Cannabis use disorder affects roughly 10% of the 193 million cannabis users in the world. The diagnosis captures the possibility that people can be negatively impacted by marijuana use without necessarily being addicted. However, it also has room to recognize cannabis addiction if it occurs.
Signs and Symptoms of Cannabis Use Disorder
One of the key things to remember with cannabis use disorder is that it involves cannabis use that creates issues or problems for the user. With that in mind, at least two of the following official criteria or symptoms occurring within a 12-month period indicate cannabis use disorder:
Continuing to use cannabis despite physical or psychological problems Continuing to use cannabis despite social or relationship problems Craving cannabis Difficulty controlling or cutting down cannabis use Giving up or reducing other activities in favor of cannabis use Problems at work, school, and home as a result of cannabis use Spending a lot of time on cannabis use Taking cannabis in high-risk situations Taking more cannabis than was intended Tolerance to cannabis Withdrawal when discontinuing cannabis
Diagnosis of Cannabis Use Disorder
To diagnose cannabis use disorder, a healthcare provider assesses the person’s history. This includes whether they or their immediate family members have a history of substance abuse or mental health issues and also includes their medical history and exposure to environmental stress. Laboratory testing can be used to help identify cannabis use. However, a positive drug test does not necessarily mean the person has cannabis use disorder and a negative drug test does not rule it out. Instead, it is more important to look at reported cannabis intake compared to the amount that is in the blood. A cannabis use disorder diagnosis can depend, in part, on its effects—such as the 11 criteria or symptoms outlined above. The severity of the person’s problems can be captured by including an additional indicator:
Mild: two to three symptomsModerate: four to five symptomsSevere: six or more symptoms
The new cannabis use disorder classification (which separates problematic use from cannabis dependence or cannabis abuse) means that someone can have severe cannabis use disorder without having any tolerance or withdrawal, the hallmarks of addiction. By the same token, they can meet the criteria for mild cannabis use disorder despite experiencing high physical tolerance and withdrawal.
CUD and Other Mental Health Conditions
A CUD diagnosis can be complicated by comorbid or co-occurring mental health conditions. For instance, cannabis use disorder is strongly associated with both major depression and generalized anxiety disorder. Some studies have also found higher rates of cannabis use disorder in people with post-traumatic stress disorder. Research has reported connections between CUD and other specific substance use disorders as well, including:
Sedative use disorder Cocaine use disorder Stimulant use disorder Club drug use disorder Alcohol use disorder
Causes of Cannabis Use Disorder
Substance use disorders don’t have one specific cause that fits all people diagnosed with the condition. Stress, emotional distress, and other mental health conditions (such as anxiety and depression) can all contribute to the development of cannabis use disorder. There may be a genetic or hereditary component as well. Researchers have identified several gene variants that can increase the risk of developing cannabis dependence or cannabis addiction.
Treatment for Cannabis Use Disorder
There are a couple of different treatment options for people with cannabis use disorder. It’s important to note that if there is a co-occurring condition, treating both conditions at the same time can provide the most favorable treatment outcome.
Counseling and Therapy
Several types of counseling or therapy have been found beneficial for reducing cannabis use and the subsequent problems this drug creates. They are:
Cognitive behavioral therapy: A form of psychotherapy that helps people identify destructive thought patterns, then change those patterns to positively influence their behaviors Motivational enhancement therapy: A short-term therapy designed to help motivate the person to change harmful behaviors Contingency management: A behavioral therapy technique that uses a formal contract between the therapist and client to help the client change behavior through establishing goals while also setting rewards and penalties
One study involving 308 subjects also found that online interventions that include chat counseling can also be helpful for people with cannabis use disorder, especially when used by those who don’t traditionally use outpatient treatment options.
Medication
At this time, there is no medication approved by the Food and Drug Administration (FDA) to treat cannabis use disorder, though some medicines are currently under investigation. Until such options exist, cannabis use disorder is best treated through counseling and therapy. For more mental health resources, see our National Helpline Database.
