Cannabis use disorder rose among US adults as alcohol disorder severity stayed stable

Researchers analyzed responses from 186,823 US adults in the 2021 through 2024 National Surveys on Drug Use and Health. These are national surveys designed to measure substance use and related health conditions in the United States.

The team looked at past-year alcohol use disorder, or AUD, and cannabis use disorder, or CUD. These diagnoses were measured using DSM-5 criteria, the set of standards clinicians use to identify mental health and substance-use disorders. The researchers also examined moderate-to-severe forms of each disorder and compared patterns by sex and age.

This was a cross-sectional study. That means it compared survey results from different groups of people over several years, rather than following the same individuals over time. It can identify population trends, but it cannot show what caused them.

Cannabis use disorder increased among both males and females. Among males, past-year CUD rose from 7.3% in 2021 to 9.3% in 2024. Among females, it rose from 4.5% to 5.6%.

Moderate-to-severe CUD also increased. Among males, it rose from 3.1% to 4.1%. The increase was especially clear among males ages 35 to 49, where it rose from 2.7% to 3.9%, and among males 50 and older, where it rose from 0.6% to 1.2%.

Among females, moderate-to-severe CUD rose from 1.7% to 2.5%. Increases appeared among females ages 21 to 34, ages 35 to 49, and ages 50 and older. For women 50 and older, the estimate increased from 0.1% to 0.7%. Because the starting number was very small, this large relative change should be read alongside the still-low percentage.

The study also found that, among females with CUD, the share with moderate-to-severe CUD increased from 37.0% to 45.0%. In 2024, most males and females ages 18 to 20, and males ages 21 to 34, who had CUD had moderate-to-severe CUD.

The alcohol findings were different. Moderate-to-severe AUD stayed stable overall among males and females and in most age groups. The exception was males ages 21 to 34, who saw a decline. The journal abstract does not provide overall counts of adults with AUD or CUD, so this study is best understood through the reported percentages.

The findings do not mean that every person who uses cannabis will develop a disorder. They do show that cannabis-related problems meeting diagnostic criteria were becoming more common in this national adult survey. The researchers said the pattern challenges the idea that cannabis has little addictive potential.

The study cannot explain the reasons behind the changes. The authors point to the importance of screening, access to evidence-based treatment, and strategies addressing acceptance, availability, and potency of cannabis products. But this survey analysis cannot establish that any of those factors caused the rise.

More research would need to examine possible drivers of these trends, including changes in products, policies, use patterns, and access to care. Studies that follow people over time could also help clarify who is most likely to develop more severe cannabis-related problems.