Cannabis Use Disorder Climbs 20% as Alcohol Disorder Declines in U.S.

Federal Data Shows Cannabis Disorder Outpacing All Substances

Cannabis use disorder now affects an estimated 16.3 million Americans, up from 13.6 million in 2022. The Substance Abuse and Mental Health Services Administration released the figures in its National Survey on Drug Use and Health annual report. Alcohol use disorder fell to 28.1 million cases from 30.5 million over the same window.

The reversal marks a significant shift in the nation's substance-use picture. Alcohol disorder rates held steady or rose slightly for three decades. Cannabis disorder remained relatively flat. That pattern broke in 2023 as legal cannabis markets expanded to 24 states and medical programs reached 38 jurisdictions.

Youth and Young-Adult Rates Drive the Increase

Americans aged 18 to 25 account for 41% of new cannabis use disorder cases, the highest concentration in any age bracket. The disorder is defined by the DSM-5 as continued use despite clinically significant impairment, including tolerance, withdrawal, and failure to meet major obligations.

Adolescent rates also climbed. Among 12- to 17-year-olds, cannabis disorder prevalence rose from 2.1% in 2022 to 2.9% in 2025. That's roughly 720,000 teenagers meeting diagnostic criteria, up from 520,000 three years earlier.

Potency and Concentrate Use Linked to Higher Risk

Products with THC concentrations above 20% showed a 2.4-times higher association with disorder onset compared to flower below 15% THC. Concentrates, vapes, and edibles now represent 38% of total cannabis sales in legal markets, up from 22% in 2020. High-potency formats have surged in tandem with the disorder spike.

Researchers at the National Institute on Drug Abuse noted that daily or near-daily use is the strongest predictor of dependence. It's common among concentrate consumers. Roughly 30% of regular cannabis users meet criteria for the disorder, a rate comparable to opioid misuse and higher than cocaine.

Alcohol Disorder Declines Slowly Across Most Demographics

Alcohol use disorder fell 8% nationally, with the steepest declines among adults aged 26 to 34. Public-health officials attribute the drop to reduced binge-drinking rates, stricter DUI enforcement, and cultural shifts toward moderation. Alcohol still affects nearly twice as many Americans as cannabis, but the gap is narrowing faster than projected.

The decline wasn't uniform. Rural counties in the Southeast and Midwest saw alcohol disorder rates hold steady or rise slightly, while urban centers on the coasts recorded double-digit drops. For context on broader substance trends, see the CannIntel topic hub on Cannabis Use Disorder.

Treatment Access Lags Behind Rising Cannabis Disorder Cases

Only 9.2% of individuals with cannabis use disorder received treatment in 2025, compared to 14.1% of those with alcohol disorder. The gap reflects both stigma and infrastructure. Most states lack dedicated cannabis-disorder programs. Insurance reimbursement for cannabis-related treatment remains inconsistent.

Cognitive-behavioral therapy and contingency management show the strongest evidence for cannabis disorder, but few providers are trained in these protocols. The American Society of Addiction Medicine called for expanded training and state-level funding in a statement accompanying the data release.

What Growers and Operators Should Watch

Regulators in California, Colorado, and Washington are drafting potency caps and mandatory health warnings in response to the disorder data. The caps range from 15% to 30% THC depending on product category. Industry groups argue the limits will push consumers to illicit markets. Public-health advocates cite the disorder statistics as justification.

We're watching three variables this fall: state-level potency regulations, federal rescheduling timelines, and whether SAMHSA revises its disorder screening tools to account for concentrate use. The next federal survey drops in February 2027.