Characterizing the Cannabis Use Disorder Cascade of Care in the United States: Treatment Gaps and Barriers to Care

OBJECTIVE: Cascade-of-care models characterize population-level gaps in treatment delivery. A cannabis use disorder cascade of care has not been described. The authors aimed to estimate treatment prevalence and associations with sociodemographic and behavioral health characteristics across stages of the cannabis use disorder treatment cascade and to explore perceived barriers to such treatment. METHODS: Pooled 2022-2023 National Survey on Drug Use and Health data were used to identify U.S. adults with past-year cannabis use disorder (N=8,630). Conditional prevalences of health care utilization, a drug use screening with a health care provider, and receipt of outpatient cannabis use disorder treatment were estimated. Multivariable logistic regressions were used to estimate associations between sociodemographic and behavioral health characteristics and engagement at each cascade stage. Perceived treatment barriers were examined in a subsample of adults with untreated cannabis use disorder (N=408). RESULTS: Health care utilization was common among adults with cannabis use disorder (78.1% [weighted]); among those who used care, 75.7% received a drug use screening. However, only 4.2% of those screened received outpatient cannabis use disorder treatment. Past-year mental health treatment was positively associated with engagement with care at each stage in the cascade. For the subsample with untreated cannabis use disorder, 73.5% avoided treatment because they thought they could manage on their own. CONCLUSIONS: Adults with cannabis use disorder often use health care and are screened for drug use by a health care provider. However, few receive cannabis use disorder treatment after these screenings.