Gender differences in cannabis use disorders: results from the National Epidemiologic Survey of Alcohol and Related Conditions.

Background: To examine gender differences among individuals diagnosed with DSM-IV lifetime cannabis use disorder (CUD).

Methods: A nationally representative sample of U.S. adults aged 18 years or older that were diagnosed with lifetime CUD (n=3297): Men (n=2080), Women (n=1217). Data were drawn from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, n=43,093). The survey response rate was 81%.

Results: Nearly all individuals with CUD had a psychiatric comorbidity (95.6% of men, 94.1% of women). Men with lifetime CUD were more likely than women to be diagnosed with any psychiatric disorder, any substance use disorder and antisocial personality disorder, whereas women with CUD had more mood and anxiety disorders. After adjusting for gender differences in sociodemographic correlates and the prevalence of psychiatric disorders in the general population, women with CUD were at greater risk for externalizing disorders. Men with CUD met more criteria for cannabis abuse, had longer episodes of CUD, smoked more joints, and were older at remission when compared to women with CUD. Women experienced telescoping to CUD. Treatment-seeking rates were very low for both genders, and there were no gender differences in types of services used or reasons for not seeking treatment.

Conclusions: There are important gender differences in the clinical characteristics and psychiatric comorbidities among individuals with CUD.