Disparities in Treatment Outcomes for Cannabis Use Disorder Among Adolescents.

Background: This study examined treatment outcomes for cannabis use disorder (CUD) among adolescents (12-17 years old) in the United States. Methods: Data from the 2018-2021 Treatment Episode Data Set-Discharges (TEDS-D) included 40,054 adolescents diagnosed with CUD. Descriptive statistics, Chi-square tests, and multivariable logistic regression assessed treatment outcomes and factors associated with treatment completion. Results: Only 36.8% of adolescents completed treatment. The most common reasons for not completing treatment were dropping out (28.4%) and transferring to another facility/program (17.0%). Males and Black non-Hispanic adolescents had lower odds of completing treatment (OR = 0.79, 95%CI: 0.75-0.84), while Hispanic (OR = 1.13, 95%CI: 1.08-1.18), Asian (OR = 1.56, 95%CI: 1.3-1.86) and Native Hawaiian/Pacific Islander adolescents (OR = 2.31, 95%CI: 2.04-2.61) had higher odds of completion compared to their White counterparts. Independent living arrangements, homelessness, arrests in the past 30 days and younger age (<15 years old) decreased the likelihood of treatment completion. Adolescents with co-occurring mental health and substance use disorders also had lower completion rates (OR = 0.79, 95%CI: 0.77-0.86). Referral from schools/employers and treatment settings were associated with a higher success, particularly with stays of 4-6 months and 7-12 months. Conclusion: This study highlights the need for targeted CUD treatment programs that support at-risk adolescents, especially those experiencing homelessness or facing legal issues. High dropout and transition rates suggest a need for continuity of care and program integration between facilities. Strengthening coordination among public health officials, community organizations, and stakeholders is essential to developing culturally responsive treatment interventions that address social determinants of health, substance use, and mental health in this vulnerable population.