The first publication, "Day-Level Shifts in Social Contexts During Youth Cannabis Use Treatment" published in the Journal of Consulting and Clinical Psychology examined daily shifts in youth's social contexts with the goal of characterizing how specific social contexts (time with cannabis-using friends and siblings, non-using friends and siblings, parents, and alone) relate to cannabis craving and use during treatment. This double-blind randomized control trial tested the effects of motivational enhancement and cognitive behavioral therapies plus either adjunctive pharmacotherapy or placebo on cannabis craving and use in 65 cannabis using participants. Time-varying effects models indicated that time spent with cannabis-using friends and siblings decreased, where time spent with non-using friends or alone increased across the trial. Time with parents or non-using siblings was unchanged. More time spent with cannabis-using friends and with siblings was uniquely associated with greater craving and use during treatment. Results from the present study highlight the need for increased attention to shifting youths’ social contexts to enhance treatment success.

Co-authors: Dr. Ryan W. Carpenter, Dr. Hayley Treloar Padovano, and Dr. Robert Miranda Jr.

The second publication, "Combined pharmacotherapy and evidence-based psychosocial Cannabis treatment for youth and selection of cannabis-using friends" published in Drug and Alcohol Dependence examined whether combining evidence-based psychosocial treatment with adjunctive pharmacotherapy helps youth decrease their affiliations with cannabis-using friends and increas their affiliations with non-using friends during cannabis misuse treatment by altering socialization and selection processes. This six-week intervention testing the effects of motivational enhancement and cognitive behavioral therapy plus topiramate or placebo on cannabis craving and use in 65 youth (15-24 years) used ecological momentary assessment data assessed youths’ time with cannabis-using and non-using friends, cannabis use, and craving in daily life. Multiple group multilevel structural equation modeling indicated that greater time spent with cannabis-using friends promoted greater next day cannabis use and craving (socialization effect). In turn, cannabis craving, but not use, promoted continued selection of cannabis-using friends. This indirect effect was only supported in the placebo condition due to the selection piece of this cycle not being significant for youth who received topiramate. Neither cannabis craving nor use were associated with time with non-using friends the next day. This finding suggests that the interruption of youth selection processes could be one mechanism by which MET-CBT and adjunctive topiramate pharmacotherapy works.

Co-authors: Dr. Hayley Treloar Padovano and Dr. Robert Miranda Jr.