Among Young People Who Use Cannabis, the Rate of Use Disorder Does Not Increase With Age
Using DSM-5 criteria among 26,276 US youth and emerging adults, the prevalence and severity of cannabis use disorder among those who used cannabis did not differ across age groups from 12-25, challenging the assumption that older users develop worse problems.
Quick Facts
What This Study Found
While past-year cannabis use rates increased with age, the prevalence of CUD and its severity distribution (mild, moderate, severe) among those who used cannabis did not differ across age cohorts 12-13, 14-15, 16-17, 18-20, and 21-25 (effect size phi-c = 0.04). This pattern differed from less common substances like heroin and methamphetamine where SUD severity varied by age.
Key Numbers
26,276 participants aged 12-25. Cannabis CUD severity distribution did not differ by age cohort (phi-c = 0.04). Alcohol use disorder showed similar stability (phi-c = 0.04). Less common substances (heroin, methamphetamine) showed age-dependent severity patterns.
How They Did This
Cross-sectional analysis of 2022 NSDUH data from 26,276 participants aged 12-25. Estimated DSM-5 SUD prevalence and severity across five age cohorts using chi-square tests and Cramer's V effect sizes for cannabis, alcohol, and other substances.
Why This Research Matters
This finding challenges the assumption that the risk of disordered use escalates with age or duration of use during adolescence and young adulthood. For cannabis, the proportion developing problematic use is consistent from age 12 through 25, suggesting vulnerability to CUD is relatively stable across this developmental period.
The Bigger Picture
If the risk of developing CUD is the same whether someone starts using at 13 or 23, then prevention strategies should target all ages of cannabis initiation equally rather than disproportionately focusing on younger teens. This also suggests that the mechanisms driving CUD may be more about individual vulnerability than cumulative exposure during development.
What This Study Doesn't Tell Us
Cross-sectional data capture prevalence at one time point, not individual trajectories from use to disorder. DSM-5 criteria may perform differently across age groups. NSDUH sampling and self-report limitations apply.
Questions This Raises
- ?Does the stability of CUD rates across ages reflect consistent individual vulnerability or changing patterns of use at different ages?
- ?Would longitudinal data confirm that CUD development risk does not increase with earlier onset?
Trust & Context
- Key Stat:
- CUD prevalence among cannabis users did not differ from ages 12-25 (phi-c = 0.04)
- Evidence Grade:
- Strong: large nationally representative sample with DSM-5 criteria and systematic age cohort analysis, though cross-sectional design limits causal inference.
- Study Age:
- 2025 study using 2022 NSDUH data.
- Original Title:
- Estimated Prevalence of Substance Use Disorders Among US Adolescents and Emerging Adults by Substance Class, Severity, and Age, 2022.
- Published In:
- JAACAP open, 3(4), 959-971 (2025)
- Authors:
- Adams, Zachary W(2), Dellucci, Trey V, Agley, Jon(2), Bixler, Kristina, Sullivan, Maggie, Hinckley, Jesse D, Hulvershorn, Leslie A
- Database ID:
- RTHC-05866
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Does this mean younger cannabis use is not riskier?
Not exactly. The study shows that among those who use cannabis, the proportion developing disordered use is similar at all ages 12-25. However, younger teens may face other developmental risks from cannabis (brain development, academic effects) beyond just the risk of developing a use disorder.
Why is this different from heroin and methamphetamine?
For less commonly used substances, SUD prevalence and severity varied more across age groups. This may reflect that individuals who use these substances at younger ages represent a more vulnerable population, while cannabis use is common enough that users span the full range of vulnerability.
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Cite This Study
https://rethinkthc.com/research/RTHC-05866APA
Adams, Zachary W; Dellucci, Trey V; Agley, Jon; Bixler, Kristina; Sullivan, Maggie; Hinckley, Jesse D; Hulvershorn, Leslie A. (2025). Estimated Prevalence of Substance Use Disorders Among US Adolescents and Emerging Adults by Substance Class, Severity, and Age, 2022.. JAACAP open, 3(4), 959-971. https://doi.org/10.1016/j.jaacop.2025.01.002
MLA
Adams, Zachary W, et al. "Estimated Prevalence of Substance Use Disorders Among US Adolescents and Emerging Adults by Substance Class, Severity, and Age, 2022.." JAACAP open, 2025. https://doi.org/10.1016/j.jaacop.2025.01.002
RethinkTHC
RethinkTHC Research Database. "Estimated Prevalence of Substance Use Disorders Among US Ado..." RTHC-05866. Retrieved from https://rethinkthc.com/research/adams-2025-estimated-prevalence-of-substance
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.