"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.
Addictive Properties of Drugs
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:
Cannabis and Addiction
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)."
According to the Substance Abuse and Mental Health Service's Treatment Episode Data Set, in 2015 in the US there were 213,001 admissions to treatment with marijuana reported as the primary substance of abuse out of the total 1,537,025 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 373,338, and total admissions peaked in 2008 at 2,074,974.
Estimated Prevalence of Substance Use Dependence or Addiction in the US by Race/Ethnicity, 2014, According to NSDUH: "Approximately 21.5 million people aged 12 or older in 2014 had SUDs [Substance Use Disorders] in the past year, including 17.0 million people with an alcohol use disorder and 7.1 million people with an illicit drug use disorder (Figure 30). An estimated 2.6 million people aged 12 or older had both an alcohol use disorder and an illicit drug use disorder in the past year.
Addictive Potential: "Of the people who sample a particular substance, what portion will become physiologically or psychologically dependent on the drug for some period of time? Heroin and methamphetamine are the most addictive by this measure. Cocaine, pentobarbital (a fast-acting sedative), nicotine and alcohol are next, followed by marijuana and possibly caffeine. Some hallucinogens—notably LSD, mescaline and psilocybin—have little or no potential for creating dependence."
Ranking of Substances by Potential for Harm: "Method: Members of the Independent Scientific Committee on Drugs, including two invited specialists, met in a 1-day interactive workshop to score 20 drugs on 16 criteria: nine related to the harms that a drug produces in the individual and seven to the harms to others. Drugs were scored out of 100 points, and the criteria were weighted to indicate their relative importance."