The Cannabis Abuse Screening Test and the DSM‐5 in the general population: Optimal thresholds and underlying common structure using multiple factor analysis

The Cannabis Abuse Screening Test (CAST) aims at screening the problematic use of cannabis. It has never been validated against the Diagnostic and Statistical Manual of Mental Disorders (DSM)‐5 and its relationships with this latter have never been studied. We used a probabilistic telephone survey collected in 2014 (1351 past‐year cannabis users aged 15–64) implementing the CAST and a DSM‐5 adaptation of the Munich Composite International Diagnostic Interview assessing cannabis use disorders. Data were weighted, and CAST items were considered categorical. Factorial structures were assessed with confirmatory factor analyses; the relationships between the instruments were studied with multiple factor analysis (MFA). One factor for the DSM‐5 and two correlated factors for the CAST were the best confirmatory factor analyses solutions. The CAST thresholds for screening moderate/severe and severe cannabis use disorders were 5 (sensitivity = 78.2% and specificity = 79.6%) and 8 (sensitivity = 86.0% and specificity = 86.7%), respectively. The MFA identified two orthogonal dimensions: The first was equally shared by both instruments; the second was the second CAST dimension (extreme frequencies of use before midday and alone, memory problems, and reproaches from friends/family). T he CAST structure and screening properties were confirmed. The MFA explains its screening performances by its first dimension and identified the problematic patterns (the second dimension) that are not captured by the DSM‐5.     

Properties of the Cannabis Abuse Screening Test (CAST) in the general population

This paper explores the DSM‐IV latent structure of cannabis users (especially its invariance towards gender and age) and assesses the psychometric properties of the Cannabis Abuse Screening Test (CAST) by confrontation with the theoretical diagnoses [dependence and cannabis use disorders (CUD)] and the latent class structure of the DSM‐IV. The random sample comprised 550 French cannabis smokers aged 15–62 years interviewed by telephone. DSM‐IV diagnoses were assessed with the Munich Composite International Diagnostic Interview. Internal structures of both instruments were assessed using factor analysis and latent class analysis. Optimal CAST cutoffs were determined by sensitivity, specificity and area under the receiver operating curve (AUC). CAST and DSM‐IV were unidimensional (Cronbach's α = 0.742 and 0.752, respectively), although a two‐factor solution showed a better fit for the CAST. CAST cutoffs for screening CUD and dependence were three (AUC = 0.851) and five (AUC = 0.868), respectively. DSM‐IV latent class structure varied only marginally in age and gender. Three classes of cannabis smokers were determined, ordered along a continuum of symptoms: non‐symptomatic (61.1%), moderate (32.9%) and severe (6.0%). CAST cutoff scores for screening moderate/severe and severe were, respectively, three (AUC = 0.869) and eight (AUC = 0.952). Results are compared to those obtained in previous CAST studies and discussed in line with the DSM‐5. Copyright © 2015 John Wiley & Sons, Ltd.     

The Cannabis Abuse Screening Test (CAST) revisited: examining measurement invariance by age

Defensible use of self‐reported cannabis use problem scales in age comparative frameworks requires that measured constructs have equal psychometric properties across age groups. This study compares the psychometric properties of the Cannabis Abuse Screening Test (CAST) across three age groups (18–24, 25–29, 30–40). Data was collected online from an accessible sample of 1316 cannabis users. Factor analysis compared the optimal factor structure and dimensionality diffraction. Multi‐group Model Invariance tests examined measurement invariance across the three age groups. CAST was two‐dimensional in all age groups with one factor measuring cannabis use problems and the other measuring deviation from a common standard of use. The two‐dimensional structure was more pronounced in older age groups. Weak factorial invariance was supported, suggesting that the meaning of the CAST factors is equivalent across age groups. Partial, but not full, strong factorial invariance was supported, indicating that only the cannabis use problem factor can be defensibly used to measure age group mean differences. Results confirm a well‐defined two‐dimensional CAST structure and factorial invariance across age groups. However, caution is needed when using the two items measuring deviation from a common standard in an age‐comparative framework. Replication studies based on a representative sample are needed.     

