Why Few Teens Finish Treatment for Cannabis Use Disorder

Cannabis use among teens is more common than many people realize, and while not all adolescent users develop a dependency, some go on to experience cannabis use disorder (CUD), a condition that can have long-lasting impacts on mental health, brain development, and quality of life. Yet even when teens seek or are referred to treatment for CUD, many don’t complete the programs designed to help them recover.

A new study¹ published in Pediatric Reports (MDPI, July 2025) analyzed nationwide treatment records to explore just how often teens with CUD complete treatment and what factors are linked to successful outcomes. Researchers reviewed over 40,000 cases of adolescents aged 12 to 17 who entered public treatment programs for cannabis use disorder between 2018 and 2021. Their goal was to better understand treatment completion patterns, especially across different demographic, social, and clinical groups.

The findings paint a concerning picture of treatment retention among American youth and point to specific barriers that could be addressed with more targeted, equitable interventions.

The Goal of the Study

The researchers sought to quantify how many adolescents diagnosed with cannabis use disorder successfully completed treatment and identify which personal, social, and structural factors influenced those outcomes. They used data from the U.S. Treatment Episode Data Set–Discharges (TEDS-D), which tracks outcomes from publicly funded substance use treatment facilities across the country. The study offers one of the most detailed national views of how young people fare in formal CUD treatment settings.

Treatment Completion Rates: What the Numbers Reveal

Only 36.8% of adolescents completed their treatment programs. This means that nearly two-thirds either dropped out, transferred to another facility, were terminated by the provider, or left for other reasons. Over the four years studied, the completion rate remained relatively steady, indicating a persistent issue in treatment retention.

The most common outcome besides completion was dropping out, which accounted for 28.4% of cases. Transfers made up another 17%. These outcomes raise concerns about continuity of care and the effectiveness of current treatment approaches for youth.

What Factors Influence Teen Treatment Success?

Researchers identified several factors that were statistically associated with whether a teen was likely to finish treatment:

• • Gender: Males had slightly lower odds of completing treatment than females.
  • Race and Ethnicity: Black non-Hispanic adolescents had lower odds of completion compared to Caucasian peers. On the other hand, Hispanic, Asian, and Native Hawaiian or Pacific Islander youth were more likely to finish treatment.
  • Age of First Use: Teens who started using cannabis at age 11 or younger had the lowest completion rates, with just 12.9% finishing treatment.
  • Living Situation: Those in dependent living situations (such as with family or guardians) had the highest completion rates. Teens who were homeless or living independently fared significantly worse.
  • Criminal Justice Involvement: Adolescents who had been arrested in the 30 days before treatment were less likely to complete their programs.
  • Mental Health and Substance Co-Use: Teens with co-occurring mental health conditions or other substance use disorders were less likely to complete treatment.
  • Treatment Duration: The best outcomes were seen in programs lasting four to six months. Teens in treatment for less than a month had the lowest odds of completion, while stays longer than a year didn’t show added benefits.
  • Referral Source: Adolescents referred by schools or employers were more likely to complete treatment than those referred through the criminal justice system.

Why Treatment Completion Matters

Finishing treatment doesn’t guarantee full recovery, but it’s a critical milestone in addressing substance use disorders. Adolescents who complete their programs are more likely to sustain long-term recovery, avoid legal trouble, and reduce their risk of mental health complications. When nearly two-thirds of youth are not reaching that milestone, it signals a public health gap that needs immediate attention.

Cannabis use disorder during adolescence is especially concerning because the teen brain is still developing. Heavy cannabis use during this time has been linked to cognitive impairment, emotional regulation issues, and increased risk for other mental health disorders. When young people don’t complete treatment, they may carry those challenges into adulthood.

Solutions to Improve Treatment Completion

The researchers emphasize that these low completion rates are not just about personal willpower or motivation. Many of the barriers are structural, such as lack of stable housing, systemic racial disparities, and inadequate mental health support. The study suggests a need for more customized treatment approaches, especially for those who face greater socioeconomic or legal challenges.

Improving coordination between providers during treatment transfers could help reduce dropouts. Expanding support for families, offering culturally responsive care, and reducing stigma around treatment might also improve engagement. And since referral source made a difference, efforts to divert youth from the justice system and toward school or community-based interventions could offer better outcomes.

The Urgent Need for Teen-Focused CUD Reforms

This study offers an important reality check. Even when teens with cannabis use disorder enter treatment, only a minority stay long enough to complete it. The reasons are complex, ranging from housing insecurity to racial disparities to how and where teens are referred. But the message is clear: if we want to support adolescents in overcoming cannabis use disorder, we need more than just treatment access; we need treatment systems designed to retain and support them through recovery.

With the right changes, we can shift these outcomes. But first, we have to recognize where the system is falling short and commit to building something better for the next generation.

Studies Referenced:

^{1. Miranda, H., Ostanin, J., Shugar, S., Mejia, M. C., Sacca, L., Doucette, M. L., Hennekens, C. H., & Kitsantas, P. (2025). Disparities in Treatment Outcomes for Cannabis Use Disorder Among Adolescents. Pediatric Reports, 17(4), 74. https://doi.org/10.3390/pediatric17040074}