Clinical Manifestations of Cannabis Use Disorder
Alan J. Budney, Jacob T. Borodovsky, and Ashley A. Knapp
C Springer Nature Switzerland AG 2019
Cannabis use disorder (CUD) or its colloquial synonym, cannabis addiction, remains controversial in that many in the general public believe that cannabis use does not pose substantial risk for harm and is not addictive in the same sense that tobacco, alcohol, cocaine, or heroin is addictive. Although assessment of people’s beliefs about addiction and harm is complicated by the lack of a consensus definition or a common understanding of addiction, the difference in perception of risk between cannabis and other substances that are used recreationally is clear. For example, in the most recent Monitoring the Future (MTF) survey, when asked “how much do you think people risk harming themselves (physically or in other ways) if they smoke marijuana regularly?”, only 32% of US 12th graders responded, “great risk,” on a 5-point scale that ranged from no risk to great risk . In comparison, responses of “great risk” were 85% for take heroin regularly, 81% for take cocaine powder regularly, 74% for take any narcotic other than heroin regularly, 76% for smoke one or more packs of tobacco cigarettes per day, 59% for take 4–5 drinks (alcohol) nearly every day, 54% for take amphetamines regularly, and 50% for take sedatives regularly. Note that the 32% response rate of “great risk” to regular marijuana use is down from 50% in 1980, 78% in 1990, 58% in 2000, and 47% in 2010. Indeed, it is lower than the previous lowest MTF survey rating by 12th graders, which was 35% in 1978. In contrast, the percentages of youth endorsing great risk for heroin have never ranged out of the mid to high 80s over this time period, and cocaine has ranged from its low of 68% in 1978 to a stable range of above 80% since 1986.