Among 905 Australians using cannabis for medical reasons, 32% met criteria for any cannabis use disorder and 12.9% for moderate-to-severe CUD, with inhaled use, frequent use, and mental health indications as key risk factors.
Medical cannabis patients, prescribing physicians, addiction medicine providers
32% met CUD criteria; inhaled use OR 2.96
What the researchers found
CUD criteria were met by 32% (any-CUD) and 12.9% (moderate-severe CUD) of medical cannabis users. The strongest CUD correlates were inhaled route (OR=2.96), higher frequency of use (OR=1.24 per unit increase), tobacco use (OR=1.10), younger age (OR=0.75), and using cannabis for mental health rather than pain (OR=0.58 for pain as protective).
Why it matters
As medical cannabis access expands, understanding that one-third of medical users may meet CUD criteria challenges the assumption that medical use is inherently lower-risk than recreational use.
The numbers in context
905 participants; 98% used illicit cannabis; 32% any-CUD; 12.9% moderate-severe CUD; tolerance 21%; withdrawal 35%; inhaled route OR=2.96; pain protective OR=0.58
How the study worked
Cross-sectional anonymous online survey (2018-2019) of 905 Australians reporting medical cannabis use in the past year. 98% used illicit products. CUD assessed by DSM-5 criteria. Bayesian Horseshoe logistic regression for correlates.
What this study cannot tell us
Cross-sectional survey with self-selected participants. 98% used illicit products, which may differ from regulated medical cannabis. Cannot determine if CUD preceded or followed medical use.
How to read the evidence
Large cross-sectional survey with validated CUD assessment, but self-selected sample and predominantly illicit cannabis use.
When this study was published
Published in 2022
The bigger picture
CUD prevalence in medical users was comparable to recreational users in other studies. This suggests the medical context itself does not protect against developing problematic use patterns.
Questions still open
- Would CUD rates be lower among users of regulated medical cannabis products with controlled dosing? Should medical cannabis programs include routine CUD screening?
Common questions
Can medical cannabis users develop cannabis use disorder?
What increases CUD risk in medical cannabis users?
Read the original research
Prevalence and correlates of cannabis use disorder among Australians using cannabis products to treat a medical condition.
Drug and alcohol review, 41(5), 1095-1108
Citation
Mills, Llewellyn; Lintzeris, Nicholas; O'Malley, Michael; Arnold, Jonathon C; McGregor, Iain S. (2022). Prevalence and correlates of cannabis use disorder among Australians using cannabis products to treat a medical condition.. Drug and alcohol review, 41(5), 1095-1108. https://doi.org/10.1111/dar.13444
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