More than one-fifth of people who use cannabis struggle with dependency or problematic use, according to a study published on Tuesday in The Journal of the American Medical Association Network Open.

The research found that 21 percent of people in the study had some degree of cannabis use disorder, which clinicians characterize broadly as problematic use of cannabis that leads to a variety of symptoms, such as recurrent social and occupational problems, indicating impairment and distress. In the study, 6.5 percent of users suffered moderate to severe disorder.

Cannabis users who experience more severe dependency tended to be recreational users, whereas less severe but still problematic use was associated roughly equally with medical and recreational use. The most common symptoms among both groups were increased tolerance, craving, and uncontrolled escalation of cannabis use.

Cannabis use is rising nationwide as more states have legalized it. The new findings align with prior research, which has found that around 20 percent of cannabis users develop cannabis use disorder. The condition can be treated with detoxification and abstinence, therapies and other treatments that work with addictive behaviors.

The new study drew its data from nearly 1,500 primary care patients in Washington State, where recreational use is legal, in an effort to explore the prevalence of cannabis use disorder among both medical and nonmedical users. The research found that 42 percent of cannabis users identified themselves solely as medical users; 25 percent identified as nonmedical users, and 32 percent identified as both recreational and medical users.

“The results here underscore the importance of assessing patient cannabis use and CUD symptoms in medical settings,” the study concluded. That finding is consistent with prior research that urged people to learn about the risks of developing cannabis use disorder, particularly “among those who initiate early and use frequently during adolescence.”

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