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A Swedish Registry Study of 3.3 Million People Found Four Distinct Profiles Among Those With Cannabis Use Disorder

Registry StudyStrong evidence
The takeaway

In a population of over 3.3 million Swedes, cannabis use disorder diagnoses increased across younger birth cohorts, and 80% of people with CUD also had another psychiatric diagnosis, with cluster analysis revealing distinct gender-linked subgroups.

Addiction researchers, public health officials, clinicians treating cannabis use disorder.

80% of people with cannabis use disorder also had another psychiatric diagnosis

What the researchers found

Of 3,307,759 individuals born 1970-2000, 14,046 (0.42%) received a CUD diagnosis. CUD rates rose from 61 per 100,000 (born 1990-1994) to 107 per 100,000 (born 1995-2000) by 2016. Four clusters emerged: Cluster 1 was mainly men with low income and substance use disorders; Clusters 2, 3, and 4 were mainly women with higher rates of mood, stress-related, and behavioral disorders.

Why it matters

The finding that 80% of people with CUD also had another psychiatric diagnosis (vs. 19% without CUD) underscores the need for integrated mental health and substance use treatment. The distinct gender profiles suggest men and women with CUD may need different clinical approaches.

The numbers in context

N=3,307,759 total. 14,046 CUD diagnoses (0.42%). CUD rates: 61/100,000 (born 1990-1994) to 107/100,000 (born 1995-2000). 80% psychiatric comorbidity in CUD vs. 19% without.

How the study worked

Population-based registry study using Swedish national register data on 3,307,759 individuals born 1970-2000, with records extending to 2016. K-mode cluster analysis identified subgroups.

What this study cannot tell us

Registry data capture diagnosed CUD only, likely underestimating total problematic use. Swedish population may not generalize to other countries with different cannabis policies. Cannot determine causal direction between CUD and psychiatric comorbidity.

How to read the evidence

Large population-based registry study covering over 3.3 million individuals with national-level data.

When this study was published

Published in 2023 using Swedish registry data through 2016.

The bigger picture

Rising CUD diagnoses among younger generations in a country with relatively restrictive cannabis policies raise questions about what is driving the trend. The strong link between CUD and other psychiatric conditions suggests that cannabis problems rarely exist in isolation.

Questions still open

  • What is driving the increase in CUD diagnoses among younger cohorts in Sweden?
  • Would gender-specific treatment approaches improve CUD outcomes?

Common questions

How common is cannabis use disorder in Sweden?
About 0.42% of the 3.3 million people in this study received a CUD diagnosis, with rates increasing across younger birth cohorts.
Do men and women with CUD differ?
Yes. Men with CUD tended to have lower income and substance use disorders, while women with CUD had higher rates of mood, stress-related, and behavioral disorders.

Read the original research

Cannabis use disorder in relation to socioeconomic factors and psychiatric comorbidity: A cluster analysis of three million individuals born in 1970-2000.

Scandinavian journal of public health, 51(1), 82-89

Citation

Rabiee, Rynaz; Lundin, Andreas; Agardh, Emilie; Allebeck, Peter; Danielsson, Anna-Karin. (2023). Cannabis use disorder in relation to socioeconomic factors and psychiatric comorbidity: A cluster analysis of three million individuals born in 1970-2000.. Scandinavian journal of public health, 51(1), 82-89. https://doi.org/10.1177/14034948221122431

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