More than one-third of people prescribed medical cannabis meet the current criteria for cannabis use disorder (CUD), according to a
study published in
Addiction—although this number was primarily driven by people not using their cannabis as prescribed.
Why It’s Relevant
The Diagnostic and Statistical Manual of Mental Disorders Version 5 (DSM-5) offers a modified framework for assessing disordered use of certain prescription medications—sedatives, stimulants, and opioids. The framework uses nine criteria and excludes the consideration of tolerance and withdrawal. As 40 U.S. states now allow full medical cannabis prescribing, the addition of “prescription cannabis use disorder” to the DSM might also need to be considered.
By the Numbers
- Among 2,054 people in Australia who reported past-year use of medical cannabis, 48% reported using cannabis only as prescribed. Respondents adhering to prescribed conditions were more likely to be using cannabis to treat pain rather than a mental health condition.
- Under the traditional 11-item CUD framework, the rates of any CUD and moderate-to-severe CUD in people using cannabis only as prescribed were 20% and 5%, respectively. This included 34 individuals (17% of total) who only reported experiencing tolerance and withdrawal.
- Under a modified nine-item prescription-CUD framework, 9% of individuals using cannabis as prescribed met the threshold for any CUD and 2% had moderate-to-severe CUD.
- Among respondents who used cannabis not as medically prescribed (for example, using the product for another condition or smoking it with a pipe or bong), 51% met the criteria for any CUD using the 11-item framework, while 20% met the criteria using the nine-item framework.
The Other Side
The survey relied on self-reported data and did not ask whether respondents adhered to their prescribed dose. In addition, researchers relied on a non–randomly recruited sample, which may have introduced bias in participant responses.
Takeaway Message
“Our findings emphasize the importance of examining each person’s cannabis use—for both medical and non-medical purposes—and the extent to which they comply with the conditions identified in their prescriptions,” the researchers wrote. However, they added that in many parts of North America, practitioners give authorization for medical cannabis without specifying treatment dose, frequency, or formulation—complicating the application of the modified DSM-5 framework for prescription CUD.
Related Information
Source
Nicholas Lintzeris, et al. Cannabis use disorder in patients prescribed medical cannabis—should we consider prescription cannabis use disorder as a new diagnostic condition? Addiction. Published online August 2, 2026. doi: 10.1111/add.70559
(Image: Getty Images/iStock/RobsonPL)