Cannabis use disorder is rising among both American men and women, according to new research published in JAMA Psychiatry.
This cross sectional study analyzed data from over 180,000 adults between 2021 and 2024, and found CUD increased from 7.3% to 9.3% among men and increased from 4.5% to 5.6% among women. Furthermore, moderate-to-severe CUD increased from 3.1% to 4.1% among men and from 1.7% to 2.5% among women. The trends were most pronounced among middle-aged and older adults.
What Is Cannabis Use Disorder?
CUD is a pattern of cannabis, or marijuana use, in which a person has difficulty controlling consumption despite experiencing detrimental consequences; like difficulties at work or school. These individuals may use more marijuana than intended, spend substantial time obtaining or craving it and continue to use it despite physical and psychological problems. CUD is not just about how frequently one uses cannabis, but rather impaired control and clinically meaningful consequences.
Misconceptions Surrounding Cannabis Use
Marijuana has traditionally been perceived as a relatively safe drug that is substantially less addictive than other commonly used substances. The new aforementioned study challenges that assumption, with the rising amount of Americans being diagnosed with CUD. In 2024, roughly 36% of men who used cannabis met the criteria for CUD.
The potency of modern cannabis products also matters. Today’s high-THC (the psycho-active component of the drug that is responsible for its harmful health effects) can deliver substantially more THC than cannabis products available decades ago. The JAMA researchers point to increasing potency, greater availability and declining perceptions of harm as important factors contributing to the rise of CUD.
Public Health Implications
The rise of CUD does not mean marijuana is equally dangerous for everyone, nor does it mean everyone will become addicted to it. Cannabis can have legitimate medical applications; including but not limited to treating pain from damaged nerves or nausea and vomiting from chemotherapy. However, it can also cause harmful health effects; including an increased risk of lung disease like bronchitis if marijuana is smoked, as well as an increased risk of psychotic disorders like schizophrenia. Millions of Americans also suffer from cannabinoid hyperemesis syndrome, a condition that can develop characterized by abdominal pain, nausea and vomiting that can lead to dehydration and even death.
Thus, the public health conversation surrounding cannabis needs nuance. The public health response should be focused less on stigma and more on education, prevention and treatment.
Needed Public Health Interventions
Education about marijuana should evolve, and the American public should understand that the drug being legalized for medical and recreational use does not mean “risk-free”. High-potency formulations of marijuana may carry greater risks for problematic use.
In addition, primary care physicians and healthcare providers should routinely screen patients for cannabis use, just as they do for alcohol and tobacco. This is especially true if patients present with anxiety, sleep disturbances and impaired functioning for which they may be self-medicating. Screening more patients offers an opportunity to educate Americans on the benefits and harms of marijuana use.
Finally, people with CUD should be offered evidence-based treatments rather than judgement. This would include behavioral interventions, counseling and treatment of coexisting mental health or substance-use disorders that could help reduce or stop cannabis use.
As cannabis use becomes more accessible and socially accepted, public health must meet the challenge—make sure Americans understand the risks well enough to make informed decisions.