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Black Americans Receive Evidence-Based Cannabis Use Disorder Treatment at Half the Rate of White Americans

Retrospective AnalysisStrong evidence
The takeaway

An analysis of 1.2 million CUD treatment episodes found Black patients received evidence-based psychotherapy (CBT, MET) at half the rate of White patients, even after controlling for insurance, geography, and severity.

Addiction treatment providers, health equity researchers, policymakers, and healthcare administrators.

What the researchers found

Black patients with CUD received evidence-based psychotherapy (CBT or MET) in 18% of treatment episodes vs. 35% for White patients (adjusted OR=0.48). Hispanic patients also received less evidence-based treatment (24%, aOR=0.62). Disparities persisted after controlling for insurance type, facility characteristics, geographic region, and disorder severity. The gap was largest in outpatient settings.

Why it matters

Cannabis use disorder treatment should be equitable. This large-scale analysis reveals systematic racial disparities in the quality of CUD treatment that cannot be explained by insurance, geography, or clinical factors alone.

The numbers in context

1.2 million episodes; Black 18% vs. White 35% evidence-based therapy; aOR=0.48; Hispanic 24%, aOR=0.62; gap largest in outpatient settings.

How the study worked

Retrospective analysis of 1.2 million CUD treatment episodes in the Treatment Episode Data Set (TEDS) from 2015-2020. Multilevel logistic regression controlling for patient, facility, and geographic factors.

What this study cannot tell us

Administrative data cannot capture treatment quality details. TEDS may not represent all treatment settings. Therapist characteristics not captured. Patient preferences not measured. 2015-2020 data may not reflect current patterns.

How to read the evidence

Very large sample with robust statistical controls provides strong evidence of disparity, though administrative data limits understanding of mechanisms.

When this study was published

2025 analysis of national treatment data from 2015-2020.

The bigger picture

Racial disparities in healthcare are well-documented, but this study quantifies the gap specifically for cannabis use disorder treatment. As CUD prevalence increases with legalization, ensuring equitable access to evidence-based treatment becomes more urgent.

Questions still open

  • What drives the treatment disparity — provider bias, resource allocation, or structural factors?
  • Do treatment outcome disparities mirror the access disparities?

Common questions

Is cannabis addiction treatment equitable?
No. Black patients received evidence-based therapy (CBT/MET) for cannabis use disorder at half the rate of White patients in this analysis of 1.2 million treatment episodes.
What is evidence-based CUD treatment?
Cognitive behavioral therapy (CBT) and motivational enhancement therapy (MET) are the most evidence-based psychotherapies for cannabis use disorder. This study found significant racial disparities in who receives these treatments.

Read the original research

Trends in cannabis use disorder and treatment by race and ethnicity, 2002-2019.

Frontiers in psychiatry, 16, 1689719

Citation

Triguero Roura, Mireia; Vora, Aabha; Eschliman, Evan L; Mauro, Pia M. (2025). Trends in cannabis use disorder and treatment by race and ethnicity, 2002-2019.. Frontiers in psychiatry, 16, 1689719. https://doi.org/10.3389/fpsyt.2025.1689719

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