Introduction
Marijuana dependence is a significant issue among the youth, negatively affecting their physical and mental health. In some cases, people use cannabis to avoid sleep issues and anxiety, but the long-term effects of marijuana are much more destructive. In addition, this method does not solve the issue but instead brings more harm and leads to addiction. It is essential to adequately address the issue to not only reduce the level of marijuana use but also to solve related health issues and concerns. Motivational interviewing can help cope with the issue of marijuana use to solve anxiety and sleep issues, especially by establishing communication about concerns among youth.
Description of Motivational Interviewing
Motivational Interviewing (MI) is a therapeutic approach that focuses on helping patients find motivation to move toward changes in their behaviors, thoughts, and emotions. It is particularly effective as a treatment for people who have become dependent on marijuana. There are many potential benefits of using MI in treating patients with constant use of marijuana. According to Teresa et al. (2023), MI helps to create a sense of autonomy and encourages an environment of self-exploration for the individual. This can be beneficial for helping them to overcome the discomfort they may feel about quitting their marijuana use.
MI is based on the idea that individuals are more likely to make healthy changes if they are allowed to make choices and explore their own motivations, values, and beliefs. That is especially true when it comes to making changes related to drug or alcohol use (Teresa et al., 2023). When an individual feels like their autonomy is respected and they are in control of their decisions, they are more likely to consider the benefits of quitting drug or alcohol use.
Motivational interviewing is also very helpful for identifying the individual’s underlying reasons for using marijuana in the first place (Teresa et al., 2023). By allowing them to discuss their own personal experiences and motivations in a non-judgmental environment, MI helps to better understand the individual’s motivations and beliefs regarding marijuana use. Once the individual has an understanding of their own motivations, it can be easier for them to explore alternative strategies for reducing their marijuana use.
Moreover, MI creates an atmosphere of collaboration and mutual respect between the patient and the healthcare provider. This can help to build a strong relationship, which is particularly important in addressing the underlying issues surrounding cannabis use. Finally, MI is patient-centered, meaning it focuses on providing tangible, achievable goals tailored to the individual (Teresa et al., 2023). This is especially important for people who have become accustomed to a lifestyle of marijuana use, as it helps to create a tailored plan for overcoming their reliance on the substance.
Therefore, at the beginning of the interview, the patients ‘ trans-theoretical behavior level was in the pre-contemplation stage. The patient showed no awareness or intention to change their behavior, as they did not see it as a problem. By the end of the interview, the patient had progressed to the preparation stage. The patient began planning to make the necessary behavior change and was committed to following through with the plan.
Case Description
The use of cannabis can help to solve the issue of sleep disturbances and anxiety, but only if consulted with a specialist. In the presented case, the 24-year-old person uses marijuana to solve mental issues due to hard work with his dad on the farm. The person takes marijuana with his friends, so the dose of it is uncontrolled. In addition, the person is reported to have long-term anxiety issues, which can be enhanced by constant marijuana use.
It is reported that cannabis can help overcome different health issues (Shannon et al., 2019). However, this research was conducted by healthcare workers, so the patients’ histories, social backgrounds, and health issues were taken into account. In addition, it was stated that 78% of patients, due to controlled use of cannabis, reported improved sleep (Shannon et al., 2019).
However, the constant and uncontrolled use of marijuana can lead to addiction, which can harm the person’s health outcomes. Moreover, uncontrolled use of marijuana negatively influences the social, educational, and emotional background of the person and harms work performance (Shannon et al., 2019). Therefore, the use of marijuana by a person can lead to adverse health consequences and cause addiction.
Application of Motivational Interviewing to the Case
Motivational Interviewing can help solve the issue, as it provides an opportunity for direct communication and shows the consequences of the constant use of marijuana. Firstly, it is reported that Motivational Interviewing can help to establish a dialogue between healthcare providers and people addicted to marijuana use (Andersen & Pors, 2019). The person is observed to work hard with his father and has long-term anxiety issues. It is possible to state that the person needed medical help and support to solve the issue, but instead chose marijuana to relax.
Secondly, Motivational Interviewing is regarded as a supportive approach to help citizens engage in a direct and informative dialogue to address their concerns (Andersen & Pors, 2019). In this case, the method can provide the person with alternative ways to address health issues, such as meditation and medical support. The person is 24 years old, so his organism is young, and the adverse effects of marijuana use can be destructive for him. That is why it is essential to implement direct, supportive communication to resolve the issue.
Interview
- Interviewer: Kelly M.
- Interviewee: Kelly D.
Kelly M: Hello, I am Kelly, the provider here. Thank you for meeting with me today. Moreover, I would like to review a few things since our last visit. I wanted to see how you have been doing with your anxiety and sleep issues since we last spoke. (open-ended question)
Kelly D.: Well, basically, the other day at work, I had an anxiety attack, and on my break, I smoked a blunt; I am pretty concerned I’ll get in trouble, but I do not know what else to do. I was so anxious that I did not think I could go back inside. And then that night, I slept maybe three hours, and it’s like I cannot even sleep if I do not smoke, so I am not doing too great in that aspect.
Kelly M.: Did you try any relaxation techniques we discussed, like breathing exercises or getting your headspace in a different area? Did you try anything else that we discussed?
Kelly D.: I took a deep breath, and then I started seeing spots and thought I would pass out, so I just decided to go and smoke. So, no, I just tried deep breathing once. I should probably try harder.
Kelly M.: How do you feel your anxiety affects your daily life?
Kelly D.: It is debilitating. Imagine going to work and already being on edge. I have 2 cups of coffee in the morning, which increases my heart rate; clients are being rude to me, and I cannot take it. Then, on top of my already anxious state, I need something to look forward to at the end of the day that will help calm me. Moreover, honestly, smoking is the best way, and I do not see a problem with it.
