Background Cannabis is the second most commonly misused substance after alcohol among clients seeking treatment for other drug use, but no statistics are available regarding secondary cannabis use among drug treatment clients.
Objectives To investigate the level of secondary cannabis use among drug treatment clients and perceived need for support addressing this use from clients and staff perspectives.
Methods Multi-site cross-sectional questionnaires of clients (N=295) and staff (N=33) were conducted in 2015 in a convenience sample from four South London and Maudsley NHS Trust drug and alcohol treatment services. Client measures included drugs use in the past 30 days, type of cannabis used, Severity of Dependence Scale for cannabis, and view on treatment for secondary cannabis use. Staff measures included definition of problem cannabis use, importance and timing for addressing secondary cannabis use in treatment.
Results Amongst clients, 39.7% reported secondary cannabis use in the past 30 days, with 29.9% of them were interested in changing it. Secondary cannabis users who met the SDS threshold for problem use (30.8%) were more likely to had been offered support than non-problem users (25.7% compared to 18.7%, p = 0.40). Staff views on when to address secondary cannabis use during treatment were mixed, with 48.5% reporting that it should be addressed early in treatment.
Conclusions Two out of five drug treatment clients are using cannabis and a third experience cannabis-related problems. Many are willing to address cannabis misuse with specialists ' support, but treatment guidelines need to provide a clear pathway to facilitate this.
no conflict of interest