Among Young People Who Use Cannabis, the Rate of Use Disorder Does Not Increase With Age

What the researchers 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.

Why it 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 numbers in context

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 the study worked

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.

What this study cannot 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.

How to read the evidence

Strong: large nationally representative sample with DSM-5 criteria and systematic age cohort analysis, though cross-sectional design limits causal inference.

When this study was published

2025 study using 2022 NSDUH data.

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.

Questions still open

• 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?

Common questions

Read the original research

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

Citation

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

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