Orono, ME: Few heavy, daily users of cannabis meet the diagnostic criteria for either “moderate” or “severe” cannabis use disorder (CUD), and many don’t meet any criteria for CUD, according to data published in the Journal of Addiction Medicine.
A team of investigators affiliated with the University of Maine, Columbia University in New York, and the Dartmouth Geisel School of Medicine in New Hampshire assessed CUD severity in a cohort of 4,000 daily consumers. On average, participants reported consuming at least 200 mg of THC per day.
Despite participants’ frequent use of cannabis, nearly one-third (30 percent) of participants did not meet criteria for CUD. (People are defined as suffering from CUD if they meet two out of 11 possible diagnostic criteria, such as experiencing feelings of craving or withdrawal.) Forty-five percent of respondents were defined as suffering from “mild” CUD. Participants in this category were likely to acknowledge spending a “great deal of time” on activities related to cannabis and/or expressing a “strong desire” to consume cannabis.
Only three percent of respondents met criteria for “severe” CUD.
“Surprisingly, even though participants in our sample reported consuming on average over 200 mg [of] THC per day, the majority of the sample either did not meet CUD criteria or met criteria for mild CUD,” the study’s authors concluded.
The study’s findings are consistent with those of a recent UC San Diego study determining that among seniors diagnosed with CUD, only four percent experienced severe symptoms. By contrast, 76 percent of older Americans meeting the criteria for CUD were described as having “mild” symptoms.
Writing in a recent op-ed on the subject, NORML’s Deputy Director Paul Armentano suggested that incidences of CUD may be over-reported because current criteria make no exception for those who consume cannabis regularly for therapeutic purposes.
Armentano also questioned the real-world significance of CUD. According to data provided by the US Substance Abuse and Mental Health Services Administration, the percentage of people entering treatment primarily for cannabis use fell approximately 20 percent between 2020 and 2024, the last year for which data is available. By contrast, the percentage of individuals admitted for alcohol abuse rose every year during this period.
In a recent series of Substack posts, Dr. Peter Grinspoon – a cannabis specialist at Massachusetts General Hospital – expressed similar concerns. He opined, “To the extent that we miss nuances, and overestimate the prevalence of cannabis addiction, we muddy the societal debate about the relative harms and benefits of integrating cannabis into medical care.”
Full text of the study, “Identifying subtypes of cannabis use disorder: A latent class analysis among daily cannabis consumers and associated sociodemographic and cannabis characteristics,” appears in the Journal of Addiction Medicine.