People of Color Are Severely Underrepresented in Cannabis Use Disorder Treatment Research

Of 14 cannabis use disorder behavioral health RCTs (1994-2025), White people comprised 64% of participants despite having a smaller share of CUD cases, overrepresented at 49 times their proportional rate. Black participants were 19%, Latino 5%, Asian 0.6%, and Indigenous 0.4%. Zero studies were culturally adapted or designed to address challenges specific to people of color. Diversity has not improved over time.

Systematic review of PubMed, PsycINFO, and ClinicalTrials.gov for US-based adult cannabis use disorder behavioral health RCTs, identifying 14 of 966 studies for review.

People of color have higher CUD prevalence and severity, face unique challenges like racial discrimination, and experience more severe legal consequences of cannabis use. Yet the treatments being developed are overwhelmingly tested on White populations with no cultural adaptation.

This is part of a broader pattern in clinical research where treatment approaches are developed for and tested on predominantly White populations, then applied to diverse communities without adaptation. For CUD specifically, this means treatments may not address the role of racial discrimination, differential policing, and cultural factors in cannabis use patterns.

Only US-based behavioral health RCTs were included. The small number of eligible studies (14) reflects the limited CUD treatment research overall. Self-identified race categories may not capture nuanced identities.