Cannabis use disorder

Cannabis use disorder
Other namesCannabis addiction, marijuana addiction
Reduced blood flow in prefrontal cortex of adolescent cannabis users[1]
SpecialtyAddiction medicine, Psychiatry
SymptomsDependency of THC and other Cannabinoids and withdrawal symptoms upon cessation such as anxiety, irritability, depression, depersonalization, restlessness, insomnia, vivid dreams, gastrointestinal problems, and decreased appetite
Risk factorsAdolescence and high-frequency use
TreatmentPsychotherapy
MedicationNone approved, experimental only

Cannabis use disorder (CUD), also known as cannabis addiction or marijuana addiction, is a psychiatric disorder defined in the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and ICD-11 as the continued use of cannabis despite clinically significant impairment.[2][3]

There is a common misconception that cannabis use disorder does not exist, as people describe cannabis as non-addictive.[4][5] Cannabis use disorder is the clinical name for cannabis addiction. Cannabis is one of the most widely used drugs globally. According to the National Survey on Drug Use and Health, in 2021, nearly 6% of teens and adults met criteria for cannabis use disorder.[4]

Cannabis use is linked to a range of mental health issues, including mood and anxiety disorders, and in some individuals, it may act as a form of self-medication for psychiatric disorders. Long-term use can lead to dependence, with an estimated 9–20% of users—particularly daily users—developing cannabis use disorder (CUD). Risk factors for developing CUD include early and frequent use, high THC potency, co-use with tobacco or alcohol, adverse childhood experiences, and genetic predispositions. Adolescents are especially vulnerable due to their stage of neurodevelopment and social influences, and CUD in youth is associated with poor cognitive and psychiatric outcomes, including a heightened risk of suicide attempts and self-harm.

Cannabis withdrawal, affecting about half of those in treatment, can include symptoms like irritability, anxiety, insomnia, and depression. There are no FDA-approved medications for CUD. Current evidence for medication in the setting of CUD is weak and inconclusive.[6] Psychological treatments, such as cognitive behavioral therapy (CBT), motivational enhancement therapy (MET), and twelve-step programs show promise. Diagnosis is based on DSM-5 or ICD-11 criteria, and screening tools like CAST and CUDIT are used for assessment. Treatment demand is rising globally, and despite limited pharmacological options, structured psychological support can be effective in managing cannabis dependence.

  1. ^ Jacobus, Joanna; Goldenberg, Diane; Wierenga, Christina E.; Tolentino, Neil J.; Liu, Thomas T.; Tapert, Susan F. (1 August 2012). "Altered cerebral blood flow and neurocognitive correlates in adolescent cannabis users". Psychopharmacology. 222 (4): 675–684. doi:10.1007/s00213-012-2674-4. ISSN 1432-2072. PMC 3510003. PMID 22395430.
  2. ^ National Institute on Drug Abuse (2014), The Science of Drug Abuse and Addiction: The Basics, archived from the original on 1 April 2022, retrieved 17 March 2016
  3. ^ Gordon AJ, Conley JW, Gordon JM (December 2013). "Medical consequences of marijuana use: a review of current literature". Current Psychiatry Reports (Review). 15 (12) 419. doi:10.1007/s11920-013-0419-7. PMID 24234874. S2CID 29063282.
  4. ^ a b Smith, Dana (10 April 2023). "How Do You Know if You're Addicted to Weed?". The New York Times. Retrieved 24 June 2024.
  5. ^ MacDonald, Kai (1 April 2016). "Why Not Pot?: A Review of the Brain-based Risks of Cannabis". Innovations in Clinical Neuroscience. 13 (3–4): 13–22. PMC 4911936. PMID 27354924.
  6. ^ Cite error: The named reference Cochrane2019 was invoked but never defined (see the help page).
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