Alcohol use disorder is lower, cannabis use disorder higher in new US data
STUDY: Han B et al, JAMA Psychiatry 2026
STUDY TYPE: Cross-sectional national survey trend analysis
FUNDING: National Institute on Drug Abuse, NIH
Background
Alcohol use disorder has long been the more common substance use disorder, but cannabis use disorder has been climbing as cannabis potency rises, legalization expands, and perceived harm falls. Here is the latest US data from 2021-2024.
The Study
- 186,823 US adults from the 2021-2024 National Survey on Drug Use and Health, using DSM-5 criteria for past-year use disorder (moderate-to-severe = 4+ symptoms).
- Cross-sectional trend analysis by year, age, and sex.
Results
Cannabis use disorder rose in men (prevalence 7.3% to 9.3%) and women (4.5% to 5.6%), with moderate-to-severe cases climbing even faster, especially among men in their late 30s-40s and adults 50 and older.
Among people with cannabis use disorder, the moderate-to-severe share rose from 37% to 45%.
Alcohol use disorder stayed flat or declined.
Limitations
This survey excludes unhoused or incarcerated individuals, so the true burden is probably underestimated. Data rely on self-report, uncorrected for multiple comparisons.
Practice Implications
- The harms from cannabis are rising, while the perception that the drug is harmless is spreading.
—Chris Aiken, MD
Director, Psych Partners
Editor in Chief, Carlat Psychiatry Report
