The counselor welcomes the client and provides an overview of the session. In this session, the counselor explains that marijuana-use offers and pressures are common high-risk situations for individuals who have stopped using marijuana. The counselor and client role play marijuana refusal skills.

Discuss the Effects of Social Relationships

The counselor explains that, as a person’s marijuana use increases, his or her social relationships narrow. The individual spends less time with friends who do not use, and his or her peer group becomes mostly those who support and reinforce use. Being with such individuals increases the risk of relapse through increased

• Direct and indirect pressure to use

• Cravings associated with people, places, activities, and emotional states related to using

• Positive expectancies about the effects of using

• Access to and availability of substances.

Counselor (C): People experience two forms of social or peer pressure: direct and indirect. Direct social pressure begins with an offer of marijuana. Indirect social pressure comes with a return to the same settings, people, and activities that generate feelings associated with using. Because social pressure increases risk greatly, avoiding risky social situations is the safest behavior. However, avoiding social pressure is not always possible or practical.

Being able to refuse marijuana requires more than a decision to stop using. It requires assertiveness to act on that decision. Practicing refusing marijuana will help you respond quickly and effectively when real situations arise.

Discuss Social Pressures, Risky Situations, and Assertiveness

The counselor describes offers that may occur and with the client devises strategies for avoiding such situations. It is best to avoid situations where people are using marijuana or to leave as soon as possible. But if the client is unable to avoid certain people and situations, the next level of response is to refuse to participate in smoking marijuana. The counselor tells the client that the more quickly the person says no, the less likely he or she is to relapse. Being unsure and hesitant allows the client to begin rationalizing (e.g., One hit wouldn’t be so bad). The goal is to be ready and to say no immediately and convincingly.

An assertive response to an invitation to use depends on who offers the marijuana and how the offer is made. Sometimes a simple No, thank you is sufficient; at other times, additional strategies are necessary. Telling the person about prior using problems is useful in eliciting helpful support; at other times, it is unnecessary or even detrimental to share that information. The counselor provides guidance for marijuana refusal:

C: Nonverbal behaviors. Make direct eye contact with the person to increase the effectiveness of your message. Don’t feel guilty. You won’t hurt anyone by not using. In many situations, people won’t even know that you’re not using. You have a right not to use. Stand up for your rights!

Oral responses. Speak in a clear, firm, and unhesitating voice. Otherwise you invite questions about whether you mean what you say. “No” should be the first word out of your mouth. Suggest something else to do (e.g., go for a walk to talk, go to the movies instead of using on a Saturday night). Suggest having something to eat or a cup of coffee.

Requesting a behavior change. If a person repeatedly pressures you, ask him or her not to offer you marijuana any more. For example, if the person says, “Oh, come on, let’s get high the way we used to,” an effective response might be, “If you want to be my friend, then don’t offer me marijuana.”

Changing the subject. After saying “No,” change the subject to avoid getting drawn into a debate about using. You could say, “No, thanks, I don’t get high. You know, I’m glad I came to this party. I haven’t seen a lot of these people in a while, including you. In fact, I was wondering what you’ve been up to lately.”

Avoiding excuses. Avoid excuses (“I’m on medication for a cold right now”) and avoid vague responses (“Not tonight”). They imply that at some date you’ll accept an offer.