as a principal intervention goal (vs. using in less harmful ways or avoiding risky situations).

Conclusions: Further research is required to see if technology-based harm reduction interventions for cannabis featuring these preferences translate into greater engagement and improved outcomes in EP patients.

Keywords: cannabis; discrete choice experiment; expérience de choix discrets; harm reduction; interventions psychosociales; preferences; préférences; psychose; psychosis; psychosocial interventions; réduction des méfaits.