CBT for cannabis use disorder: how cognitive behavioural therapy can help
Medically reviewed by Paul Hornsey
In clinical circles, there exists a general consensus that cognitive behavioural therapy (CBT) is one of the most effective treatments for cannabis use disorder (CUD); indeed, one report 1 found that “[since] it is accepted that cannabis use is a learned behaviour, [then] achievement of abstinence is also a learning process.”
In UK adults aged 16-59 years old, cannabis is the most widely-used illicit drug, with 7.6% of the demographic reporting cannabis use in 2023 2. Although cannabis is often perceived as a ‘less harmful’ substance in comparison to other drugs, long-term use can become problematic and develop into dependency; affecting both mental and physical health. One condition that often presents is CUD.
In the following article, we’ll explore cannabis use disorder, and the various ways CBT can help those struggling with the condition to overcome it.
Learn more about how CBT can help individuals with CUD.
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What is cannabis use disorder?
CUD is characterised by a continuous and problematic pattern of cannabis use that negatively affects an individual’s everyday functioning and/or causes distress. A 2016 WHO report 3 concluded that the prevalence of CUD is high enough to warrant its classification as a public health problem (at least, in higher-income nations), and that its prevalence appears to have increased significantly since 2000.
According to The Diagnostic and Statistical Manual of Mental Disorders 4 (DSM-V), CUD is defined as “the presence of clinically significant impairment or distress in 12 months, manifested by at least 2 of the following:
Typically, CUD develops as a consequence of prolonged or excessive use of cannabis, where users find it increasingly difficult to control their consumption – despite experiencing negative consequences in various aspects of their lives. Anecdotal evidence often points to damage to the working memory, as well as the exacerbation of comorbid conditions 5 (such as anxiety, depression, and psychosis), which invariably lead to a negative impact on work, relationships, and everyday functioning.
In this field, the number of clinical studies are growing rapidly; that said, even today, most researchers agree 6 that “heavy and dependent cannabis use is consistently associated with a high prevalence of comorbid psychiatric disorders and learning and memory impairments.”
Increasingly, further evidence is coming to light suggesting a probable impact of cannabis use disorder on mental health. For instance, one report 7 found an “increased risk of psychotic and nonpsychotic bipolar disorder and unipolar depression”, “schizophrenia, anxiety disorders, and personality disorders”.
Interestingly, the study also suggests that the link between CUD and mental health disorders goes both ways – in that individuals who already experienced a relevant condition (such as depression, schizophrenia, or BPD) were more likely to develop CUD than those who did not.
An introduction to cognitive behavioural therapy (CBT)
In short, cognitive behavioural therapy (CBT) is a type of talking therapy that focuses on the relationship between thoughts, feelings, and behaviours.
Developed in the 1960s by psychiatrist Aaron Beck, CBT 8 is based on the theory that our thoughts significantly influence our emotions and behaviours, and by altering these thought patterns, we can change our behaviours and emotional responses.
CBT is a structured, goal-oriented therapy that is typically shorter-term, rendering it a more accessible option for many. It involves identifying and challenging negative thought patterns and replacing them with healthier, more constructive ways of thinking.
Beck Institute
“CBT is based on the theory that the way individuals perceive a situation is more closely connected to their reaction than the situation itself. Individuals’ perceptions are often distorted and unhelpful, particularly when they are distressed.
Cognitive Behavior Therapy helps people identify their distressing thoughts and evaluate how realistic the thoughts are. Then they learn to change their distorted thinking. When they think more realistically, they feel better. The emphasis is also consistently on solving problems and initiating behavioural changes.” 8
That aspect of behavioural intervention is a key note. CBT encourages individuals to engage in activities that promote wellbeing and reduce reliance on harmful behaviours – which may include substance use.
For those experiencing the challenges associated with cannabis use disorders, CBT offers a practical, effective therapeutic approach. It can dramatically enhance the addiction rehabilitation process by helping clients obtain and maintain more control over their behaviours.
How CBT for cannabis use disorder works
CBT can be particularly effective in treating cannabis use disorder 9 since its effectiveness lies in addressing the underlying cognitive and behavioural patterns that can often drive the use of the substance.
By focusing on both cognition, as well as behaviour, individuals can develop the skills and strategies needed to manage impulses, avoid triggers and, ultimately, reduce or eliminate their cannabis use.
Key CBT techniques for managing cannabis use
Several of the techniques used in CBT can be particularly effective in managing cannabis use disorder by helping individuals change their thinking patterns, modify their behaviours, and build a strong foundation for long-term recovery.
Combining CBT with other treatments for cannabis use disorder
Even deployed as a standalone treatment, CBT can prove an incredibly powerful method of treating CUD, along with a variety of other substance use disorders and mental health conditions.
Combining CBT with other treatments can compound and enhance its effectiveness, providing a more comprehensive, whole-person approach to overcoming cannabis use disorder.
CBT and CUD: the bottom line
Ultimately, CBT often represents a highly effective treatment for cannabis use disorder, as testified by the studies and research we’ve cited in this article – offering individuals the tools to understand and change the thoughts and behaviours that perpetuate their cannabis use.
In particular, by focusing on and committing to cognitive restructuring and behavioural activation, CBT empowers people to break free from the cycle of drug addiction and dependency, and regain control over their lives.
When combined with other treatments – such as medication-assisted therapy, or whole-person lifestyle interventions (eg., nutrition, exercise, and mindfulness) – CBT can form the foundation for a comprehensive, curated approach to recovery; helping individuals build healthier, sustainable habits for enduring sobriety.
Speak to our team today to learn more about CUD treatments available at Harbor London.
