The prevalence of cannabis use among young adults has reached unprecedented levels, prompting significant concerns regarding its detrimental effects on mental health and neurological development. These risks are particularly pronounced for individuals identified as being at high risk for psychosis, as cannabis consumption can intensify symptom severity, precipitate earlier onset of psychotic episodes, and contribute to prolonged hospitalizations as well as diminished cognitive functioning and overall quality of life. Despite the evident need for targeted interventions to address this vulnerable population, the availability of effective measures remains limited, particularly with respect to leveraging mobile health (mHealth) technologies. This study aims to examine the barriers and facilitators associated with reducing cannabis use among young adults at risk for psychosis, incorporating user perspectives to inform the development of a tailored, evidence-based mobile intervention.
The study recruited 20 young adults between the ages of 18 and 28, all of whom reported using cannabis at least twice per week and were clinically assessed as being at high risk for psychosis. Participants were selected from a psychiatric intensive outpatient program (IOP) and participated in individual, one-hour semi-structured interviews. These interviews were designed to examine their experiences with cannabis use, challenges associated with cessation, and recommendations for the development of a mobile intervention. The collected data were transcribed and analyzed using NVivo software, following a thematic analysis approach to identify key themes that could inform the intervention’s design.
According to the findings, the primary barriers to reducing cannabis use included dependence on cannabis to manage stress or mental health symptoms, social influences that normalize or encourage use, the accessibility of cannabis, ambivalence about change, and withdrawal-related symptoms. Conversely, key facilitators involved recognizing the negative consequences of cannabis use, focusing on personal motivations and goals, leveraging supportive social networks, and adopting alternative coping strategies. Recommendations for a mobile intervention emphasized goal-setting features, such as tracking abstinence milestones and providing rewards, alongside self-monitoring tools to document cannabis use patterns, cravings, and emotional states. Additionally, offering tailored healthy alternatives, such as mindfulness exercises and distraction techniques, was identified as critical. Participants also highlighted the importance of a user-friendly and engaging design, incorporating gamification elements to enhance usability. The findings emphasize the importance of addressing the unique barriers faced by high-risk youth in reducing or quitting cannabis use, as well as incorporating their specific preferences into the development of a tailored mobile intervention.
Takeaway: Tailored mobile interventions can play a key role in addressing challenges and supporting cannabis use reduction among high-risk young adults.