Federal Centre for Health EducationBZgA drugcom.de and quit the shit Use of the internet for cannabis prevention drugcom.de and quit the shit Use of the internet for cannabis prevention Peter Lang Federal Centre for Health Education, Cologne, Germany Reitox Academy 2007, 29 March - Berlin

Federal Centre for Health EducationBZgA Basic information about the BZgA Epidemiological data on cannabis consumption Knowledge-oriented offers for cannabis prevention on drugcom.de Behaviour test in view of cannabis consumption: cannabis check Programme to reduce cannabis consumption quit the shit Concept Course Evaluation results Transfer of quit the shit Structure

Federal Centre for Health EducationBZgA Federal Centre for Health Education (BZgA) Authority within the portfolio of the Federal Ministry of Health (BMG) Providing information on health-related topics with prime priorities, such as AIDS, addiction, sex education and family planning Communication strategies: Mass-communicative media (brochures, commercials, posters, exhibitions, internet) and personal- communicative measures (hotlines, join-in-circuits, film festivals, etc.)

Federal Centre for Health EducationBZgA % Cannabis consumption: BZgA drug affinity study 2004 N = 3,000; years was offered cannabis have already tried cannabis used cannabis in the last 12 months current cannabis consumption used at least 10 times last year

Federal Centre for Health EducationBZgA Cannabis consumption: BZgA drug affinity study 2004 % Lifetime prevalence 12-months prevalence Current consumption years

Federal Centre for Health EducationBZgA Target group: Adolescents and young adults aged 15 to 25 years who use illegal and legal drugs Addiction prevention in the “leisure time” setting

Federal Centre for Health EducationBZgA Ultimate aim: Preventing substance abuse and addiction Objectives: Raising the standard of knowledge on drugs and drug use Raising awareness of the problem and promoting a responsible attitude on one‘s own consumer behaviour Promoting a low-risk use of psychoactive substances: „point soberness“, moderate consumption in tolerated situations (behaviour) Communicating skills for substance reduction or abstinence Addiction prevention by drugcom.de

Federal Centre for Health EducationBZgA Access to drugcom.de 654,739 visits in 2006  2006: 1,794 visits, 22,906 page impressions (per day) visits/day page impressions/day

Federal Centre for Health EducationBZgA Offers for cannabis consumers on drugcom.de Entries in the drug and addiction lexicon Frequently asked questions (FAQ) Latest news and a monthly special topic “Cannabis” knowledge test Behaviour test for cannabis consumers: cannabis check Programme for cannabis consumers: quit the shit Counselling service via and a chat

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BZgA Interactive offer for an early diagnosis of critical cannabis consumption: cannabis check on drugcom.de Target group: cannabis consumers Aim: self-critical reflection on personal cannabis consumption Implementation: Online questionnaire including indicators of personal cannabis consumption Differentiated, individual and automatically generated feedback Recommendation to turn to quit the shit or the online counselling service if high-risk consumption prevails

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BZgA quit the shit Target group: High-risk cannabis consumers and cannabis-addicted adolescents and young adults Aim: Reduction of cannabis consumption or abstinence within a time frame of 50 days Content and method: 50-day online diary which serves to reflect on one‘s own cannabis consumption and on all related aspects (amount, frequency, social context, motives). Every week, a professional team of counsellors gives an online feedback on this self-monitoring scheme.

Federal Centre for Health EducationBZgA quit the shit Drug abstinence Temporary drug abstinence/consumption breaks Reduction of consumption frequency / intensity Goal pyramid

Federal Centre for Health EducationBZgA Stages of behavioural change according to the transtheoretical model (Prochaska & DiClemente) Precontemplation Contemplation Preparation Action Maintenance

Federal Centre for Health EducationBZgA quit the shit: methodical concept Short intervention Concise time frame Target-oriented approach Counselling concept – Motivational interviewing Mediating an empathetic attitude Strengthening self-efficacy Promoting personal responsibility Offering alternatives based on a coping or change strategy Giving feedback on the critical reflection of the current situation Providing supportive information and recommendations

