Australia
Evaluation of diagnostic criteria for cannabis use disorder in prescribed patients
This Australian survey study of 2,054 medical cannabis patients compared standard diagnostic criteria for cannabis use disorder against a modified framework excluding tolerance and withdrawal. Applying the modified criteria to patients using cannabis strictly as prescribed significantly reduced diagnosed disorder rates compared to standard measures. A key limitation is the reliance on self-reported data from an anonymous online survey.
- Standard diagnostic criteria may overestimate cannabis use disorder rates in patients adhering to their prescriptions.
- Modified diagnostic criteria reduced the diagnosed rate from twenty percent to nine percent in compliant patients.
- Over half of the surveyed Australian patients reported using medical cannabis in ways not prescribed.
Our view
Applying criteria designed for illicit use to people taking a prescribed medicine produced a diagnosis rate more than twice as high as criteria that exclude tolerance and withdrawal — 20 per cent against 9 per cent in the same patients. Tolerance and withdrawal are expected pharmacological responses to many prescribed medicines and, on their own, are not evidence of a disorder. The distinction matters for how prescribers monitor patients and for how patients are perceived. It is worth noting alongside this that just over half of those surveyed used cannabis outside their prescription, which is an adherence problem that better diagnostic criteria do not solve.
Sources
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