As Drinking Problems Hold Steady, Cannabis Addiction Climbs Across Nearly Every Age Group

Serious cannabis addiction became more common among US adults between 2021 and 2024, and it spread in a way that cuts against the usual warnings. A new national analysis found the fastest increases not among teenagers and college students, but among adults in their late thirties and forties and among men past fifty. Over the same four years, serious alcohol addiction held flat or declined. Two of the country’s most-used substances were moving in opposite directions.

The analysis came from Beth Han and colleagues at the National Institute on Drug Abuse, the federal agency that studies addiction, with the institute’s director, Nora Volkow, as senior author. Their raw material was the National Survey on Drug Use and Health, a yearly government count that asks a large, nationally representative sample of Americans about their drinking and drug use. The team pooled four years of it, then sorted the answers by age and sex to see whether the two disorders were tracking together or pulling apart. They pulled apart.

The survey doesn’t just ask whether someone uses cannabis or alcohol. It applies the standard psychiatric checklist, the same one a clinician would use, and counts symptoms: using more than intended, trying to cut back and failing, craving, letting the habit crowd out work or family. Four or more symptoms marks the disorder as moderate-to-severe, the level that generally warrants treatment. That distinction matters, because a mild disorder and a severe one are not the same clinical animal, and the study’s central finding is about the severe end.

Two Habits Moving in Opposite Directions

On that severe end, cannabis and alcohol split apart. Serious cannabis use disorder rose in men from roughly 3 to 4 cases per 100, and in women from under 2 to about 2.5 per 100. Serious drinking problems, by contrast, barely moved in most groups and declined in a few. The gap did not open because drinking got safer in any dramatic way. It opened because cannabis problems kept accumulating while alcohol problems held their ground.

The Steepest Climbs Were Not Among the Young

The intuitive guess would put the fastest growth among teenagers and college-age users. The data point elsewhere. The steepest increases in serious cannabis use disorder showed up among adults aged 35 to 49, of both sexes, and among men 50 and older. The single most dramatic shift was among women 50 and older, where serious cannabis use disorder rose about sevenfold. That figure deserves a cautious read: it climbed from a starting point so low that a small absolute rise produces a large multiple, and it is one of the least statistically precise numbers in the paper. The direction is clear; the exact size is not.

Younger adults were not spared, though. In 2024, among people aged 18 to 20, cannabis use disorder was more common than alcohol use disorder, even though more of them reported drinking than reported using cannabis. Put plainly, alcohol was the more popular substance but the less habit-forming one in this group. Among young adults who used cannabis, the share who met the criteria for a disorder was more than double the share of drinkers who met the criteria for an alcohol disorder.

The Backdrop: Stronger Product, Wider Access

None of this is happening in a vacuum. The cannabis on sale today is far stronger than the cannabis of a generation ago. According to the US Centers for Disease Control and Prevention, the average concentration of THC, the main intoxicating compound, nearly doubled over roughly a decade, and a comprehensive review of seized samples tracked mean THC rising from under 10 percent in 2009 to close to 15 percent by 2018. Clinicians have started calling the result a different drug from the one many parents remember. Higher potency, spreading legalization, and a growing sense that cannabis is harmless all move in the same direction the disorder numbers do.

The addiction risk itself is not new information, even if it is widely underestimated. A systematic review and meta-analysis found that among people who use cannabis, roughly a fifth to a third meet the criteria for a use disorder, with the risk higher for those who start young and use often. The authors put it bluntly. Their findings, they write in the study’s discussion, “repudiate conventional assumptions that cannabis carries a low addiction risk and that most young adults with CUD have mild symptoms,” using the abbreviation for cannabis use disorder. The size of the moderate-to-severe share among users who have a disorder is their main evidence.

Where the Evidence Stops

This is a snapshot, not a film. Because it is cross-sectional, it can show that cannabis problems rose alongside potency and legalization, but it cannot prove that one caused the other. It relies on self-report, so some use goes unmentioned. It leaves out people who are unsheltered or incarcerated, which likely undercounts the true burden. And the authors deliberately skipped a statistical correction usually applied when testing many comparisons at once, a reasonable choice for an exploratory look at trends, but one that means the borderline results should be read as leads rather than verdicts.

One practical gap sharpens the stakes. Treatment for cannabis use disorder has actually declined even as the disorder has spread, and unlike alcohol, cannabis has no medication approved by regulators to treat the disorder. The tools that exist are behavioral, and fewer people are reaching for them.

The authors read their numbers as a call for routine screening and earlier intervention, especially for the middle-aged and older adults their data flagged. Whether the sevenfold figure among older women holds up in future surveys is the open question. It sits on a small base, and the next few years of data will decide whether it was a signal or noise.

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