Why Many Avoid Help for Cannabis Use Disorder (CUD)

The Underserved Reality of Cannabis Use Disorder

Despite increasing legalization and social acceptance of cannabis across the United States, Cannabis Use Disorder (CUD) remains a significant and undertreated condition.  In an effort to shed light on the situation, a peer-reviewed study¹ recently published in Substance Use & Misuse has examined 16 years of national data to better understand who receives CUD treatment, who does not, and why.

CUD Treatment Rates Are Falling—Here’s Why That Matters

The study, led by researchers from Florida Atlantic University and others, analyzed data from the National Survey on Drug Use and Health across three key years: 2003, 2011, and 2019.  One of the most striking findings was the steady decline in CUD treatment utilization, which dropped from 19.3% in 2003 to just 13.3% in 2019.

This drop is potentially concerning, as during the same period, there has been a rise in cannabis potency, usage, and accessibility.  THC levels, for instance, more than doubled between 2008 and 2017, while adult usage grew from 10.4% to 15.3%.

Who Gets Help? The Demographics and Determinants of CUD Treatment

So, of those that received help, what does the demographic look like?   In the study, the following were found to be consistent predictors of CUD treatment:

• Receiving mental health treatment in the past year
• Involvement in community supervision (parole or probation)
• Older age (especially 35 and up)
• Holding non-traditional insurance plans (neither public nor private)

Interestingly, while race and ethnicity showed significance in earlier years, particularly for Hispanics, these disparities diminished by 2019, indicating potential progress in equitable access.

Why People Avoid Treatment: The Growing List of Barriers

Perhaps more revealing were the reasons individuals gave for not pursuing treatment.  In 2019, the top barriers included:

Notably, these figures have grown significantly over time.  In 2003, only 8% said they didn’t know where to go, and just 6% feared job repercussions.  The rising stigma, or perhaps fear of stigma, suggests that there could be a persisting failure on the part of public health services in communicating both the availability and benefits of treatment.

When Overuse Has Consequences: CUD and Colon Cancer Risks

In a recent piece, we looked at another study that underscored the need to provide better access to CUD treatments.  It was found in the study that individuals with CUD and colon cancer had a 30% higher risk of inpatient mortality compared to those without CUD.

These findings suggest that cannabis overuse may have physiological effects that impair recovery or complicate treatment, underscoring the need for early detection and intervention.

When people avoid treatment due to stigma or lack of awareness, the consequences can ripple far beyond cannabis itself.  This makes public health messaging, screening programs, and education campaigns about CUD even more essential, not just for mental and behavioral outcomes but also for broader physical health.

Final Thoughts: Bridging the Gap Between Use and Care

Cannabis can offer many excellent benefits when used appropriately. However, there are always cases of misuse. Unfortunately, the disconnect between cannabis use trends and treatment uptake has real consequences.  With only 6% of individuals with CUD actually seeking treatment and only 2% recognizing the need, it can be argued that there is a strong need to increase awareness, reduce stigma, and make services easier to access.  Encouragingly, the study notes a rise in people receiving treatment through mental health centers and self-help groups, underscoring the importance of diverse care channels.

The bottom line is that, as cannabis becomes more mainstream, so too must the infrastructure for recognizing and treating cannabis-related disorders.  The growing disconnect between cannabis normalization and low CUD treatment engagement is a warning sign.  It tells us that legalization alone does not solve the underlying health issues.  Rather, it is easy access, education, and proactive outreach that remain critical.

Studies Referenced:

^{1. Graves, B. D., Mowbray, O., Aletraris, L., & O’Shields, J. (2025). An analysis of 16-year trends in cannabis use disorder treatment: Predictors, barriers, and utilization patterns. Substance Use & Misuse. https://doi.org/10.1080/10826084.2025.2505773}