Psychosocial functioning among regular cannabis users with and without cannabis use disorder

Katherine T. Foster, Brooke J. Arterberry, William G. Iacono, Matt McGue, Brian M. Hicks

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


In the United States, cannabis accessibility has continued to rise as the perception of its harmfulness has decreased. Only about 30% of regular cannabis users develop cannabis use disorder (CUD), but it is unclear if individuals who use cannabis regularly without ever developing CUD experience notable psychosocial impairment across the lifespan. Therefore, psychosocial functioning was compared across regular cannabis users with or without CUD and a non-user control group during adolescence (age 17; early risk) and young adulthood (ages 18-25; peak CUD prevalence).Method Weekly cannabis users with CUD (n = 311), weekly users without CUD (n = 111), and non-users (n = 996) were identified in the Minnesota Twin Family Study. Groups were compared on alcohol and illicit drug use, psychiatric problems, personality, and social functioning at age 17 and from ages 18 to 25. Self-reported cannabis use and problem use were independently verified using co-twin informant report.Results In both adolescence and young adulthood, non-CUD users reported significantly higher levels of substance use problems and externalizing behaviors than non-users, but lower levels than CUD users. High agreement between self- and co-twin informant reports confirmed the validity of self-reported cannabis use problems.Conclusions Even in the absence of CUD, regular cannabis use was associated with psychosocial impairment in adolescence and young adulthood. However, regular users with CUD endorsed especially high psychiatric comorbidity and psychosocial impairment. The need for early prevention and intervention - regardless of CUD status - was highlighted by the presence of these patterns in adolescence.

Original languageEnglish (US)
Pages (from-to)1853-1861
Number of pages9
JournalPsychological medicine
Issue number11
StatePublished - Aug 1 2018

Bibliographical note

Publisher Copyright:
Copyright © Cambridge University Press 2017.


  • adolescence
  • adulthood
  • cannabis
  • cannabis use disorder
  • psychosocial functioning


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