Prevalence and Risk of Developing Cannabis Use Disorder in Adults Who Use Cannabis

Visual Abstract

Summary

Background
  • Cannabis has become increasingly accessible and more commonly used in the US over the past 20 years. Between 2002 and 2017, the proportion of US adults reporting past-year cannabis use grew from 10.4% to 15.3%, while the proportion reporting near-daily or daily use doubled from 1.9% to 4.2%.
  • Long-term and regular use of cannabis may be associated with more serious adverse effects, including cannabis use disorder (CUD). Individuals with CUD may have a physiological dependence on cannabis and can experience withdrawal symptoms similar to other substance use disorders.
  • The purpose of this living systematic review is to evaluate the prevalence and incidence of CUD in adults who use cannabis in the US, and to identify the sociodemographic, health, and cannabis use characteristics that may be associated with a higher risk of CUD.
Methods

Living systematic review

STEM PTSD Methods

(Searched February 23, 2022)

APA PsycINFO

EBM Reviews – Cochrane Central Register of Controlled Trials

Ovid MEDLINE ALL

Screening

Observational studies with comparison groups comprised of US users of non-synthetic (e.g., spice) cannabis products (e.g., cannabis flowers, tinctures, oils), including FDA-approved cannabinoids, that report prevalence, incidence, or factors associated with developing CUD.

Risk of Bias

  • National Heart, Lung, and Blood Institute checklist for observational cohort and cross-sectional studies

Assessing the certainty of the body of evidence

  • We did not perform the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) assessment for select outcomes because of the breadth of the review.

Updates

  • Search to be updated every 6 months with new reports as needed.
Findings
  • We focused on data from the National Survey on Drug Use and Health (NSDUH) and National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) surveys to estimate the prevalence of past-year cannabis use.
  • We present findings from 57 studies, either reporting on prevalence in Veterans or on factors associated with CUD.
    • Most studies were cross-sectional and reported on risk factors associated with CUD.
Conclusions
  • In people reporting past-year cannabis use, the most recent population-based estimates of CUD prevalence range from 9.1% to 30.6% in the US. The differences in estimates likely reflect differences in survey methods, including the use of different screening tools. The prevalence of CUD among past-year users has also declined in recent years.
  • Risk factors for CUD include identifying as male, being younger, and using cannabis more frequently and for longer.
Gaps in Evidence
  • We found very limited data on how the risk of CUD may differ by the route of administration (e.g., smoking, edibles, topical) or by the use of FDA-approved synthesized, pharmaceutically prepared cannabinoids.

Shaw B, Robalino S, Durbin S, Harrod C, Kansagara, D. Prevalence and risk of developing cannabis use disorder in adults who use cannabis. Portland, OR: Center for Evidence-based Policy, Oregon Health & Science University; 2022

Full Report

Full Systematic Review:

‘Prevalence and Risk of Developing Cannabis Use Disorder (CUD) in Adults Who Use Cannabis’

Appendix E