Therapeutic Use of Cannabis and Cannabinoids

OG article by Michael Hsu, MD^1,2; Arya Shah, MD³; Ayana Jordan, MD, PhD⁴

November 28, 2025

State-level cannabis legalization correlates with a modest uptick in treatment admissions for cannabis use disorder (CUD), yet overall prevalence remains stable, per a JAMA analysis of national surveys from 2002–2020. Researchers, led by Wilson M. Compton from the National Institute on Drug Abuse, examined data from 1.3 million adults across medical, recreational, and non-legal states, revealing past-year CUD rates holding at 2.5%–3.0%, but treatment-seeking rising from 7.7% to 13.3% in legalized areas.

This paradox stems from increased awareness and access; recreational states saw 1.5 times higher odds of treatment entry versus prohibition ones, adjusted for demographics and use patterns. Medical-only legalization showed no significant CUD prevalence shift but boosted admissions by 1.2-fold, suggesting policy-driven stigma reduction. Daily/near-daily use climbed to 10.1% nationally by 2020, outpacing alcohol, yet only 13% of CUD cases sought help, underscoring barriers like perceived mildness.

Limitations include self-reported data and confounding socioeconomic factors, but findings urge tailored interventions in legal states to match rising use with support. As 38 states now permit medical cannabis and 24 recreational, policymakers must monitor addiction trajectories, investing in education to destigmatize treatment and mitigate potential public health burdens from potent products.