"The issues of measurement and conceptualization described above in relation to efforts to screen for problematic or harmful cannabis use highlight the shortcomings of ‘one-size-fits-all’ approaches to screening.
"Illicit drug use disorder is defined as meeting DSM-IV criteria for either dependence or abuse for one or more of the following illicit drugs: marijuana, cocaine, heroin, hallucinogens, inhalants, methamphetamine, or prescription psychotherapeutic drugs that were misused (i.e., pain relievers, tranquilizers, stimulants, and sedatives). There are seven possible dependence criteria for specific illicit drugs:
"1. spent a lot of time engaging in activities related to use of the drug,
"2. used the drug in greater quantities or for a longer time than intended,
Alternative Analysis of the Relative Risk from MDMA Use: "Nutt et al. (2007) attempted to compare the relative dangers of the main types of psychosocial drug, using a series of subjective rating scales. Heroin and cocaine were graded as the two most harmful drugs, whereas Ecstasy/MDMA emerged as one of the least harmful (18th out of 20). Unfortunately, it was unclear how this low harm rating score for Ecstasy/MDMA was given, as they cited no empirical research studies or reviews. Instead, Nutt et al.
Probability of Transition From First Use to Dependence For Various Substances: "In a large, nationally representative sample of US adults, the cumulative probability of transition to dependence was highest for nicotine users, followed by cocaine users, alcohol users and, lastly, cannabis users. The transition to cannabis or cocaine dependence occurred faster than the transition to nicotine or alcohol dependence. Furthermore, there were important variations in the probability of becoming dependent across the different racial-ethnic groups.
Criteria for Defining Substance Dependence: "The 1988 Surgeon General’s report lists the following general 'criteria for drug dependence,' including nicotine dependence (USDHHS 1988, p. 7): "Primary Criteria "• Highly controlled or compulsive use "• Psychoactive effects "• Drug-reinforced behavior "Additional Criteria "• Addictive behavior, often involves: "– stereotypic patterns of use "– use despite harmful effects "– relapse following abstinence "– recurrent drug cravings "• Dependence-producing drugs often produce:
Estimated Prevalence of Cannabis Dependence: "Some 4.3 percent of Americans have been dependent on marijuana, as defined in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR; American Psychiatric Association, 2000), at some time in their lives. Marijuana produces dependence less readily than most other illicit drugs. Some 9 percent of those who try marijuana develop dependence compared to, for example, 15 percent of people who try cocaine and 24 percent of those who try heroin. However, because so many people use marijuana, cannabis dependence is twice as prevalent as dependence on any other illicit psychoactive substance (cocaine, 1.8 percent; heroin, 0.7 percent; Anthony and Helzer, 1991; Anthony, Warner, and Kessler, 1994)."
Social Determinants and Substance Use: There is strong evidence of an association between social determinants—such as unemployment, homelessness, poverty, and family breakdown—and drug use. Socio-economic status has been associated with drug-related harms such as foetal alcohol syndrome, alcohol and other drug disorders, hospital admissions due to diagnoses related to alcoholism, lung cancer, drug overdoses and alcohol-related assault.
Admissions to Treatment for Marijuana in the US: According to the federal Treatment Episode Data Set, in 2014 there were 247,461 admissions to treatment with marijuana reported as the primary substance of abuse out of the total 1,614,358 admissions to treatment in the US for those aged 12 and older for all substances that year. This is the lowest number of marijuana admissions and total treatment admissions in at least a decade: marijuana admissions peaked in 2009 at 373,257, and total admissions peaked in 2008 at 2,076,291.
Teen Drug Use and Risk of Future Addiction Disorder: "Teen users are at significantly higher risk of developing an addictive disorder compared to adults, and the earlier they began using, the higher their risk. Nine out of 10 people who meet the clinical criteria for substance use disorders involving nicotine, alcohol or other drugs began smoking, drinking or using other drugs before they turned 18. People who begin using any addictive substance before age 15 are six and a half times as likely to develop a substance use disorder as those who delay use until age 21 or older (28.1 percent vs. 4.3 percent)."
"Early Drug Exposure and Later Drug Use: "The teen brain is a work in progress, making it more vulnerable than the mature brain to the physical effects of drugs. The potential for developing substance abuse and dependence is substantially greater when an individual’s first exposure to alcohol, nicotine and illicit drugs occurs during adolescence than in adulthood."