How Do You Know If You Have Cannabis Use Disorder If You Use It For Therapeutic Purposes?

As marijuana use continues to rise along with a national legalization trend, the Centers for Disease Control and Prevention warns that estimates reveal every 3 in 10 people who consume it have cannabis use disorder.

The question is – how is cannabis use disorder diagnosed?

Oftentimes, not accurately, according to Tammy Chung, director of Rutgers Center for Population Behavioral Health and Health Care Policy and Aging Research. Chung and colleagues Marc Steinberg of Robert Wood Johnson Medical School and Mary Barna Bridgeman of the Ernest Mario School of Pharmacy are urging clarification, especially for medical marijuana patients, writes MedicalExpress. They published a commentary on the issue in JAMA Psychiatry.

Diagnosing Challenges: 2 Out Of 11

According to Chung, one of the challenges with wide medical marijuana (MMJ) legalization in combination with the manual used to define substance use disorder, which was developed before so many states embraced cannabis use for therapeutic purposes.

With MMJ being recommended not prescribed, difficulties include dosing, consumption methods, lack of dosing guidelines for certain diagnoses and stricter regulation of marijuana products, among others.

“The manual's diagnosis of cannabis use disorder requires an individual to meet only two or more of 11 criteria. These criteria might include only increased tolerance for cannabis and withdrawal symptoms, which are commonly reported by individuals who use cannabis for therapeutic reasons,” Chung said. 

Chung explains that people who confirm two criteria could be diagnosed with having a cannabis use disorder, even though these two symptoms alone may not indicate problematic use. 

She proposes a model where tolerance to marijuana effect and withdrawal symptoms can’t be taken as only two criteria for diagnosis. However, Chung suggests if two or more other symptoms like trouble quitting or consuming it in a dangerous situation (such as driving while feeling the effects), then the standard model of diagnosing can be used. 

How To Avoid Misdiagnosis?

“Our suggested model is based on the one used to diagnose substance use disorder in an individual who has been prescribed medication, such as opioids or sedatives,” Chung said.

She added that the current manual relies on different guidelines for diagnosing substance use disorder for prescription medication and for an illicit substance. Chung suggests a similar approach to avoid misdiagnosis among people who use marijuana for medical purposes under medical supervision. 

“Misdiagnosis, particularly overdiagnosis, represents a medical error with stigmatizing consequences for an individual,” Chung said, highlighting the importance of changing the manual. 

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