From the Guidelines
The primary distinction between cannabis use disorder and cannabis dependence is that cannabis use disorder is a more comprehensive and current term, encompassing a spectrum of problematic use patterns, whereas cannabis dependence is an outdated term focusing primarily on physical and psychological dependence symptoms. The shift from cannabis dependence to cannabis use disorder reflects an evolution in understanding, acknowledging that problematic cannabis use exists on a continuum rather than in distinct categories 1.
Key Differences
- Cannabis use disorder, as defined in the DSM-5, includes criteria such as impaired control, social impairment, risky use, and pharmacological criteria like tolerance and withdrawal 1.
- Cannabis dependence, an older term, was more narrowly focused on symptoms of physical and psychological dependence.
- The diagnosis of cannabis use disorder allows for a more nuanced approach, categorizing the condition as mild, moderate, or severe based on the number of symptoms present.
Implications for Treatment
- Treatment for cannabis use disorder typically involves psychosocial interventions, such as cognitive behavioral therapy, which are cited as effective but underutilized 1.
- There is a need for research and development of effective treatments, including pharmacotherapy, for cannabis use disorder, as current medications are not FDA-approved for this specific condition 1.
- Addressing barriers to care, such as stigma, cost, and access to healthcare professionals with expertise in diagnosing and treating cannabis use disorder, is crucial for improving treatment outcomes 1.
From the Research
Definition and Diagnosis
- Cannabis use disorder (CUD) is a condition that affects ~10% of the 193 million cannabis users worldwide 2
- CUD is characterized by a pattern of cannabis use that leads to significant impairment or distress, as evidenced by multiple studies 3, 2, 4, 5, 6
Comparison with Cannabis Dependence
- Cannabis dependence is often used interchangeably with CUD, but the terms are not exactly synonymous
- Cannabis dependence typically refers to the physical and psychological reliance on cannabis, whereas CUD encompasses a broader range of symptoms and consequences 2, 5
- The distinction between CUD and cannabis dependence is not always clear-cut, and more research is needed to fully understand the relationship between the two conditions
Treatment and Intervention
- Psychosocial interventions, such as cognitive-behavioral therapy, motivational enhancement therapy, and contingency management, are effective in reducing cannabis use and related problems 3, 4, 5, 6
- Pharmacological treatments, such as cannabinoid agonists, have shown promise but require further evaluation 2, 5
- Treatment of CUD is often complicated by comorbid mental health and other substance use disorders, highlighting the need for comprehensive and integrated care 2, 5