A new analysis of national survey data reveals that the way people use cannabis dramatically affects their risk of developing cannabis use disorder. Researchers examined data from 2022 to 2023, representing an estimated 58.9 million U.S. adults who used cannabis in the past year.
More than half of these users-53.9%-reported using multiple modes of cannabis, such as smoking, vaping, eating, and dabbing. The overall prevalence of cannabis use disorder was 30.3%, but rates varied sharply by mode. The lowest risk, at 4.4%, was among those who used oral or mucosal forms only. The highest risk, at 40.5%, was among those who used multiple modes.
Moderate-to-severe cannabis use disorder affected 13.2% of all users, concentrated among multimodal and dab-only users. After adjusting for demographic, behavioral, clinical, and policy factors, multimodal users had more than fourfold higher odds of cannabis use disorder compared with oral or mucosal-only users. Those who used smoke, vape, oral, and dab modes together faced nearly 20-fold higher odds.
The findings suggest that clinicians need to ask not only how often patients use cannabis, but how they use it. Inhaled routes and combined use appear to signal higher-risk patterns. The authors conclude that mode of cannabis use is statistically associated with both the prevalence and severity of cannabis use disorder in U.S. adults.