Context Among illicit substance use disorders, marijuana use disorders are the
most prevalent in the population. Yet, information about the prevalence of
current Diagnostic and Statistical Manual of Mental Disorders,
Fourth Edition (DSM-IV) marijuana use disorders
and how prevalence has changed is lacking.
Objective To examine changes in the prevalence of marijuana use, abuse, and dependence
in the United States between 1991-1992 and 2001-2002.
Design, Setting, and Participants Face-to-face interviews were conducted in 2 large national surveys conducted
10 years apart: the 1991-1992 National Longitudinal Alcohol Epidemiologic
Survey ([NLAES] n = 42 862) and the 2001-2002 National Epidemiologic
Survey on Alcohol and Related Conditions ([NESARC] n = 43 093).
Main Outcome Measures Rates of past year marijuana use, abuse, and dependence.
Results Among the adult US population, the prevalence of marijuana use remained
stable at about 4.0% over the past decade. In contrast, the prevalence of DSM-IV marijuana abuse or dependence significantly (P = .01) increased between 1991-1992 (1.2%) and 2001-2002
(1.5%), with the greatest increases observed among young black men and women
(P<.001) and young Hispanic men (P = .006). Further, marijuana use disorders among marijuana users significantly
increased (P = .002) in the absence of increased
frequency and quantity of marijuana use, suggesting that the concomitant increase
in potency of delta-9-tetrahydrocannabinol (Δ9-THC) may have
contributed to the rising rates.
Conclusions Despite the stability in the overall prevalence of marijuana use, more
adults in the United States had a marijuana use disorder in 2001-2002 than
in 1991-1992. Increases in the prevalence of marijuana use disorders were
most notable among young black men and women and young Hispanic men. Although
rates of marijuana abuse and dependence did not increase among young white
men and women, their rates have remained high. The results of this study underscore
the need to develop and implement new prevention and intervention programs
targeted at youth, particularly minority youth.