Among US adults, 23% used cannabis in the past year and 30.3% of those users met criteria for cannabis use disorder, while only 16.5% of those with CUD received substance use treatment.
People interested in cannabis use disorder prevalence, treatment gaps, and the impact of legalization.
30.3% of cannabis users met CUD criteria; 16.5% received treatment
What the researchers found
23% of US adults used cannabis in the past year. Among users, 30.3% met CUD criteria (16.9% mild, 8.4% moderate, 5.0% severe). 52.4% of those with CUD had co-occurring substance use disorders. Only 16.5% of those with CUD received treatment. Among users without other substance disorders, only severe CUD (aOR=6.03) predicted treatment use.
Why it matters
As cannabis legalization expands, understanding the prevalence of problematic use is critical. The finding that nearly a third of users meet CUD criteria yet very few receive treatment reveals a significant gap between need and service utilization.
The numbers in context
23% past-year cannabis use. 7% of all US adults had CUD (3.9% mild, 1.9% moderate, 1.2% severe). 30.3% of users had CUD. 38.4% of those with CUD had moderate/severe mental illness. 52.4% had other substance use disorders. 16.5% received treatment. Cannabis users had 3-4x higher rates of other SUDs.
How the study worked
Analysis of 2022 National Survey on Drug Use and Health (N=47,100 adults 18+). CUD severity categorized as mild, moderate, or severe per DSM-5 criteria. Logistic regression examined associations between CUD severity and treatment use, framed by Andersen behavioral model.
What this study cannot tell us
Self-report survey data subject to reporting bias. Cross-sectional design limits causal inference. NSDUH does not capture quantity, potency, or method of cannabis use. Treatment definition is broad and may include treatment for co-occurring conditions.
How to read the evidence
Nationally representative survey of 47,100 adults using validated DSM-5 criteria. Provides reliable prevalence estimates though cross-sectional design and self-report are inherent limitations.
When this study was published
Published in 2024 using 2022 NSDUH data.
The bigger picture
The treatment gap for cannabis use disorder mirrors patterns seen with alcohol. Most people with CUD do not seek or receive treatment, partly because cannabis is perceived as low-risk and partly because treatment infrastructure has not kept pace with legalization.
Questions still open
- Why do so few people with CUD receive treatment? Would expanded screening in primary care increase treatment uptake? Has CUD prevalence increased with state-level legalization?
Common questions
How common is cannabis use disorder?
Do people with cannabis use disorder get treatment?
Read the original research
Cannabis use disorder and substance use treatment among U.S. adults.
Journal of substance use and addiction treatment, 167, 209486
Citation
Choi, Namkee G; Moore, John; Choi, Bryan Y. (2024). Cannabis use disorder and substance use treatment among U.S. adults.. Journal of substance use and addiction treatment, 167, 209486. https://doi.org/10.1016/j.josat.2024.209486
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