My daughter has become a published author! Her paper on Cannabis Use Disorders has been published in the Community Mental Health Journal and I’m so proud of her. It’s not exactly an easy read – far too many long words, references, dates and numbers for me to understand most of it, but I’m going to summarise some of it below because it’s an important study into Cannabis use in our young people and the serious associated outcomes.
From personal experience I’ve sadly seen too many young people affected with psychiatric disorders after using the high potency, extremely stinky skunk – there’s been lots about the increased use of it in the press of late – so how worried should we be?
As a highlight, she says:-
A recent meta-analysis estimated that approximately one in six young people who use cannabis develop Cannabis Use Disorder, a condition defined by the persistent use of cannabis despite significant distress or impairment in functioning with this rate rising to nearly one in three in those who use weekly.
Furthermore, cannabis use during adolescence is associated with increased risk for a spectrum of psychiatric disorders, including psychotic, mood, and substance use disorders, in a dose-dependent manner.
The most robust association exists between youth cannabis use and the development of psychotic disorders, particularly with frequent use of high-potency tetrahydrocannabinol (THC) strains.
If you’re interested in reading it in full, you can click on the title below:-
Cannabis is the third most commonly used psychoactive substance globally, following alcohol and tobacco. In 2019, an estimated 200 million individuals aged 15–64 reported using cannabis at least once, with usage rates peaking among youth aged 15–16.
Over the past decade, the legal and cultural landscapes surrounding cannabis have shifted significantly, with over 20 countries legalising its medical use and numerous others decriminalising recreational consumption.
These regulatory changes have coincided with a decline in the perceived risks associated with cannabis use, particularly among youth.
This trend is particularly concerning, as youth—typically defined as individuals aged 10–19—may be more susceptible to the adverse consequences of cannabis use compared to adults (World Health Organisation 2019).
Empirical evidence links youth cannabis use to a range of short- and long-term negative outcomes, including respiratory problems, diminished educational attainment and reduced life satisfaction.
Furthermore, cannabis use during adolescence is associated with increased risk for a spectrum of psychiatric disorders, including psychotic, mood, and substance use disorders, in a dose-dependent manner.
The most robust association exists between youth cannabis use and the development of psychotic disorders, particularly with frequent use of high-potency tetrahydrocannabinol (THC) strains.
Additionally, a recent meta-analysis found a modest but significant association between youth cannabis use and increased risk of depression, self-harm, and suicidal behaviours.
The frequency and intensity of cannabis use further compound these risks. Early initiation and regular use have been consistently linked with the development of cannabis use disorder (CUD), a condition defined by the persistent use of cannabis despite significant distress or impairment in functioning. A recent meta-analysis estimated that approximately one in six young people who use cannabis develop CUD, with this rate rising to nearly one in three in those who use weekly.
Given the high prevalence of cannabis use and the serious associated outcomes among youth, there is a pressing need for reliable and valid screening tools to identify problematic cannabis use in this population. Effective screening instruments enable clinicians to detect harmful patterns of use, assess severity, and monitor treatment outcomes. While several tools exist for adult populations, relatively little research has focused on the development or validation of such instruments for youth.
One of the most widely used screening instruments for cannabis use among adults is the Cannabis Use Disorders Identification Test-Revised (CUDIT-R; Adamson et al 2010). This eight-item, self-report questionnaire assesses problematic cannabis use over the past six months, capturing domains such as consumption, dependence, and psychological consequences. Responses are scored on a five-point Likert scale, with total scores ranging from 0 to 32. Higher scores indicate more severe use, and specific cut-offs are used to guide further assessment (Adamson et al. 2010)
To date, no studies have evaluated the psychometric properties of the CUDIT-R in a purely youth sample. The present study aims to address this gap by examining the validity and reliability of the CUDIT-R in a clinical youth population with a history of cannabis use. We hypothesised that the CUDIT-R would demonstrate good psychometric performance and retain the unidimensional structure established in adult samples.
What is CUDIT-R?
The Cannabis Use Disorders Identification Test–Revised (CUDIT-R) is an eight-item screening tool designed to identify problematic cannabis use. The present study intended to assess the psychometric properties of the measure in a youth sample. N = 76 participants completed the CUDIT-R and a measure of cannabis consumption. All participants underwent an assessment for a current cannabis use disorder using the Structured Clinical Interview for DSM-IV. The CUDIT-R exhibited good internal consistency (Cronbach’s α = 0.76) and concurrent validity with a cannabis consumption measure. Discriminant validity was demonstrated with an area under the ROC curve of 0.96. The CUDIT-R proved to be a reliable and valid screening tool amongst youth with heavy cannabis use, which suggests the scale has clinical utility.
The Method, Design, Sample, Procedure, Data Analysis and Results make very little sense to me, so I’m leaving them out. If you’re interested then you can click on the link to the full paper at the top of this post.
Discussion
The present study aimed to assess the applicability of the Cannabis Use Disorders Identification Test-Revised (CUDIT-R) within a youth clinical sample characterised by high levels of cannabis use. Findings suggest the measure may not function identically in youth as it does in adults. While the one-factor structure found in adult samples showed adequate fit, item 8 (“considering cutting down use”) did not load as expected, indicating differing performance in this younger cohort. Although internal consistency was acceptable (Cronbach’s α = 0.76), the single-factor solution explained only 42.5% of the shared variance.
Despite these limitations, this study provides the first published evidence supporting the use of the CUDIT-R in an youth clinical sample. The scale effectively distinguished those with cannabis dependence and demonstrates clinical utility in identifying problematic use. Its brevity, ease of administration, and straightforward scoring make it a practical tool in busy clinical environments. Although screening tools are not substitutes for comprehensive assessment, the CUDIT-R can support clinicians in identifying CUDs among youth, much as it has been used in adult populations (Adamson et al.2010). It may also inform treatment intensity and monitor outcomes, although this requires further validation.
Conclusion
In conclusion, this study offers initial support for the use of the CUDIT-R in youth clinical settings but suggests caution when interpreting results, particularly regarding motivation-related items. Further research in larger and more diverse youth samples is essential to evaluate and potentially refine the scale for this population.
