The Largest Study of Cannabis Addiction in America
Prevalence of marijuana use disorders in the United States between 2001-2002 and 2012-2013
Bottom Line
From 2001-2002 to 2012-2013, past-year cannabis use in U.S. adults more than doubled, and the share of the total population meeting DSM-IV criteria for a cannabis use disorder nearly doubled, even as the proportion of users with a disorder fell modestly.
Why It Matters
As laws and social acceptance shifted in the 2000s and early 2010s, this study provided a clear national snapshot of two linked trends: many more adults reporting cannabis use, and a larger number of adults meeting criteria for a use disorder. It also showed that the likelihood of disorder among users went down, pointing to population expansion as the main driver of the higher disorder count.
The Backstory
Is cannabis addictive? Ask a cannabis advocate and you'll hear "less addictive than caffeine." Ask an addiction psychiatrist and you'll hear "more common than people think." Ask Deborah Hasin — the Columbia University epidemiologist who literally wrote the DSM-5 criteria for substance use disorders — and you'll get the numbers. Not opinions. Not ideology. Numbers drawn from face-to-face interviews with nearly 80,000 Americans across a decade.
Those numbers tell a story more complicated than either side of the debate wants to hear.
The Largest Substance Use Survey in America
NESARC — the National Epidemiologic Survey on Alcohol and Related Conditions — is the gold standard for understanding substance use in the United States. It is not an online poll. It is not a convenience sample of college students. It is a massive, nationally representative, face-to-face household survey conducted by trained interviewers using validated diagnostic instruments.
Hasin's study compared two waves:
- NESARC (2001-2002): 43,093 adults
- NESARC-III (2012-2013): 36,309 adults
Between those two surveys, the American cannabis landscape transformed. Medical marijuana laws expanded from 8 states to 20. Public approval of legalization shifted from minority to majority. Colorado and Washington voted to legalize recreational use. And the data showed it.
The Three Numbers That Matter
9.5%
of US adults reported using cannabis in the past year by 2012-2013 — more than double the 4.1% rate from 2001-2002. This wasn't a marginal increase. America went from roughly 1 in 25 adults using cannabis to nearly 1 in 10.
The increase was not confined to any single group. It was statistically significant across sex, age, race/ethnicity, education, marital status, income, urban/rural residence, and region. Cannabis use expanded everywhere, among everyone.
Hasin et al. (2015), JAMA Psychiatry
2.9%
of all US adults met DSM-IV criteria for cannabis use disorder in 2012-2013 — nearly double the 1.5% rate from a decade earlier. That translates to roughly 6.8 million Americans with a diagnosable cannabis use disorder.
For comparison, past-year alcohol use disorder affects approximately 13.9% of the population (NESARC-III), and past-year opioid use disorder affects roughly 0.8%. Cannabis use disorder sits between — far less common than alcohol problems, far more common than opioid addiction.
Hasin et al. (2015), JAMA Psychiatry
30.6%
of past-year cannabis users met criteria for a use disorder in 2012-2013 — roughly 1 in 3 users. This was actually a decrease from 35.6% in 2001-2002.
This is the number that both sides of the debate get wrong. The rate among users went DOWN even as the total number of people with disorders went UP. The increase in total disorders was driven entirely by more people using cannabis, not by cannabis becoming more dangerous per user. New, more casual users were entering the population and diluting the disorder rate — but the sheer number of additional users meant more total cases.
Hasin et al. (2015), JAMA Psychiatry
The Nuance Everyone Misses
How Addictive Is Cannabis, Really?
Hasin's data fits into a larger comparative framework. The best reference point remains Anthony et al. (1994), which used the earlier National Comorbidity Survey to estimate lifetime dependence risk among people who had ever tried each substance:
The Controversy: Are the Numbers Real?
Shortly after publication, Richard Grucza and colleagues raised a pointed methodological question in a JAMA Psychiatry commentary: were the increases real, or were people simply more willing to admit cannabis use in 2012-2013 due to changing social norms?
The concern was legitimate. The two NESARC waves used different interviewing organizations — Wave 1 used US Census Bureau employees, Wave 3 used a private contractor. It is plausible that people would be more forthcoming about illegal drug use with a private interviewer than with a government employee.
The Woman Behind the Numbers
Deborah Hasin earned her PhD in epidemiology from Columbia in 1986 and never left. Over four decades, she has published more than 550 papers on substance use epidemiology. She directed the NIDA-funded Substance Abuse Epidemiology Training Program at Columbia — training the next generation of researchers who would study the very trends her data revealed.
Her authority on this topic is not just academic. Hasin was the text editor for the Substance Use Disorder sections of DSM-5-TR — meaning she literally wrote the diagnostic criteria that define cannabis use disorder. She served as President of the College on Problems of Drug Dependence (CPDD) in 2023-2024, the oldest and largest organization dedicated to substance use research.
When Hasin publishes cannabis epidemiology data, she is not an outside observer. She is the person who defined the measurements, validated the instruments, and trained the researchers. This gives her work unusual authority — and unusual responsibility to get it right.
What This Means for You
The practical implication of Hasin's data is straightforward: if you use cannabis, there is a meaningful probability — roughly 1 in 3 among current users — that your use pattern meets the clinical criteria for a use disorder. This does not mean you are "addicted" in the way most people imagine addiction. DSM-IV cannabis use disorder includes a spectrum from mild (2-3 criteria) to severe (6+ criteria). Many people with diagnosable CUD would not recognize themselves as having a problem.
But the criteria exist for a reason. They capture patterns — using more than intended, failed attempts to cut back, continued use despite problems, tolerance, withdrawal — that predict real-world impairment. If you're unsure where you fall, our CUD self-assessment guide walks through the DSM-5 criteria, and our guide to whether weed is addictive provides the full scientific context.
Frequently Asked Questions
Cite this study
Hasin, Deborah S.; Saha, Tulshi D.; Kerridge, Bradley T.; Goldstein, Rishe B.; Chou, S. Patricia; Zhang, Haitao; et al.. (2015). Prevalence of marijuana use disorders in the United States between 2001-2002 and 2012-2013. JAMA Psychiatry, 72(12), 1235-1242. https://doi.org/10.1001/jamapsychiatry.2015.1858