A survey of 1,796 Australian medical cannabis users found 43% met criteria for any cannabis use disorder, with frequency of use and mental health being stronger predictors than prescription status.
Medical cannabis prescribers, patients using medical cannabis, addiction researchers
43% of medical cannabis users met criteria for cannabis use disorder
What the researchers found
Among 1,796 medical cannabis users, 43% met any CUD criteria and 17% met moderate-severe CUD criteria. While illicit-source users had higher raw CUD rates (53% vs 41%), after controlling for confounders, use frequency, mental health, THC content, and proportion of recreational use were more important predictors than whether cannabis was prescribed.
Why it matters
As medical cannabis prescribing expands globally, this study provides the most detailed look yet at CUD prevalence among medical users and what drives risk beyond simply having a prescription.
The numbers in context
N=1,796. 43% met any CUD criteria (>=2/11 DSM-5). 17% met moderate-severe CUD (>=4/11). Illicit users: 53% any CUD, 25% moderate-severe. Prescribed users: 41% any CUD, 15% moderate-severe.
How the study worked
Online anonymous cross-sectional survey of Australians who used medical cannabis in 2022-2023, comparing prescribed versus illicitly-sourced users on DSM-5 CUD criteria using Bayesian regression.
What this study cannot tell us
Online self-selected sample may over-represent heavier users. Anonymous survey cannot verify prescription status. Cross-sectional design limits causal claims. Australian regulatory context may not apply elsewhere.
How to read the evidence
Large survey with sophisticated Bayesian analysis, but online self-selected sample and cross-sectional design limit generalizability.
When this study was published
2025 study from a 2022-2023 Australian survey.
The bigger picture
The high CUD prevalence challenges the assumption that medical cannabis use is inherently lower-risk. A prescription alone does not protect against problematic use; it is how, how often, and why people use that matters most.
Questions still open
- Should medical cannabis prescribers screen more aggressively for CUD? Does the Australian prescribing model adequately monitor for problematic use? Can prescribing guidelines reduce CUD rates?
Common questions
Can you develop cannabis use disorder from medical cannabis?
Is prescribed medical cannabis safer than illicit?
Read the original research
Factors associated with cannabis use disorder among Australians using prescribed and illicitly-sourced medical cannabis.
Drug and alcohol dependence reports, 16, 100362
Citation
Mills, Llewellyn; Arnold, Jonathon C; Mcgregor, Iain S; Lintzeris, Nicholas. (2025). Factors associated with cannabis use disorder among Australians using prescribed and illicitly-sourced medical cannabis.. Drug and alcohol dependence reports, 16, 100362. https://doi.org/10.1016/j.dadr.2025.100362
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