Cannabis Use Disorder Increased Among U.S. Adults

Cannabis use disorder (CUD) became more common among U.S. adults between 2021 and 2024. The number of adults with CUD increased from 15.3 million to 19.4 million during the period. Among males age 18 and older, past-year CUD increased from 7.3% in 2021 to 9.3% in 2024. Among females, it increased from 4.5% to 5.6%.

In contrast, the number of U.S. adults with alcohol use disorder (AUD) declined from 28.8 million in 2021 to 27.1 million in 2024. Among females, AUD declined from 9.7% to 8.2%. Among males, AUD remained statistically stable, changing from 13.3% to 12.6%.

The increase in CUD also included more serious cases. Moderate-to-severe CUD among males increased from 3.1% to 4.1%, while among females it increased from 1.7% to 2.5%. Moderate-to-severe CUD was defined as meeting at least four symptoms used to identify the disorder. The steepest increases in CUD and moderate-to-severe CUD occurred among males and females ages 35 to 49 and males age 50 and older. Among males ages 35 to 49, overall CUD increased from 7.2% to 10.4%, and among males age 50 and older, it increased from 2.4% to 3.8%. Among females ages 35 to 49, CUD increased from 3.8% to 5.6%.

Meanwhile, AUD declined among adults ages 21 to 34, from 20.0% to 17.0% among males and from 15.0% to 12.6% among females. Among adults ages 18 to 20 in 2024, 14.9% of males and 14.5% of females met criteria for CUD, compared with 10.4% of males and 10.3% of females who met criteria for AUD, even though alcohol use was more common than cannabis use in this age group.

Among 18- to 20-year-olds who used cannabis during the previous year, 50.0% of males and 47.2% of females met criteria for CUD in 2024. By comparison, among those who used alcohol, 21.7% of males and 20.5% of females met criteria for AUD.

The study included 186,823 adults who participated in the 2021 through 2024 National Surveys on Drug Use and Health. The surveys provided nationally representative information about U.S. civilians who were not living in institutions. Researchers used the surveys to estimate whether participants had experienced CUD or AUD during the previous year based on criteria from the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. Researchers compared prevalence and severity by year, age, and sex.

The researchers suggested that the opposing trends may reflect behavioral and cultural changes, including a growing preference for cannabis over alcohol and decreases in binge or heavy drinking. They also noted that the findings challenge the belief that cannabis has little potential for addiction, particularly because many young adults with CUD had moderate-to-severe symptoms. The survey excluded unsheltered and incarcerated people, which may have led to underestimates, and the information was self-reported. The study was cross-sectional, comparing population patterns across survey years.

These findings were presented in Trends in the Prevalence and Severity of Alcohol and Cannabis Use Disorders Among US Adults by Beth Han, M.D., Ph.D., MPH; Wilson M. Compton, M.D., MPE; Jennifer A. Hobin, Ph.D.; and Nora D. Volkow, M.D. The goal was to investigate trends in AUD and CUD prevalence and severity by age and sex.

The full text of Trends in the Prevalence and Severity of Alcohol and Cannabis Use Disorders Among US Adults was published on August 19, 2026, by JAMA Psychiatry. A free copy is available (accessed September 3, 2026).

For more information, contact: Nora D. Volkow, M.D., National Institute on Drug Abuse, National Institutes of Health, 301 N Stonestreet Avenue, 3WFN Room 09D20, MSC 6025, Bethesda, Maryland 20892; Email: nvolkow@nida.nih.gov; Website: https://nida.nih.gov/