A pilot randomized clinical trial of Brief Behavioral Treatment for Insomnia to reduce problematic cannabis use among trauma-exposed young adults

J Subst Abuse Treat. 2021 Dec:131:108537. doi: 10.1016/j.jsat.2021.108537. Epub 2021 Jun 16.

Abstract

Background: Insomnia symptoms may be an important etiological factor for substance use disorders; however, whether improving sleep leads to reductions in problematic substance use among at-risk populations remains unclear.

Method: As such, the current pilot study used a randomized controlled design to test the effects of Brief Behavioral Treatment for Insomnia (BBTI) against a waitlist control among a sample of trauma-exposed young adults with elevated insomnia symptoms who regularly use cannabis (N = 56).

Results: Intent-to-treat multilevel modeling analyses indicated that BBTI may be more efficacious than waitlist control in reducing self-reported insomnia symptoms, with large effects three months post-treatment (d = 1.34). Further, our initial evidence suggested that BBTI resulted in reductions in cannabis-related problems with medium to large effects at three months post-treatment (d = 0.75). The current pilot analyses indicated BBTI also reduced cravings to use cannabis to reduce negative emotions in response to trauma cues with a large effect size.

Conclusion: This pilot study suggests BBTI may be efficacious not only in improving insomnia symptoms among cannabis users but also in reducing cannabis-related problems and cravings over three months. Future research should replicate these results in a larger, fully powered sample with improved follow-up rates designed to test temporal mediation using multimethod assessments of insomnia symptoms and problematic cannabis use. Overall, BBTI may be a promising intervention for trauma-exposed cannabis users to improve sleep and reduce cannabis-related problems.

Keywords: Cannabis; Insomnia; Post-traumatic stress; Substance use disorder; Trauma.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Behavior Therapy / methods
  • Cannabis*
  • Humans
  • Pilot Projects
  • Sleep Initiation and Maintenance Disorders* / therapy
  • Treatment Outcome
  • Young Adult