16-Year Trends Show Fewer People with Cannabis Use Disorder Are Getting Treatment | Research

The takeaway

CUD treatment rates declined over 16 years, with increasing numbers of people saying they did not know where to access treatment or could not afford it.

Addiction medicine specialists, public health policymakers, substance use counselors, individuals questioning their cannabis use

What the researchers found

Across three national survey time points (2003, 2011, 2019), CUD treatment utilization decreased while most individuals meeting diagnostic criteria did not receive treatment. Barriers shifted over time: people increasingly reported not knowing where to access treatment, not being ready to stop, inability to afford treatment, and concerns about stigma or occupational impact. Consistent predictors of receiving treatment included having past-year mental health treatment and being under community supervision (probation/parole).

Why it matters

As cannabis potency increases and recreational use expands, fewer people with diagnosable CUD are accessing treatment. The shifting barriers suggest systemic issues with treatment accessibility and awareness rather than individual unwillingness.

The numbers in context

Three time points: 2003, 2011, 2019; CUD treatment utilization decreased over time; barriers: not knowing where to access treatment, inability to afford, stigma concerns; prior arrest associated with 2-3x higher odds of treatment in later years

How the study worked

Analysis of three cross-sectional waves from the National Survey on Drug Use and Health (2003, 2011, 2019). Included individuals meeting diagnostic criteria for CUD. Multivariate logistic regression examined predictors of receiving treatment and self-reported reasons for not receiving treatment.

What this study cannot tell us

Cross-sectional survey design at each time point. Self-reported CUD diagnosis may differ from clinical assessment. NSDUH methodology changes across years may affect comparability. "Treatment" broadly defined and may include brief interventions or mandated programs.

How to read the evidence

Moderate: national survey data across three time points with regression analysis, but cross-sectional design at each wave.

When this study was published

2025 publication analyzing 2003, 2011, and 2019 data

The bigger picture

The declining treatment rate for CUD stands in contrast to the increasing availability and potency of cannabis products. If most people with CUD do not receive treatment and barriers are growing, the public health implications of cannabis liberalization may be underappreciated.

Questions still open

Has the normalization of cannabis use reduced treatment-seeking even among those experiencing problems?
Would lower-barrier treatment options (telehealth, apps) reach the growing pool of untreated CUD?

Read the original research

An Analysis of 16-Year Trends in Cannabis Use Disorder Treatment: Predictors, Barriers, and Utilization Patterns.

Substance use & misuse, 60(10), 1540-1549

View on PubMed ↗Publisher’s paper ↗

Citation

Graves, Brian D; Mowbray, Orion; Aletraris, Lydia; O'Shields, Jay. (2025). An Analysis of 16-Year Trends in Cannabis Use Disorder Treatment: Predictors, Barriers, and Utilization Patterns.. Substance use & misuse, 60(10), 1540-1549. https://doi.org/10.1080/10826084.2025.2505773