Integrated Cognitive Behavioral Therapy for Comorbid Cannabis Use and Anxiety Disorders

Julia D. Buckner, Louisiana State University, Baton Rouge, USA.
Anthony H. Ecker, Louisiana State University, Baton Rouge, USA.
Jennifer S. Beighley, Louisiana State University, Baton Rouge, USA.
Michael J. Zvolensky, University of Houston, TX, USA.
Norman B. Schmidt, Florida State University, Tallahassee, FL, USA.
Sonia M. Shah, Louisiana State University, Baton Rouge, USA.
Kathleen M. Carroll, Yale University School of Medicine, New Haven, CT, USA.


Cannabis use disorders (CUDs) co-occur with anxiety disorders at high rates, presumably because some individuals with anxiety disorders may rely on cannabis to manage anxiety. Motivation enhancement therapy (MET) combined with cognitive-behavioral therapy (CBT) is an efficacious intervention for CUD, yet outcomes are worse for patients with elevated anxiety. The integration of MET-CBT with (FSET) may be useful with anxious CUD patients, as the use of cannabis to manage anxiety can be targeted as a false safety behavior. Here, we describe the integrated treatment and the successful use of it among two patients-one with CUD and comorbid social anxiety disorder (SAD) and one with CUD and comorbid SAD and generalized anxiety disorder. Data support the feasibility of this integrated treatment as a viable approach to the treatment of CUD and comorbid anxiety disorders. Future controlled trials are now warranted to further evaluate the intervention.