Sixteen-Year Trends in Cannabis Use Disorder Treatment Utilization

Background and Purpose: Increases in cannabis potency, prevalence of use, and recreational use policies in the United States may have implications for those with cannabis use disorder (CUD). However, little is known about correlates and trends of individuals who received CUD treatment compared to those with CUD who have not received treatment. In the present study, we examine demographic, co-occurring, and criminal justice-related predictors of CUD treatment among a nationwide sample of individuals with CUD for three different years.

Methods: Data were analyzed from three separate years of the National Survey on Drug Use and Health, examining individuals who met diagnostic criteria for CUD in 2003 (N= 1,742), 2011 (N= 2,100), and 2019 (N= 2,305). Treatment was a dichotomous measure indicating whether individuals with CUD received treatment primarily for cannabis in the past year. Demographics included a dichotomous measure for gender, a continuous measure for age, and categorical measures for race/ethnicity, education, income, health insurance, and county type (small metropolitan, large metropolitan, and non-metropolitan). Co-occurring mental health and substance use disorders were dichotomous measures that included alcohol, heroin, and cocaine use disorder, as well as past-year major depressive episode and past-year mental health treatment. We also examined a dichotomous indicator whether someone has ever been arrested and booked, and if they were on probation or parole in the past year. Logistic regressions among each of the three years identified predictors of receiving CUD treatment.

Results: In 2003, 444 individuals (19.26%) received CUD treatment, 374 (17.81%) in 2011, and 231 (13.26%) in 2019. Respondents were largely male (60-70%) across all years and more White, older, and lower-income adults received treatment across years. Respondents mainly reported they received treatment in outpatient rehab facilities (40-49%) and self-help groups (60-67%) across years. Logistic regressions revealed that age (those over 35), other insurance type (not private or public), past-year mental health treatment, and being in probation or parole were all significant consistent predictors of CUD treatment. Latinx individuals had significantly lower odds (OR= .39, 95% CI [0.16, 0.96]) of receiving CUD treatment in 2003, but not in other years. Inconsistent predictors included co-occurring substance use and arrests. Being arrested was associated with higher odds of CUD treatment in 2019 (OR= 3.10, 95% CI [1.63, 5.88]) and 2011 (OR= 2.12, 95% CI [1.18, 3.82]), but not in 2003.

Conclusions: CUD treatment usage has decreased since 2003. While our findings identified several consistent predictors, our findings also suggest that disparities in treatment utilization for Latinx individuals with CUD may be decreasing. Additionally, higher odds of receiving treatment for those with prior justice system involvement may be related to the rise in diversion programming and justice-related treatment efforts. Social workers may benefit from this work as it illuminates consistent predictors of treatment usage. Future social work research should further examine the reasons for not receiving CUD treatment, as well as the implementation, type, and quality of CUD treatment in correctional facilities and within the community.