A recently published study highlights the need for doctors to take into account the risk of cannabis use disorder (CUD) when prescribing medicinal cannabis.
Simply put, CUD is where people who are using marijuana are unable or find it difficult to stop consumption even though it’s causing health and social problems in their lives. CUD is quite common, with prevalence among people using cannabis recreationally estimated at 22%.
But what about those who are using cannabis purely for medicinal reasons?
A group of Australian researchers sought to systematically review the prevalence of CUDs in people who use cannabis medicinally. The review involved 14 eligible publications, providing data for 3681 participants from five different countries.
The researchers found for individuals using medicinal cannabis in the past 6–12 months, the prevalence of CUDs was 29%. Across all prevalence periods, the figure was estimated at 25% (CI: 18-33%). These results were based on the DSM-5 criteria that included:
- Tolerance: a need for higher doses to achieve desired effect; or a significantly decreased effect with current dose.
- Withdrawal symptoms: among which are cravings, anxiety, restlessness and irritability.
- Cannabis taken in larger amounts or over a longer period than intended.
- A persistent desire or unsuccessful efforts to cut down or control cannabis use.
- Recurrent cannabis use in situations in which it is physically hazardous
- Continued use despite knowledge of having a persistent or recurrent physical or psychological condition likely to have been caused or exacerbated by cannabis use.
Withdrawal and tolerance were the most frequently reported criteria across the studies included in the review.
The review found a higher proportion of mild CUD (55–80%) compared to moderate (11–27%) and severe (0–20%) instances across the studies evaluated. It also found people who were in the 18–29 year-old age bracket were more likely to develop CUDs when using cannabis medicinally than older people (Range=30–44), and one study reported males were more likely to develop CUDs than females.
“As medicinal cannabis popularity grows, there is a need for ongoing research to monitor CUDs prevalence in people who use medicinal cannabis,” state the authors.
While it’s not clear from the publication, it’s assumed “medicinal cannabis” to mean preparations containing THC, which is an intoxicating cannabinoid.
The study has been published in the journal Drug and Alcohol Dependence.
