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. 2019 Nov 1:204:107468.
doi: 10.1016/j.drugalcdep.2019.05.008. Epub 2019 Sep 12.

Cannabis use disorders among adults in the United States during a time of increasing use of cannabis

Wilson M Compton  1 , Beth Han  2 , Christopher M Jones  3 , Carlos Blanco  4
Affiliations

Cannabis use disorders among adults in the United States during a time of increasing use of cannabis

Wilson M Compton et al. Drug Alcohol Depend. .

Abstract

Background: Using U.S. National Surveys on Drug Use and Health (NSDUH) data, researchers found that prevalence of cannabis use among adults increased in recent years, but prevalence of DSM-IV cannabis use disorder (CUD) was stable. Examining trends of all individual CUD criteria and of CUD severity may elucidate reasons for the lack of increases in CUD.

Methods: Data were from 749,500 persons aged 18 or older who participated in the 2002-2017 NSDUH. Descriptive analyses and logistic regressions were applied.

Results: Among adults during 2002-2017, past-year prevalence of DSM-IV CUD remained stable at 1.5% to 1.4%, but cannabis use increased from 10.4% to 15.3%, daily/near daily use increased from 1.9% to 4.2%, and mild DSM-5 CUD increased from 1.4% to 1.9%. Among adult cannabis users, past-year prevalence of DSM-IV CUD decreased from 14.8% to 9.3%, daily/near daily use increased from 18.0% to 27.2%, and DSM-5 moderate (4-5 criteria) and severe (6+ criteria) CUD decreased from 4.3% to 3.1% and from 2.4% to 1.3%, respectively. Examining trends in individual CUD criteria during 2002-2017 among adults overall revealed increases in two criteria (tolerance; spending a lot of time getting/using cannabis or getting over cannabis effects) and decreases/no changes in other criteria; among adult cannabis users, there was no change in one criterion (tolerance) and decreases in other criteria.

Conclusions: DSM-5's single dimension CUD measure may be more sensitive to diagnosis prevalence changes than the separate DSM-IV cannabis dependence and abuse categories. Future diagnostic approaches to assessing CUD may benefit from quantitatively oriented criteria.

Keywords: Cannabis use; Cannabis use disorder; DSM-5; DSM-IV; Diagnostic criteria for cannabis use disorder.

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Conflict of interest statement

Conflict of Interest Disclosures: Unrelated to the submitted work, Compton reports ownership of stock in General Electric Co., 3M Co., and Pfizer Inc. Han, Jones, and Blanco have no conflicts to disclose.

References

    1. American Psychiatric Association (APA), 1994. Diagnostic and Statistical Manual of Mental Disorders (4th ed). Washington DC.
    1. American Psychiatric Association (APA), 2013. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Arlington, VA.
    1. Compton WM, Grant BF, Colliver JD, Glantz MD, Stinson FS, 2004. Prevalence of marijuana use disorders in the United States: 1991–1992 and 2001–2002. JAMA 291, 2114–21. - PubMed
    1. Compton WM., Saha TD., Conway KP., Grant BF., 2009. The Role of cannabis use within a dimensional approach to cannabis use disorders. Drug and Alcohol Depend. 100, 221–7. - PMC - PubMed
    1. Compton WM, Dawson DA, Goldstein RB, Grant BF, 2013. Crosswalk between DSM-IV dependence and DSM-5 substance use disorders for opioids, cannabis, cocaine and alcohol. Drug Alcohol Depend. 132, 387–90. - PMC - PubMed