Cannabis Use Disorder Cases in U.S. Mental Health Treatment Nearly Doubled From 2013 to 2018 | Research

The takeaway

Analysis of nearly 4 million cases over 10 years showed cannabis use disorder diagnoses in U.S. mental health facilities rose dramatically, with depression as the most common co-occurring condition (30%) and 60% of CUD patients being male.

Mental health clinicians, addiction treatment planners, health system administrators, and epidemiologists.

What the researchers found

Of 3.95 million cases with alcohol or cannabis use disorder in mental health treatment, 1.63 million had CUD. Cannabis use disorder peaked in 2018 (199,744 cases). Depression was the most common co-occurring diagnosis (30.3% of CUD cases). 60% of CUD patients were male.

Why it matters

Cannabis use disorder is often encountered in mental health settings rather than addiction treatment settings. Understanding the characteristics of CUD patients in mental health care helps clinicians prepare to screen for and address cannabis problems alongside depression and other conditions.

The numbers in context

Total analytic sample: 3,947,802 cases (6.4% of full dataset). CUD: 1,632,116 cases. AUD: 2,315,686. CUD peak year: 2018 (199,744). CUD: 60% male. Depression co-occurred in 30.3% of CUD. AUD co-occurring depression: 35.5%. AUD peak year: 2020 (278,550).

How the study worked

Descriptive epidemiological analysis of Mental Health Client-Level Data, a nationwide U.S. dataset, from 2013 to 2022. Annual cross-sectional data merged across 10 years. Separate examination of alcohol use disorder (n=2,315,686) and cannabis use disorder (n=1,632,116) samples.

What this study cannot tell us

Administrative data — depends on coding accuracy. Cross-sectional annual snapshots don't track individuals over time. Cannot determine if CUD caused depression or vice versa. Only captures people who reached treatment; many with CUD never seek help. Facility-level data may not represent all treatment settings.

How to read the evidence

Large nationwide administrative dataset spanning 10 years with nearly 4 million cases, providing robust descriptive epidemiology.

When this study was published

Published 2025, data from 2013–2022.

The bigger picture

The fact that most CUD patients are encountered in mental health settings — not addiction clinics — underscores the need for mental health providers to be competent in assessing and addressing cannabis use disorders as part of integrated care.

Questions still open

Why did CUD peak in 2018 before cannabis legalization expanded? Is the co-occurrence of depression and CUD driving treatment-seeking? How should mental health facilities adapt to address CUD alongside primary mental health disorders?

Common questions

How common is cannabis use disorder in mental health treatment?

Very common — 1.63 million CUD cases were identified in mental health facilities over 10 years, representing about 6.4% of all mental health treatment cases in the national dataset.

What mental health conditions co-occur with cannabis use disorder?

Depression was most common (30.3%), followed by other mental health disorders. This mirrors the alcohol use disorder population, where depression co-occurred in 35.5% of cases.

Read the original research

Alcohol and Cannabis Use Disorder Diagnoses in Mental Health Treatment 2013 to 2022: A Descriptive Epidemiological Study.

Substance use : research and treatment, 19, 29768357251384499

View on PubMed ↗Publisher’s paper ↗

Citation

Ware, Orrin D. (2025). Alcohol and Cannabis Use Disorder Diagnoses in Mental Health Treatment 2013 to 2022: A Descriptive Epidemiological Study.. Substance use : research and treatment, 19, 29768357251384499. https://doi.org/10.1177/29768357251384499