A validation of the Cannabis Abuse Screening Test (CAST) using a latent class analysis of the DSM‐IV among adolescents

This paper explored the latent class structure of the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM‐IV) (assessed with the Munich Composite International Diagnostic Interview). Secondly, the screening properties of the Cannabis Abuse Screening Test (CAST) in adolescents were assessed with classical test theory using the latent class structure as empirical gold standard. The sample comprised 3266 French cannabis users aged 17 to 19 from the general population. Three latent classes of cannabis users were identified reflecting a continuum of problem severity: non‐symptomatic, moderate and severe. Gender‐specific analyses showed the best model fit, although results were almost identical in the total sample. The latent classes were good predictors of daily cannabis use, number of joints per day and age of first experimentation. The CAST showed good screening properties for the moderate/severe class (area under receiver operating characteristic curve > 0.85) and very good for the severe class (0.90). It was more sensitive for boys, more specific for girls. Although structural equivalence across gender was rejected, results suggest small gender differences in the latent structure of the DSM‐IV. The performance of the CAST in screening for the latent class structure was good and superior to those obtained with the classical DSM‐IV diagnoses. Copyright © 2013 John Wiley & Sons, Ltd.     

Le cannabis dans les armées : entre passé et actualité

Cannabis in the army is a reality the authors have chosen to inscribe in a temporality, from the concept of mental hygiene to the history of cannabis and of its spreading in the French population, so as to apprehend the present interest in cannabis in the army. Consumption of psychoactive drugs in military forces actually dates back to some decades, no doubt it has given rise to a specific interest of the medical corpse in dealing with these consumers both in their medical treatment and in pure prevention as well as in expertise. The military hierarchy is equally interested in these two last domains, keeping strictly to its role without interfering in the medical field. The extent of this addictive phenomenon in the general population had to include the military domain in spite of the selective recruitment practised. This phenomenon was studied through a drug, cannabis, and via the most salient points: the media coverage of its use in the military institution; the frequency of use of this substance particularly by young adults; the legal repression of its consumption as a product classified as narcotic; its dangerousness in connection with the specificities of military duties. After having characterised the epidemiological context of the use of cannabis in the army, the authors studied its topicality by a clinical research to estimate a screening test of problematic uses of cannabis, the CAST questionnaire, in a military population. Specifically dedicated to cannabis, it was used in recent years in most of the representative enquiries of the level of psychoactive drugs use by the French observation system. Unlike other screening instruments as Fagerström for tobacco or DETA for alcohol, the validity of CAST had not been thoroughly studied until this loophole was recently closed. Our study aimed at expanding the available data concerning a specific population due to a medico-statutory demand. Its methodology consisted in a questionnaire including CAST and a psychiatric interview the result of which was a medical record specifying possible cannabis addiction and indicating determinants of its use. The psychometric qualities of CAST were confirmed both in its internal consistency and its specificity as well as in its sensitivity with a consumption risk threshold of three. The data of prevalence of cannabis consumption was added to results of previous studies of military populations although no correlation could be established with other risk factors (psychopathology, environment). The medico-military dimension of cannabis consumption was objectivised excluding the overreactions which may occur in a highly regulated environment but with the reservations due to the size of the population studied. The CAST questionnaire appears to be accepted as effective screening tool via its qualities of discrimination and feasibility and made easy by its quick and simple use. Its use by unit medical doctors seems adequate to help them approaching cannabis consumers provided that it is part of the healing process that should not be used alone. Such an approach with the use of CAST facilitates the meeting and the weaving of a link with the patient who may be in a conflicting relationship with his environment. Raising awareness of the different interested players and giving them some adequate training are desirable accompanying measures of CAST implementation in medical service units to improve its operational character.     

Source of cannabinoids: what is available,what is used,and where does it come from?

Cannabis sativa L. is an ancient medicinal plant wherefrom over 120 cannabinoids are extracted. In the past two decades, there has been increasing interest in the therapeutic potential of cannabis‐based treatments for neurological disorders such as epilepsy, and there is now evidence for the medical use of cannabis and its effectiveness for a wide range of diseases. Cannabinoid treatments for pain and spasticity in patients with multiple sclerosis (Nabiximols) have been approved in several countries. Cannabidiol (CBD), in contrast to tetra‐hydro‐cannabidiol (THC), is not a controlled substance in the European Union, and over the years there has been increasing use of CBD‐enriched extracts and pure CBD for seizure disorders, particularly in children. No analytical controls are mandatory for CBD‐based products and a pronounced variability in CBD concentrations in commercialized CBD oil preparations has been identified. Randomized controlled trials of plant‐derived CBD for treatment of Lennox‐Gastaut syndrome (LGS) and Dravet syndrome (DS) have provided evidence of anti‐seizure effects, and in June 2018, CBD was approved by the Food and Drug Administration as an add‐on antiepileptic drug for patients two years of age and older with LGS or DS. Medical cannabis, with various ratios of CBD and THC and in different galenic preparations, is licensed in many European countries for several indications, and in July 2019, the European Medicines Agency also granted marketing authorisation for CBD in association with clobazam, for the treatment of seizures associated with LGS or DS. The purpose of this article is to review the availability of cannabis‐based products and cannabinoid‐based medicines, together with current regulations regarding indications in Europe (as of July 2019). The lack of approval by the central agencies, as well as social and political influences, have led to significant variation in usage between countries.     

