French women who used cannabis heavily were nearly 4 times more likely to be dependent than men despite using less

Among 342 heavy cannabis users, 83.2% were cannabis dependent. Women had significantly higher odds of cannabis dependence (OR 3.87, p<0.05) despite lower cannabis consumption (grams/week, OR 0.96, p<0.05). Women were 5.48 times more likely to have lifetime PTSD (p<0.001), with most PTSD related to sexual assault. Women also had significantly more depression, dysthymia, agoraphobia, social phobia, generalized anxiety disorder, and PTSD.

Clinical assessment of 342 heavy cannabis users at a French cannabis clinic between 2004-2014. 2-hour structured clinical interviews using DSM-IV criteria and the MINI psychiatric assessment. Logistic regression for gender comparisons.

The "telescoping" effect (women developing dependence faster from lower doses) has been documented for alcohol but is less studied for cannabis. This finding suggests cannabis treatment programs may need gender-specific approaches, particularly addressing trauma history in women.

The intersection of sexual trauma, PTSD, and accelerated cannabis dependence in women suggests that addressing trauma may be essential for treating cannabis dependence in women, rather than focusing solely on substance use.

Treatment-seeking sample at a cannabis clinic; may not represent all heavy cannabis users. French cultural context. DSM-IV criteria (older diagnostic framework). 2004-2014 data; cannabis potency and use patterns have changed. Gender comparison based on binary categories.