| Journal | Drug and alcohol dependence |
| Study Type | Randomized Trial |
| Population | Human participants |
This systematic review exposes a critical gap in cannabis use disorder research representation that directly impacts clinical care equity. With people of color experiencing higher CUD prevalence and severity yet being dramatically underrepresented in treatment trials, we lack evidence-based interventions tailored to the populations most affected.
Researchers systematically reviewed 14 behavioral health RCTs for cannabis use disorder conducted in the US from 1994-2025, analyzing racial representation and cultural adaptation. White participants comprised 64% of study populations despite representing a much smaller proportion of actual CUD cases – included at rates 49 times greater than their disease burden would suggest. Black participants made up 19% of study populations, Latiné participants 5%, with other racial groups representing less than 1% each. Notably, zero studies incorporated culturally adapted interventions despite evidence that people of color face unique CUD-related challenges including racial discrimination.
“This research highlights a fundamental problem I see repeatedly – our treatment evidence base doesn’t reflect the patients who need it most. When the populations with highest CUD burden are systematically excluded from trials, we’re essentially practicing medicine based on incomplete data.”
💬 Join the Conversation
Have a question about how this applies to your situation? Ask Dr. Caplan →
Want to discuss this topic with other patients and caregivers? Join the forum discussion →
Have thoughts on this? Share it:
FAQ
Are people of color adequately represented in cannabis use disorder treatment research?
No, this systematic review found significant underrepresentation of people of color in CUD behavioral health research. White people comprised ~64% of participants and were included at rates 49 times greater than their actual share of CUD cases, while Black people represented only ~19%, and other racial/ethnic groups had even lower representation rates.
Do people of color experience cannabis use disorder differently than White individuals?
Yes, several groups of people of color have higher prevalence rates and more severe cases of cannabis use disorder compared to White people. They also face unique challenges such as racial discrimination, which research has linked to an increased likelihood of developing CUD.
Are current CUD treatments culturally adapted for diverse populations?
No, this review found that none of the 14 identified CUD behavioral health randomized controlled trials were culturally adapted for people of color. This represents a significant gap in treatment development despite the unique challenges faced by these populations.
How many high-quality CUD treatment studies have been conducted in the US?
Only 14 out of 966 studies met criteria for CUD behavioral health randomized controlled trials implemented in the United States for adults from 1994 to 2025. This small number highlights the limited evidence base for CUD behavioral interventions, particularly for diverse populations.
What are the clinical implications of this research gap for treating CUD in diverse populations?
The lack of culturally adapted interventions and underrepresentation in research means current CUD treatments may not be optimally effective for people of color who experience higher prevalence and severity. Clinicians should be aware of these limitations and advocate for more inclusive, culturally responsive treatment approaches.