Cannabis Use in Israel: a Cross Sectional Overview of Multiple Study Groups

The purpose of this paper is to review cannabis use among a cross section of Israeli high school, school dropouts, university students, hospitality workers, and adults in drug treatment. Based on national statistics, 27.0% last year and 19.1% last month cannabis (i.e., marijuana and hashish) use has been reported among 18–65 year olds. This is a higher rate than what is reported in the USA and European countries. Findings across the study groups evidence high rates of cannabis among school dropouts and adults in drug treatment. University students tend to have a higher rate of current use than hospitality workers. Secular status, regardless of the study group, tends to influence cannabis use. Israeli origin university students and hospitality workers report a higher level of current cannabis use than those with other country origin status (i.e., the former Soviet Union). This paper suggests multiple factors be considered, organized, and sustained for policy and prevention purposes.     

The replicability of cannabis use prevalence estimates in the United States

Recent changes in cannabis policy in the United States have prompted increased interest in cannabis use estimates, and replicability of these estimates. Here, we compare prevalence estimates from two concurrent approaches: (1) standard social survey with audio computer‐assisted self‐interviews at respondent's home (ACASI‐H), derived from the National Surveys on Drug Use and Health (NSDUH), and (2) standard health survey with ACASI assessment in a mobile health examination vehicle (ACASI‐M), derived from National Health and Nutrition Examination Surveys (NHANES), 2005–2012, with essentially the same standardized items in cannabis modules. NHANES ACASI‐M prevalence proportions for recently‐active‐cannabis‐use are an estimated 130–140% larger than corresponding NSDUH ACASI‐H estimates (p < 0.05). In exploratory stratified analyses, we sought to understand these NHANES‐NSDUH differences, and found no differences in lifetime‐history‐of‐cannabis‐use. However, for participants living with others in the same residence, moving cannabis assessment out of the dwelling unit might promote larger recently‐active‐cannabis‐use estimates; no NHANES‐NSDUH differences were found for participants living alone. The observed discrepancies might be non‐ignorable in a policy or program evaluation context. A methods research program will be needed to account for between‐survey differences of the type observed here, perhaps with a focus on within‐residence versus non‐residence assessment as a source of variation.     

Revising the Cannabis Use Disorders Identification Test (CUDIT) by means of Item Response Theory

Cannabis use among adolescents and young adults has become a major public health challenge. Several European countries are currently developing short screening instruments to identify ‘problematic’ forms of cannabis use in general population surveys. One such instrument is the Cannabis Use Disorders Identification Test (CUDIT), a 10‐item questionnaire based on the Alcohol Use Disorders Identification Test. Previous research found that some CUDIT items did not perform well psychometrically. In the interests of improving the psychometric properties of the CUDIT, this study replaces the poorly performing items with new items that specifically address cannabis use. Analyses are based on a sub‐sample of 558 recent cannabis users from a representative population sample of 5722 individuals (aged 13–32) who were surveyed in the 2007 Swiss Cannabis Monitoring Study. Four new items were added to the original CUDIT. Psychometric properties of all 14 items, as well as the dimensionality of the supplemented CUDIT were then examined using Item Response Theory. Results indicate the unidimensionality of CUDIT and an improvement in its psychometric performance when three original items (usual hours being stoned; injuries; guilt) are replaced by new ones (motives for using cannabis; missing out leisure time activities; difficulties at work/school). However, improvements were limited to cannabis users with a high problem score. For epidemiological purposes, any further revision of CUDIT should therefore include a greater number of ‘easier’ items. Copyright © 2010 John Wiley & Sons, Ltd.     

