Cannabis use disorder

Cannabis use disorder
Other names	Cannabis addiction, marijuana addiction
Reduced blood flow in prefrontal cortex of adolescent cannabis users[1]
Specialty	Addiction medicine, Psychiatry
Symptoms	Dependency of THC and withdrawal symptoms upon cessation such as anxiety, irritability, depression, depersonalization, restlessness, insomnia, vivid dreams, gastrointestinal problems, and decreased appetite
Risk factors	Adolescence and high-frequency use
Treatment	Psychotherapy
Medication	None 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 it 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 qualify 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 conditions. Long-term use can lead to dependence, with around 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 the developing brain 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 on medications for treating cannabis use disorder is weak and inconclusive.^[6] Psychological treatments such as cognitive behavioral therapy (CBT), motivational enhancement therapy (MET), and 12-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.