Marijuana and Cannabis Use Disorder Treatment

Cannabis use disorder is a medical pattern of harm, not a moral label, and it is treatable. Most people who use cannabis do not develop a use disorder. Some do. There is no FDA-approved medication for the disorder or for cannabis withdrawal. Behavioral therapies help many people cut back or stop.

If someone has severe vomiting, chest pain, trouble breathing, or will not wake, call 911. For a mental health crisis, call or text 988.

How common is cannabis use disorder?

SAMHSA's 2023 National Survey on Drug Use and Health estimated that 61.8 million people aged 12 or older used marijuana in the past year, and that 19.2 million had a past-year marijuana use disorder. Among people with that disorder, most had a mild form; about one in five had a severe form.

NIDA cites studies estimating that 22 percent to 30 percent of people who use cannabis meet criteria for the disorder. How often someone uses is the strongest predictor NIDA names. Family history and how long use has gone on also matter. Between 1995 and 2022, average delta-9 THC in cannabis seized by law enforcement rose from about 4 percent to about 16 percent. Flower and concentrates sold in dispensaries can be far stronger. Higher THC concentrations have been linked to a greater chance that use progresses to a use disorder. Strength is a health fact, not a character score.

Legal status and a use disorder are different questions. State sales rules are not mapped on this page. NIDA defines the disorder by harm and loss of control, not by whether a shop sold the product. The FDA has not approved whole-plant cannabis as a medicine. A prescribed cannabinoid product approved for a specific condition is a different category. Do not stop a prescribed medicine on your own.

What the pattern looks like

Cannabis use disorder is diagnosed when a person meets two or more criteria in a 12-month period, such as using more than intended, craving, continuing despite problems at work or home, giving up activities, needing more for the same effect, or withdrawal. Two or three symptoms is mild. Four or five is moderate. Six or more is severe. Only a clinician can place someone on that scale.

A pattern that already includes failed attempts to cut down, or use that is costing a job or a relationship, is a reason to ask for an assessment. It is not a reason to wait for a worse version of the same year. For a deeper walk through symptoms and when care helps, see treatment for cannabis use disorder.

Medications: what does not exist yet

There is no FDA-approved medication for cannabis use disorder or for medically assisted cannabis withdrawal. NIDA states that clearly, and research continues. A clinic should not hand someone a pill and call it an approved cannabis medicine. SAMHSA's quality checklist says programs should provide only FDA-approved medication for alcohol, tobacco, or opioid use, and notes that no FDA-approved medicine prevents a return to other substances such as methamphetamine and cocaine. Cannabis belongs with the group that has no approved medicine for the use disorder itself.

That does not mean nothing helps. It means the evidence base today is behavioral, and that any medicine a clinician uses is for co-occurring problems (sleep, anxiety, depression) rather than as a named cannabis treatment. Do not borrow someone else's prescription.

Behavioral therapies that have evidence

NIDA lists three behavioral approaches with evidence for cannabis use disorder:

• Cognitive behavioral therapy (CBT) helps people notice and handle the situations where they are most likely to use, and build coping skills for craving and stress.
• Motivational enhancement therapy (MET) works with the person's own reasons for change rather than arguing them into readiness.
• Contingency management (CM) uses rewards or privileges for specific goals, such as attending sessions or providing negative drug tests.

None of these guarantees a result. A clinician matches the approach to the person's pattern of use and to medical, mental, and social problems around it. Care can be outpatient counseling, intensive outpatient, or residential when the pattern is severe or home is not safe for stopping. Levels of care are described below.

Will withdrawal be difficult?

It can be. NIDA says withdrawal can follow a stop or a sharp cut in heavy or long-term use, even without a cannabis use disorder diagnosis. One study NIDA cites estimated withdrawal in about 12 percent of people who use cannabis frequently. That percentage is not a prediction for you.

Symptoms NIDA lists include anger, irritability, aggression, nervousness, restlessness, lower appetite or weight, depression, insomnia, strange dreams, headaches, sweating, abdominal pain, and tremor. Not every person gets every item. Knowing the list can keep someone from deciding, on day two, that they need cannabis to be a functional person. The list is not a home treatment plan.

Tell a clinician if sleep, mood, or appetite got markedly worse after a cut. Do not also stop alcohol or a benzodiazepine on your own. Those withdrawals can be dangerous. More detail is in marijuana withdrawal basics.

If the mood includes thoughts of suicide, call or text 988. If vomiting will not stop, breathing is hard, or someone will not wake, call 911.

Cannabinoid hyperemesis syndrome

NIDA describes cannabinoid hyperemesis syndrome (CHS) as repeated nausea, vomiting, and abdominal pain after long-term, heavy cannabis use. People sometimes stand in a hot shower for temporary relief. The syndrome resolves when cannabis stops completely, and it often needs medical attention. That is a clinical stopping point, not a lecture about willpower.

Severe vomiting, confusion, or an inability to keep fluids down belongs in emergency care. Call 911.

Teens, pregnancy, and dual diagnosis

Adolescents are a special case because the brain is still developing. NIDA says regular heavy use in the teen years is associated with problems in working memory, processing speed, and school functioning. Family-based care and confidentiality rules differ from adult care. See teens and young adults.

Pregnancy is another. NIDA reports that the American College of Obstetricians and Gynecologists recommends clinicians counsel patients not to use cannabis while trying to become pregnant, during pregnancy, or while breastfeeding. Research it cites has linked prenatal exposure with lower birth weight and preterm birth. Do not stop a prescribed medicine, or start cannabis for nausea, without the obstetric clinician. See rehab during pregnancy.

Cannabis use often overlaps with anxiety, depression, or other mental health conditions. Some evidence links use with earlier psychosis in people who already have genetic risk, and with worse symptoms in people who already have a psychotic disorder. Care that addresses both substance use and mental health is covered in dual-diagnosis treatment.

Levels of care and how to find help

Treatment is matched to the person. Options include:

• Outpatient counseling (CBT, MET, and related therapies)
• Intensive outpatient programs
• Partial hospitalization
• Residential treatment when home is not safe for stopping or the pattern is severe
• Ongoing recovery support, including mutual-help groups

Cannabis withdrawal is usually managed without a hospital detox unit, but medical evaluation still matters when symptoms are severe, when CHS is present, or when the person also uses alcohol, opioids, or benzodiazepines. Medically supervised withdrawal for those other substances is a different decision. See detox and IOP.

Use SAMHSA's FindTreatment.gov locator to search by ZIP code or service type, or call the SAMHSA National Helpline at 1-800-662-HELP (4357), which is free, confidential, and open 24/7.

To talk through options with someone who can help match level of care and insurance questions, call or text (800) 653-9376 or use the form below. We are a free information and referral service. We do not provide treatment ourselves.

Reaching out is a reasonable first step, and you do not have to have a plan before you call.

Frequently asked questions