International Aspects of CUD

Cannabis is the most prevalent illicit drug used around the world even while several countries have legalized recreational and medical use. This has led to increases in use, particularly among populations where prevalence has been generally low, for example, the elderly, and people with medical problems. With growing global use comes concern regarding problematic use and ways to prevent and treat it. This chapter attempts to summarize the epidemiology of cannabis use in most large areas of the world where data exist and what is known and not known regarding the incidence and prevalence of problematic cannabis use. Importantly, the chapter recognizes the need for continuous, systematic collection of standardized data that will improve knowledge about attitudes and risk perceptions, the nature and extent of cannabis use, and cannabis-related health, social, and economic consequences. Information about cannabis use in Africa; Asia, the Near East, and the Middle East; Europe; Oceania; and the Western Hemisphere provides regional perspectives and highlights geographical areas where data are scarce. The different approaches of the two primary international diagnostic guidelines for substance use disorders—the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) from the American Psychiatric Association and the International Classification of Diseases (ICD-11) currently under development by the World Health Organization (WHO)—may contribute to international variations in defining cannabis use disorders and setting treatment priorities. Additionally, evidence-based prevention and treatment options, the global burden of disease attributed to cannabis use, and the impact of decreased perception of risk associated with cannabis use are summarized.