Cannabis

Cannabis can be smoked, vaped, eaten, or used as concentrates. Its main intoxicating compound is THC. Many people use cannabis without major problems, but the CDC estimates that about 3 in 10 people who use cannabis have cannabis use disorder.¹

Cannabis use disorder is a recognized diagnosis. Legal status of cannabis varies by country and U.S. state; legality does not change the risk of a use disorder.

Cannabis use disorder is diagnosed when use becomes hard to control and continues despite problems. Signs listed by the CDC include using more than intended, failing to quit, craving, spending a lot of time using, giving up activities, and needing more to get the same effect.¹

• Starting young. Beginning in adolescence raises the risk.¹
• Frequent use. Daily or near-daily use raises the risk.¹
• Higher-potency products. The CDC notes average THC levels in research samples rose from about 9% in 2008 to about 17% in 2017, with many dispensary products higher.¹
• Using to cope. Using to manage anxiety, sleep, or low mood can deepen reliance.

THC acts on the brain's endocannabinoid system, which helps regulate mood, appetite, memory, and stress. With frequent use, the brain adapts by reducing its sensitivity, which contributes to tolerance and to withdrawal when use stops.²

• Withdrawal: irritability, anxiety, trouble sleeping, vivid dreams, low appetite, and restlessness are common in the first days to weeks.²
• Using to fall asleep makes early sleep difficult after stopping.
• Daily routines and social circles built around use provide constant cues.

• Using more often or in larger amounts than planned
• Trying to cut back without success
• Using first thing in the day or to get through ordinary tasks
• Needing stronger products to feel the effect
• Missing school, work, or commitments
• Driving after using

Thinking and learning

People with cannabis use disorder may face greater problems with attention, memory, and learning.¹

Mental health

Heavy use, especially of high-THC products, is associated with anxiety and, in some people, psychosis.

Safety

Impaired driving and accidental ingestion by children (especially edibles) are serious risks.

• Because cannabis is widely seen as harmless, people often feel their concern will be dismissed.
• Cutting back can feel lonely if friends still use.
• Withdrawal is real, even if it is rarely dangerous.

• Track when and why you use for a week.
• Set a clear goal: fewer days, lower potency, or stopping.
• Plan for sleep: a regular schedule, less screen time at night, and patience during the first weeks.
• Remove supplies and change routines linked to use.

Cognitive behavioral therapy, motivational enhancement therapy, and contingency management have evidence for cannabis use disorder. There is currently no FDA-approved medication specifically for it. Treating co-occurring anxiety, depression, or sleep problems often helps.

1. Decide on one first step, such as a no-use day or not buying more.
2. Plan your evening and bedtime routine.
3. Tell someone you trust what you are trying.
4. If you are experiencing paranoia, hallucinations, or thoughts of harming yourself, call or text 988 — or 911 in an emergency.

• Focus on specific effects you have noticed, not on whether cannabis is "bad."
• Ask what they get from it — sleep, calm, fun — and whether there are other ways to meet those needs.
• Keep edibles locked away from children and pets.