A landmark national survey of 36,309 adults found that 2.5% had a past-year cannabis use disorder and 6.3% had a lifetime diagnosis, with young men, Native Americans, and low-income individuals at highest risk, and only 13% ever receiving treatment.
Read this if you want to understand how common cannabis use disorder is in the US and who is most affected.
Only 13.2% of people with cannabis use disorder ever received treatment
What the researchers found
This study provided the first nationally representative prevalence data for cannabis use disorder using the updated DSM-5 criteria. Among 36,309 US adults interviewed in 2012-2013, 2.5% met criteria for a past-year cannabis use disorder and 6.3% for a lifetime diagnosis.
Those with cannabis use disorder used marijuana frequently, averaging 225 days per year for past-year cases. The disorder was strongly associated with other substance use disorders, mood disorders, anxiety, and personality disorders, with these associations strengthening as severity increased.
Perhaps the most striking finding was the treatment gap: only 13.2% of those with a lifetime cannabis use disorder ever participated in treatment or 12-step programs.
Why it matters
This was the first major study to establish DSM-5 cannabis use disorder prevalence in the US population. The high comorbidity rates, association with disability, and massive treatment gap paint a picture of a condition that affects millions but is largely unaddressed by the healthcare system.
The numbers in context
12-month prevalence: 2.5%. Lifetime prevalence: 6.3%. Mean use: 225 days/year (12-month cases), 274 days/year (lifetime cases). Young adults 18-24 had 7.2x higher odds than those 45+. Only 13.2% with lifetime diagnosis ever received treatment. 36,309 participants.
How the study worked
Data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III), a nationally representative face-to-face survey of 36,309 adults 18+ conducted in 2012-2013. Psychiatric disorders were assessed using structured clinical interviews (AUDADIS-5). DSM-5 criteria were applied.
What this study cannot tell us
Cross-sectional data cannot determine whether cannabis use disorder causes psychiatric comorbidities or vice versa. Data were collected in 2012-2013, before many state legalization initiatives. Self-reported data may undercount cannabis use disorders.
How to read the evidence
Large nationally representative sample with structured clinical interviews using DSM-5 criteria. One of the strongest epidemiological studies of cannabis use disorder available.
When this study was published
Published in 2016 using 2012-2013 data, before most state-level legalization. Prevalence may have changed.
The bigger picture
This study established baseline prevalence data just as cannabis legalization was accelerating across the US. The combination of high prevalence, significant comorbidity, functional disability, and extremely low treatment rates suggests a growing public health challenge, particularly among young adults.
Questions still open
- Has cannabis use disorder prevalence increased since legalization? Why is the treatment rate so low, and what barriers prevent people from seeking help? Would increased public awareness of cannabis use disorder improve treatment rates?
Common questions
How common is cannabis use disorder?
Who is most at risk?
Read the original research
Prevalence and Correlates of DSM-5 Cannabis Use Disorder, 2012-2013: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions-III.
The American journal of psychiatry, 173(6), 588-99
Citation
Hasin, Deborah S; Kerridge, Bradley T; Saha, Tulshi D; Huang, Boji; Pickering, Roger; Smith, Sharon M; Jung, Jeesun; Zhang, Haitao; Grant, Bridget F. (2016). Prevalence and Correlates of DSM-5 Cannabis Use Disorder, 2012-2013: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions-III.. The American journal of psychiatry, 173(6), 588-99. https://doi.org/10.1176/appi.ajp.2015.15070907
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