This talk highlights the gap between confident social media guidance and a thin, sometimes contradictory evidence base, and why individualized, evidence-based harm reduction is needed instead of one-size-fits-all advice.
Cannabis use and cannabis use disorder (CUD) are rising, but fewer than 5% of people with CUD ever seek treatment, so most people self-manage their use. “Tolerance breaks” (T-breaks) are one of the most popular self-management strategies—mentioned and recommended on over 2 billion webpages —yet almost no science has tested whether they work. In our own published study of 170 young adults, taking a T-break was linked to worse outcomes six months later, including higher hazardous use and CUD severity, directly contradicting the online resources. This is concerning in light of the many colleges that are now sharing T-break manuals as prevention and intervention approaches.
The solution(s) that you’re working on to address the problems: We have replicated our prior findings at longer durations and with other substance use outcomes. Given the push to implement T-breaks as an intervention strategy, we are currently working on a research proposal that would be the first controlled experimental study of T-breaks, incorporating both lab-based cannabis administration and real-world daily monitoring (EMA). We will implement remote contingency management and use mobile technology to evaluate what length of breaks and what other characteristics of young adults are associated with improved outcomes. This data will allow us to better understand short versus long durations on tolerance, drug effects, and use patterns.
Attendees will learn that T-breaks, despite being marketed as a tolerance-reset strategy, were linked in our data to increased hazardous use and CUD severity—the opposite of the intended effect. They’ll also learn that not all abstinence is equal: cannabis breaks taken for other reasons (work, finances, relationships) showed no such risk, and longer non-tolerance breaks were linked to improved outcomes, suggesting that motivation—not just duration—matters.
