One in Three Australians Using Cannabis Medically Met Criteria for Cannabis Use Disorder

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.

Mills, Llewellyn et al.·Drug and alcohol review·2022·Moderate EvidenceCross-Sectional
RTHC-04065Cross SectionalModerate Evidence2022RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
N=905

What This Study 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).

Key Numbers

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 They Did This

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.

Why This Research 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 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.

What This Study Doesn't 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.

Questions This Raises

  • ?Would CUD rates be lower among users of regulated medical cannabis products with controlled dosing?
  • ?Should medical cannabis programs include routine CUD screening?

Trust & Context

Key Stat:
32% met CUD criteria; inhaled use OR 2.96
Evidence Grade:
Large cross-sectional survey with validated CUD assessment, but self-selected sample and predominantly illicit cannabis use.
Study Age:
Published in 2022
Original Title:
Prevalence and correlates of cannabis use disorder among Australians using cannabis products to treat a medical condition.
Published In:
Drug and alcohol review, 41(5), 1095-1108 (2022)
Database ID:
RTHC-04065

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

Can medical cannabis users develop cannabis use disorder?

Yes. This study found 32% of medical cannabis users met criteria for any CUD and 12.9% for moderate-severe CUD, comparable to rates seen in recreational users.

What increases CUD risk in medical cannabis users?

Inhaling cannabis (vs other routes) nearly tripled CUD risk. More frequent use, younger age, tobacco use, and using cannabis for mental health rather than pain were also risk factors.

Read More on RethinkTHC

Cite This Study

RTHC-04065·https://rethinkthc.com/research/RTHC-04065

APA

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

MLA

Mills, Llewellyn, et al. "Prevalence and correlates of cannabis use disorder among Australians using cannabis products to treat a medical condition.." Drug and alcohol review, 2022. https://doi.org/10.1111/dar.13444

RethinkTHC

RethinkTHC Research Database. "Prevalence and correlates of cannabis use disorder among Aus..." RTHC-04065. Retrieved from https://rethinkthc.com/research/mills-2022-prevalence-and-correlates-of

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.