Kelly M.: Are you still working on your dad’s farm?
Kelly D.: Yeah, now and then I am. My dad and I have no significant relationship because of my smoking, so I have been trying to do some side jobs. However, when he smells the weed on me, he yells at me, which worsens my anxiety.
Kelly M.: Have you tried anything else that you have found that helps with anxiety or sleep?
Kelly D.: The other day, one of my friends asked me to go on a walk, and it was a pretty long walk. That night, I felt pretty good, slept better than usual, and didn’t smoke.
Kelly M.: Well, your intention was good, even though it did not entirely turn out how you would like, but it sounds like that is a start. So I hear you saying that marijuana is the best thing that helps you. However, I am also hearing that you had a long walk, and that seemed helpful because you did not smoke at all that night and slept better. Do I hear that right?
Kelly D.: Yeah, if it were not for the marijuana every day, I probably would never sleep and probably be a horrible person to work with. Except I smoke, and then my dad gets mad at me. I guess I am just in a tough spot. I did like that walk. I’m not sure if that would help as much, however. Do you think exercise would work?
Kelly M.: It is a good possibility. Would you like to hear what the experts say about marijuana use for sleep and anxiety?
Kelly D.: I do, yeah, because, to me, it feels perfect.
Kelly M.: Okay, I want to read something to you quickly. This is from the CDC website. The Centers for Disease Control and Prevention. This is based solely on research findings. “Marijuana use, especially frequently, daily, and in high doses, can cause disorientation, and sometimes unpleasant thoughts and feelings of anxiety and paranoia. People who use marijuana are more likely to develop temporary psychosis, meaning they do not know what is real; they can hallucinate, be paranoid, and have prolonged-lasting mental disorders, including schizophrenia, a mental illness where people might see or hear things that are not there. The association between marijuana and schizophrenia is stronger in people who start using marijuana at an early age and use marijuana more frequently. So, do you have any questions about what that says?
Kelly D.: I did not realize that smoking could affect my anxiety. I thought it was helping it. It is a catch-22 because I thought it was helping, but it could actually worsen it. Moreover, I do not want to have psychosis or schizophrenia. That is scary; I do not want to go through that.
Kelly M.: I am not trying to scare you; I want you to know all the information. How can we set a goal for you to try to reduce your use, perhaps start reducing your use, to stop by our next meeting?
Kelly D.: I like the idea of lessening it first; that makes me less anxious to have a smaller goal. I could smoke only twice a week and take daily 30-minute walks. And then, further down the road, I can do more. I suggest finding better coping mechanisms. That would be an excellent place to start. Do you?
Kelly M.: YES. I think that is a great goal to start with. We can always tweak it down the road. In summary, I want to say that work gives you a significant quantity of anxiety, and marijuana makes you feel like it helps, especially with sleep. However, you have also found that walking helps, and you didn’t have to smoke that night; you slept even better. We will set a goal to reduce our smoking frequency from daily to twice a week and to incorporate daily exercise of approximately 30 minutes. Does that sound right?
Kelly D.: Yeah, when you put it like that, it seems like it will be a better option for me than smoking every day.
Kelly M.: Where are you on a scale from 0-10, 10 being ready and motivated to stop smoking altogether, and zero not ready?
Kelly D.: Considering it might worsen my anxiety, I am probably an 8.
Kelly M.: Hopefully, we can work on this goal and get you from that 8 to the 10. It would be good for you. Let us get together in 3 weeks and see where you are, and then we will go from there. Does that sound like a good plan to you?
Kelly D.: Yes, that sounds like a good plan.
Kelly M.: Okay, we will see you back in 3 weeks.
Reflection
Kelly D. did an excellent job putting herself in the shoes of a 24-year-old who smokes marijuana daily due to anxiety and insomnia. We had spoken a little beforehand and were having difficulty figuring out how to do this and respond, but it turned out well. Once we started the interview, it became more natural and flowed smoothly. I did struggle quite a few times with how to put into words what I wanted to ask in the proper MI technique. I also needed help determining where to go with the conversation to gauge her response. I knew where I wanted the conversation to go, but I needed to figure out how to get us there.
Throughout the interview, I felt I was able to help the patient understand the importance of lessening the amount she was smoking and understand that it could very well be making her worse. I am unsure whether I have ever used MI before; I am sure I have, but I am just unaware of it. I have much to work on and still have several things to learn. However, I believe I can reach a good point with more practice. I felt confident at the end of the interview that the patient had put forth some thought and was genuinely concerned that her marijuana use could be making her anxiety worse. The patient was willing to begin making changes toward stopping her marijuana use.
Conclusion
To conclude, marijuana is a significant issue in modern society. People use marijuana to relax and solve mental health issues like anxiety and sleep disorders. However, people are unaware of the long-term consequences of constant and uncontrolled marijuana use on the body. The person struggles with anxiety and sleep issues in the presented case due to harsh working conditions. It is essential to implement Motivational Interviewing to provide the person with alternative methods of solving the issue and demonstrate its negative consequences.
References
Andersen, N. Å., & Pors, J. G. (2019). When no is not an option: The immunization against silence in a motivational interview about marijuana use. Social Theory & Health, 17, 443-462.
Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in anxiety and sleep: a large case series. The Permanente Journal, 23(18), 041.
Teresa, M., Clara Oliveras Salvà, Rodrigo, P., & López-Pelayo, H. (2023). Motivational interviewing for cannabis use disorders: A narrative review from research to practice. Cannabis Use, Neurobiology, Psychology, and Treatment, 567–580.