Is my cannabis use a problem?

What your CUDIT-R score means

The CUDIT-R has eight questions covering four areas: how much and how often you use, the problems use has caused, signs of dependence, and how you feel about your own use. Seven items score 0 to 4 and the last scores 0, 2 or 4, for a total between 0 and 32.

The cut-offs come from the instrument’s validation study, which tested it against a structured diagnostic interview. In that sample a score of 12 or more identified people with a current cannabis use disorder with 91% sensitivity and 90% specificity. That is good for an eight-question screen — and it still means the screen gets some people wrong in both directions.

A screen is not a diagnosis

Cannabis use disorder is a real diagnosis in the DSM-5. It is made when at least two of eleven criteria are present within a twelve-month period: things like using more or for longer than intended, repeated unsuccessful attempts to cut down, spending a great deal of time obtaining or recovering from use, cravings, use interfering with work or home or school, continued use despite it causing problems, giving up other activities, using in hazardous situations, tolerance, and withdrawal. Two or three criteria is mild; four or five is moderate; six or more is severe.

The CUDIT-R touches many of those criteria but doesn’t establish any of them. A high score is a reason to talk to someone. A low score is information, not a clean bill of health — especially if you were answering about a “good” six months.

It’s legal in Illinois. Can it still be a problem?

Yes. Illinois legalized adult-use cannabis on January 1, 2020, and dispensaries are now an ordinary part of the Chicago streetscape. Legality changed access, price, potency and how people talk about it. It didn’t change how the drug interacts with a brain that has learned to rely on it.

Two numbers are worth sitting with. The CDC estimates that about 3 in 10 people who use cannabis have cannabis use disorder, with higher risk for people who started young or use frequently. And a 2024 analysis of national survey data found that in 2022, for the first time, more Americans reported daily or near-daily cannabis use (17.7 million) than daily or near-daily drinking (14.7 million). People who used cannabis in the past month were almost four times as likely as drinkers to be using daily or near-daily — 42% versus 11%.

Today’s products are also not what most people picture. Flower routinely tests above 20% THC; concentrates, vapes and dabs run far higher; edibles delay the effect in a way that makes dosing hard. Higher potency means tolerance builds faster and withdrawal is more noticeable — which is part of why “I’ll just stop for a while” turns out to be harder than expected.

Signs cannabis use has become a problem

The score above is one lens. Here is the other one — the things I actually listen for.

• It has become the first thing and the last thing: a wake-and-bake, or you can’t fall asleep without it.
• You’ve set limits — weekends only, not before work, a tolerance break — and they keep not holding.
• The amount it takes has crept up, and the effect has crept down.
• When you run out or can’t use, you’re irritable, anxious, restless, or can’t sleep.
• You’re using in situations where being high is genuinely risky — driving, at work, while responsible for kids.
• Memory, concentration or motivation are noticeably worse than they used to be, and you’ve started to suspect why.
• You’ve minimized how much you use to a partner, a doctor, or yourself.
• You’ve thought about cutting down more than once — and thinking about it is as far as it has gotten.

If several of these land, the score is telling you something even if it’s under 12.

What about stopping? Cannabis withdrawal is real

Cannabis withdrawal is recognized in the DSM-5. It is not medically dangerous the way alcohol withdrawal can be, and you don’t need medical supervision to stop. But it is real, and it is the reason a great many attempts to stop end on night three.

The usual pattern: irritability, anxiety, restlessness, trouble falling asleep, vivid or unpleasant dreams, low appetite and low mood, starting within a day or three of stopping, peaking in the first week, and mostly settling within two weeks. Sleep can take longer to come back. Knowing the timeline in advance changes what night three feels like — it becomes a symptom you expected rather than proof that you can’t do this.

If you drink as well, don’t assume the two behave the same way. Alcohol withdrawal can be dangerous, and heavy drinkers should not stop abruptly without medical guidance. The two often travel together, and it is worth taking the alcohol use test too if you’re not sure where your drinking sits.

When it’s worth talking to someone

Not everyone who scores in the hazardous range needs therapy. Plenty of people read a score of 9, recognize what it’s describing, and change something on their own. The people who benefit from talking to someone are usually the ones who have already tried that — more than once — and found that the reasons they use are stronger than the reasons they’ve given themselves to stop.

Treatment for cannabis use disorder is talk-based. There is no FDA-approved medication for it. The approaches with the best evidence are cognitive behavioral therapy, motivational enhancement therapy, and contingency management, usually in combination. In practice that means understanding what cannabis is doing for you — sleep, anxiety, boredom, the transition out of the workday — and building something else that does that job, while getting through the first weeks with a plan rather than willpower.

I work with adults in Chicago in person and online throughout Illinois and Minnesota. Cannabis is often not the only thing on the table when someone reaches out — it travels with drinking, with anxiety, with sports betting, with a life that feels stalled — and that is fine. Start with what you can name.

About the CUDIT-R

The Cannabis Use Disorders Identification Test – Revised was developed by Simon Adamson and colleagues as a shorter, better-performing revision of the original CUDIT, itself modeled on the World Health Organization’s AUDIT for alcohol. It is freely available for clinical and research use. The eight questions and their response options on this page are the published instrument, unchanged; the introduction, the explanations, and the ranges’ wording are mine.

Adamson, S. J., Kay-Lambkin, F. J., Baker, A. L., Lewin, T. J., Thornton, L., Kelly, B. J., & Sellman, J. D. (2010). An improved brief measure of cannabis misuse: The Cannabis Use Disorders Identification Test–Revised (CUDIT-R). Drug and Alcohol Dependence, 110(1–2), 137–143. · Caulkins, J. P. (2024). Changes in self-reported cannabis use in the United States from 1979 to 2022. Addiction. · Centers for Disease Control and Prevention, Understanding Your Risk for Cannabis Use Disorder. · American Psychiatric Association, DSM-5-TR.