Probability and correlates of transition from cannabis use to DSM-5 cannabis use disorder: Results from a large-scale nationally representative study

Introduction and Aims: It has been previously reported that more than 34% of individuals who use cannabis may qualify for a diagnosis of DSM-IV cannabis abuse or dependence throughout their lifetime. The introduction of the DSM-5 cannabis use disorder (CUD) diagnostic criteria reflects several intrinsic changes in the perception of substance use disorders. However, little is known about the probability of transition from cannabis use to CUD over time nor about the sociodemographic and clinical correlates associated with this transition. Design and Methods: Participants were individuals ≥18 years interviewed in the National Epidemiologic Survey on Alcohol and Related Conditions-III in 2012–2013. Measurements included univariable and multivariable discrete-time survival analyses performed to examine the association between previously reported cannabis dependence predictors and the hazards of transitioning from cannabis use to CUD. Survival plots assessed the probability of transition from cannabis use to CUD over time since age of first use and differences in probability between predictor levels. Results: Among lifetime cannabis users (N = 11 272), lifetime probability of transition to CUD was approximately 27%. A higher probability of transition from cannabis use to CUD was observed in the following: men, participants belonging to an ethnic minority group, early-onset cannabis users and individuals who reported experiencing three or more childhood adverse events. Discussion and Conclusions: This is the first study to explore transition from cannabis use to the DSM-5 CUD diagnosis. The current study identified specific predictors of this transition, which may assist in targeting at-risk populations.