Risk of Cannabis Use Disorder Among Adults with Pre-Existing Depression: Evidence from the U.S. NESARC-III (2012–2013)

Among adults who use cannabis, 20–33% develop cannabis use disorder (CUD). Depressive disorders frequently co-occur with cannabis use and are considered potential risk factors for CUD, yet evidence quantifying this risk over time. remains limited, particularly across sociodemographic groups. Using nationally representative data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (2012–2013; n = 11,272), we examined adults with lifetime cannabis use. Discrete-time survival analyses and failure plots assessed the probability of developing DSM-5 CUD from the time of cannabis onset, comparing individuals with and without pre-existing depressive disorders. Analyses were stratified by sex and other sociodemographic characteristics. Adults with pre-existing depressive disorders had a 58% greater risk of developing CUD (p <.0001) and consistently showed higher cumulative probability across time. Elevated risk was also observed among men, younger adults, and high school graduates. Pre-existing depressive disorders substantially increase CUD risk, supporting targeted prevention efforts.