Among 125 inpatients in addiction treatment who reported medical cannabis use, 28% of medical-only users and 51% of those also using recreationally met DSM-5 criteria for cannabis use disorder, alongside very high rates of anxiety, depression, and PTSD.
Addiction treatment providers, medical cannabis prescribers, patients using cannabis for medical purposes.
51% of dual-use medical cannabis patients in addiction treatment met CUD criteria
What the researchers found
Of 125 inpatients, 42% reported medical-only cannabis use and 58% reported dual medical and recreational use. CUD prevalence was 28% in the medical-only group and 51% in the dual-use group (p = 0.016). Psychiatric comorbidities were extremely high in both groups: anxiety 79-81%, depression 60-61%, PTSD 57-66%.
Why it matters
Medical cannabis is often framed as distinct from recreational use, but this study shows that a significant proportion of people citing medical reasons for use meet criteria for a cannabis use disorder, especially when recreational use is also involved. The extremely high psychiatric comorbidity rates highlight the complex clinical picture.
The numbers in context
125 inpatients. 42% medical-only, 58% dual-use. CUD: 28% medical-only, 51% dual-use (p = 0.016). Anxiety: 79-81%. Depression: 60-61%. PTSD: 57-66%.
How the study worked
Cross-sectional study of 125 inpatients in substance use disorder treatment who reported medical cannabis use at admission. Assessed CUD via DSM-5 criteria, anxiety (GAD-7), depression (PHQ-9), and PTSD (PCL-5).
What this study cannot tell us
Sample is from inpatient addiction treatment, so results cannot be generalized to all medical cannabis users. Small sample size. Cross-sectional design cannot determine causation. Self-reported cannabis use motives may not be reliable.
How to read the evidence
Small clinical sample from a specialized treatment setting using validated assessment tools, limiting generalizability but providing detailed clinical characterization.
When this study was published
Published 2023.
The bigger picture
This finding complicates the medical vs. recreational cannabis dichotomy. It suggests that in addiction treatment settings, medical cannabis use should be clinically assessed for CUD, especially when recreational motives are also present. The high psychiatric burden in both groups points to cannabis use as part of a broader mental health picture.
Questions still open
- How prevalent is CUD among medical cannabis users in community (non-treatment) settings?
- Does treating underlying psychiatric conditions reduce problematic cannabis use in this population?
Common questions
Can medical cannabis users develop cannabis use disorder?
What other mental health issues were present?
Read the original research
Prevalence of cannabis use disorder among individuals using medical cannabis at admission to inpatient treatment for substance use disorders.
Addictive behaviors, 142, 107667
Citation
N S Gendy, Marie; Taisir, Radia; Sousa, Sarah; Costello, Jean; Rush, Brian; Busse, Jason W; Mackillop, James. (2023). Prevalence of cannabis use disorder among individuals using medical cannabis at admission to inpatient treatment for substance use disorders.. Addictive behaviors, 142, 107667. https://doi.org/10.1016/j.addbeh.2023.107667
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