Cannabis Use Disorder

This Factsheet is adapted from the public domain resources SAMHSA's "Substance Use Disorders" (1) and NIDA's "Research Report on Marijuana." (2)

In 2013, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) replaced the diagnostic terms substance abuse and substance dependence with the term substance use disorders, categorized as mild, moderate, or severe to indicate the level of severity as determined by the number of diagnostic criteria met by an individual. (3)

Substance use disorders occur when the recurrent use of alcohol and/or drugs causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school, or home.

According to the DSM-5, a diagnosis of substance use disorder, including cannabis use disorder, is based on evidence of impaired control, social impairment, risky use, and pharmacological criteria.

What is the Risk of Developing Cannabis Use Disorder?

Marijuana is the most-used drug after alcohol and tobacco in the United States.

Estimates of the number of people addicted to marijuana are controversial, in part because epidemiological studies of substance use often use dependence as a proxy for addiction even though it is possible to be dependent without being addicted. Those studies suggest that 9 percent of people who use marijuana will become dependent on it, (9,10) rising to about 17 percent in those who start using in their teens. (11, 12)

What are the Effects of Cannabis Use?

Marijuana’s immediate effects include:

Long-term use of the drug can contribute to respiratory infection, impaired memory, and exposure to cancer-causing compounds. Heavy marijuana use in youth has also been linked to increased risk for developing mental illness and poorer cognitive functioning. (13)

What are the Symptoms of Cannabis Use Disorder?

Some symptoms of cannabis use disorder include:

Are there Treatments for Cannabis Use Disorder?

Treatment of cannabis use disorder usually involves behavioral therapies, such as cognitive behavioral therapy, contingency management, and motivational enhancement therapy. Self-help groups like Marijuana Anonymous can be a useful adjunct to other treatment approaches; online tools to help quit or cut back on their marijuana use are also available. There are no FDA-approved drugs for cannabis use disorder, but research is underway in this area. A few medications such as N-acetylcysteine and gabapentin have shown promise in clinical trials.

Related Resources

Cited References

1. Susbstance Abuse and Mental Health Administration (SAMHSA) Substance Use Disorders (https://www.samhsa.gov/disorders/substance-use) Accessed 5/25/2017
2. National Institute on Drug Abuse (NIDA) Research Report on Marijuana (https://www.drugabuse.gov/publications/research-reports/marijuana/) Accessed 5/25/2017
3. Hasin DS, O’Brien CP, Auriacombe M, et al. DSM-5 Criteria for Substance Use Disorders: Recommendations and Rationale. Am J Psychiatry 2013;170(8):834-851. doi:10.1176/appi.ajp.2013.12060782. PMCID: PMC3767415
4. Center for Behavioral Health Statistics and Quality (CBHSQ). Results from the 2015 National Survey on Drug Use and Health: Detailed Tables. http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2015/NSDUH-DetTabs-2015/NSDUH-DetTabs-2015.htm. Accessed 10/11/2016.
5. Center for Behavioral Health Statistics and Quality (CBHSQ). Treatment Episode Data Set (TEDS): 2003-2013. National Admissions to Substance Abuse Treatment Services. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2015. BHSIS Series S-75, HHS Publication No. (SMA) 15-4934. https://wwwdasis.samhsa.gov/dasis2/teds_pubs/2013_teds_rpt_natl.pdf
6. Hasin DS, Saha TD, Kerridge BT, et al. Prevalence of Marijuana Use Disorders in the United States Between 2001-2002 and 2012-2013. JAMA Psychiatry. 2015;72(12):1235-1242. doi:10.1001/jamapsychiatry.2015.1858.|
7. Winters KC, Lee C-YS. Likelihood of developing an alcohol and cannabis use disorder during youth: Association with recent use and age. Drug Alcohol Depend. 2008;92(1-3):239-247. PMCID: PMC2219953.
8. Center for Behavioral Health Statistics and Quality (CBHSQ). Treatment Episode Data Set (TEDS): 2003-2013. State Admissions to Substance Abuse Treatment Services. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2015. BHSIS Series S-80, HHS Publication No. (SMA) 16-4964. . https://wwwdasis.samhsa.gov/dasis2/teds_pubs/2013_teds_rpt_st.pdf
9. Anthony JC, Warner LA, Kessler RC. Comparative epidemiology of dependence on tobacco, alcohol, controlled substances, and inhalants: Basic findings from the National Comorbidity Survey. Exp Clin Psychopharmacol. 1994;2(3):244-268.
10. Lopez-Quintero C, Pérez de los Cobos J, Hasin DS, et al. Probability and predictors of transition from first use to dependence on nicotine, alcohol, cannabis, and cocaine: results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Drug Alcohol Depend. 2011;115(1-2):120-130. PMCID: PMC3069146.
11. Anthony JC. The epidemiology of cannabis dependence. In: Roffman RA, Stephens RS, eds. Cannabis Dependence: Its Nature, Consequences and Treatment. Cambridge, UK: Cambridge University Press; 2006:58-105
12. Hall WD, Pacula RL. Cannabis Use and Dependence: Public Health and Public Policy. Cambridge, UK: Cambridge University Press; 2003.
13. Shrivastava A, Johnston, M, Tsuang M. Cannabis use and cognitive dysfunction. Indian J Psychiatry 2011; 53(3): 187–191. PMCID: PMC3221171