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BZgA Starting quit the shit Registration First interview on motivation Information on the terms of use (data protection) Choosing a nickname First interview on the consumption (frequency, amount, causes of consumption, age at first consumption, general mixed consumption, impairments to health, self-assessment of addiction, age, sex, education, job, housing situation) Making an appointment for a one-to-one chat 30 to 40-minute conversation in the chat in order to fix a personal target for quit the shit

Federal Centre for Health EducationBZgA quit the shit 50-day diary Keeping the 50-day diary (“50- tagebuch“) Daily entries on cannabis consumption (yes/no) Including additional information if required: time, amount and type, alone or with others, reason/cause of consumption Personal summary of the day Weekly feedback by the drugcom counsellor

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BZgA Completing participation in quit the shit Closing interview in an one-to-one chat with the following questions: How did the consumption pattern change in view of the agreed target? Which problem-solving strategies were successful? How can sustainability of the results be ensured? Does the client require further treatment? Option to continue counselling on drugcom.de Follow-up interview

Federal Centre for Health EducationBZgA Evaluation of quit the shit

Federal Centre for Health EducationBZgA Evaluation of quit the shit: method Acceptance and efficacy assessment of the quit the shit cannabis withdrawal programme Written online interviews: when logging in (t1), when completing (t2) the programme and 3 months after completion (t3) Survey period: Programme start between 1 Jan 2005 and 31 Dec 2005 Items: Acceptance: assessment of the programme information, satisfaction, recommendation… Efficacy: frequency, amount, behavioural change, addiction…

Federal Centre for Health EducationBZgA Programme start: n=429 Sex: 77.2 % male, 22.8 % female Age: M=24.2 years (SD=5.6 years) School education: 60.8 % grammar, 18.2 % upper secondary, 8.6 %, secondary, 5.8 % comprehensive, 6.5 % others Addiction according to DSM IV: 86.7 % Subjective addiction self-assessment: 92.1 % Monthly cannabis consumption: M=21.2 g (SD=19.3) Consumption units per day: Md=4 Participants of quit the shit (t1: n=429) 1 Jan –31 Dec 2005

Federal Centre for Health EducationBZgA quit the shit: Consumption days during the last 30 days (n=429) Figures are quoted in %

Federal Centre for Health EducationBZgA quit the shit: consumption frequency (n=429) Think of a typical day: How often do you use cannabis? Figures are quoted in % Consumption frequency per day 8 x and more

Federal Centre for Health EducationBZgA Evaluation of quit the shit: participation (n=429) Up to 10 daysdays

Federal Centre for Health EducationBZgA Subjective use of the diary, feedback after completing “quit the shit“ (t2: n=199) helped moderately helped a lot helped a little / did not help at all

Federal Centre for Health EducationBZgA *Konsumfrequenz (T-Test für gepaarte Stichproben): T=6,81; df=80; p<.001 **Konsummenge (T-Test für gepaarte Stichproben): T=5,00; df=80; p<.001 Monthly cannabis consumption before and 3 months after quit the shit (t3: n=81) Frequency in days* Amount in grammes** t3: 3 months after completion *Consumption frequency (T-test for paired samples): T=6.81; df=80; p<001 ** Consumption amount (T-test for paired samples): T=5.00; df=80; p<001

Federal Centre for Health EducationBZgA Co-operation project “Transfer of quit the shit“ (QTS-T)

Federal Centre for Health EducationBZgA Transfer of quit the shit Objectives: Use of quit the shit by local drug information centres in order to respond to the demand for quit the shit and enable users to turn to local drug information centres directly for personal counselling Co-operation partners: Twelve drug information centres in seven German Federal States with very high professional qualification and sufficient resources for QTS-T (5 hours/week plus training)

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BZgA Transfer of quit the shit Co-operating drug information centres Düren Freiburg Munich Leipzig Pirna Berlin Detmold Hanover Delmenhorst Dannenberg Hamburg

Federal Centre for Health EducationBZgA Thank you for your attention!