As More Americans Turn to Cannabis, Problem Use Is Increasing

A growing number of Americans say their cannabis use is problematic, according to a large new study released Wednesday.

The study, based on nationally representative data of U.S. adults, found that more than 9 percent of the men — or almost 1 in 10 — reported symptoms of cannabis use disorder in 2024, up from about 7 percent in 2021. The prevalence of cannabis use disorder also rose among women, increasing to nearly 6 percent in 2024, up from about 5 percent in 2021. Symptoms of the disorder include not being able to cut back or quit, or continuing to use the drug despite it leading to interpersonal problems.

“The notion that cannabis is not addictive may basically be incorrect,” said Dr. Nora D. Volkow, the director of the National Institute on Drug Abuse and the paper’s senior author.

She said the fact that many cannabis products now contained much higher amounts than in the past of tetrahydrocannabinol or THC, the psychoactive compound in cannabis, was making problematic use of the drug more visible.

“It’s a completely different story,” Dr. Volkow said, adding, “The dosing is actually enabling us to see the emergence of the addictiveness. The higher the content of the drug, the higher the risk for addiction.”

Overall, cannabis use rose among all adults during this time. In 2024, 26 percent of men reported using the drug, up from 22 percent in 2021. Among women, 21 percent said they used cannabis in 2024, up from nearly 18 percent in 2021.

Dr. Volkow said especially striking was that the risk of cannabis use disorder was so high. Of the survey participants who said they used cannabis, about 30 percent showed symptoms consistent with cannabis use disorder. Those findings suggested that those who used cannabis were at higher risk of developing problematic use than those who drank alcohol, as fewer than 20 percent of those who reported drinking in the survey showed symptoms of alcohol use disorder.

While alcohol use is stable or declining, alcohol use is still much more common than cannabis use, the surveys found.

The paper, published in the journal JAMA Psychiatry on Wednesday, drew on figures from the National Survey on Drug Use and Health, which asked the participants to report on their past year’s drug use. The annual survey is conducted by the Substance Abuse and Mental Health Services Administration.

Experts on cannabis said they were not surprised by the new data, given that many states now allow recreational use of cannabis, and most allow medical use. The Department of Justice in April loosened regulations for medical marijuana, indicating a lower potential for abuse and dependence.

“This study highlights an anticipated consequence of rising levels of use and increasing potency of the product,” said Dr. Daniel Myran, an ***istant professor of family medicine at University of Ottawa who studies health outcomes ***ociated with cannabis use. “The product is really changing under enormous pressure from market forces to increase the THC content — that’s where there’s consumer demand.”

There is currently no treatment for cannabis use disorder that is approved by the Food and Drug Administration, and the treatments that are available are limited. These include therapies like cognitive behavior therapy, as well as prescription medications to reduce cravings and help manage withdrawal symptoms like anxiety or insomnia. Marijuana Anonymous also offers peer support groups.

The prevalence of moderate-to-severe cannabis use disorder, which has more troubling features than mild cannabis use disorder, also rose. In 2024, about 4 percent of men and just under 3 percent of women reported symptoms of the moderate to severe form of the disorder.

The researchers cl***ified survey participants as having a moderate to severe cannabis use disorder if they reported at least four out of 11 symptoms. Users who reported two to three symptoms were considered to have mild cannabis use disorder.

Some of the steepest increases in the prevalence of both mild cannabis use disorder and the more severe form occurred among men and women 35 to 49 and men 50 and older.

Dr. Laura Bierut, a professor of psychiatry at Washington University School of Medicine, expressed concern that cannabis use in midlife and older age could be damaging to the aging brain.

“Usually what happens with substance use disorder is that people go through this period and then they mature — they get a job and they have kids,” Dr. Bierut said. “This group of 35- to 49-year-olds have children, teenage kids and adolescents who are going to be seeing their parents having a substance use disorder and boy, that’s not a good role model. That worries me.”