The Dutch Cannabis Dependence (CanDep) study on the course of frequent cannabis use and dependence: objectives, methods and sample characteristics

This paper presents an overview of the prospective cohort design of the Dutch Cannabis Dependence (CanDep) study, which investigates (i) the three‐year natural course of frequent cannabis use (≥ three days per week in the past 12 months) and cannabis dependence; and (ii) the factors involved in the transition from frequent non‐dependent cannabis use to cannabis dependence, and remission from dependence. Besides its scientific relevance, this knowledge may contribute to improve selective and indicated prevention, early detection, treatment and cannabis policies. The secondary objectives are the identification of factors related to treatment seeking and the validation of self report measures of cannabis use. Between September 2008 and April 2009, baseline data were collected from 600 frequent cannabis users with an average age of 22.1 years, predominantly male (79.3%) and an average cannabis use history of 7.1 years; 42.0% fulfilled a (12‐month DSM‐IV) diagnosis of cannabis dependence. The response rate was 83.7% after the first follow up at 18 months. The second and last follow‐up is planned at 36 months. Computer assisted personal interviews (CAPI) were conducted which covered: cannabis use (including detailed assessments of exposure, motives for use and potency preference); use of other substances; DSM‐IV internalizing and externalizing mental disorders; treatment seeking; personality; life events; social support and social functioning. Copyright © 2011 John Wiley & Sons, Ltd.     

The use of cannabis in the Federal Republic of Germany

Since more than 30 years cannabis is the most common illicit drug in Germany and other European countries. According to different Studies conducted in representative community samples, it can be assumed, that every fifth woman and about every third man, aged 18 to 59 years had used cannabis at least once. Epidemiologic studies also show that cannabis use is strongly associated with adolescence and young adulthood, though. Thus, cannabis consumption significantly increases from age 15, while beginning with the age 23 the proportion of cannabis consumers continuously decreases. Following the results of current studies the majority of consumers uses cannabis rather occasional. Nevertheless about 10-15% of the current consumers show patterns of cannabis dependence according to international diagnostic criteria. Although counselling centres note an increasing demand for addiction specific treatment, cannabis users still remain a small group in treatment centre statistics.     

Alcohol,cannabis and other drugs and subsequent suicide ideation and attempt among young Mexicans

ObjectiveTo report results from a follow-up study of alcohol, cannabis and other drugs on suicidal behavior.MethodWe estimated prospective associations of substance use as a risk factor for incident suicide ideation and attempt, from a follow-up conducted in 2013 (n = 1071) of the original Mexican Adolescent Mental Health Survey conducted in 2005.ResultsCannabis use before age 15 (ideation risk ratio (RR) = 3.97; 95% confidence interval (CI) = 1.43–11.03; attempt RR = 5.23; 95% CI = 1.17–23.32), early onset of DSM-IV drug use disorder (DUD) among cannabis users (ideation RR = 3.30; 95% CI = 1.11–9.84; attempt RR = 4.14; 95% CI = 1.28–13.36), high frequency of cannabis use (RR for attempts = 4.60; 1.03–20.60) and recent DSM-IV-DUD among cannabis users (RR for attempts = 4.74; 1.09–20.57) increased the RR. For “other drug use”, significant results were found among those with high frequency use of other drugs such that they had a higher RR of suicide attempt (5.04; 1.03–24.64). For alcohol, only those who initiated alcohol before age 15 had higher RRs of suicide attempt (1.79; 1.00–3.20).DiscussionThose who used cannabis at an early age, early onset of DSM-IV-DUD, and those with heavy cannabis use and recent DSM-IV-DUD among cannabis users in the last 12-months had increased risk of suicide ideation and attempt. Drugs other than cannabis showed some of these associations, but to a lesser degree. Prevention of substance use and treatment of those already engaged in drug use, by decreasing suicide ideation and attempt, may help to prevent suicide in Mexico.     

The initiation of cannabis use in adolescence is predicted by sex‐specific psychosocial and neurobiological features

Cannabis use initiated during adolescence might precipitate negative consequences in adulthood. Thus, predicting adolescent cannabis use prior to any exposure will inform the aetiology of substance abuse by disentangling predictors from consequences of use. In this prediction study, data were drawn from the IMAGEN sample, a longitudinal study of adolescence. All selected participants (n = 1,581) were cannabis‐naïve at age 14. Those reporting any cannabis use (out of six ordinal use levels) by age 16 were included in the outcome group (N = 365, males n = 207). Cannabis‐naïve participants at age 14 and 16 were included in the comparison group (N = 1,216, males n = 538). Psychosocial, brain and genetic features were measured at age 14 prior to any exposure. Cross‐validated regularized logistic regressions for each use level by sex were used to perform feature selection and obtain prediction error statistics on independent observations. Predictors were probed for sex‐ and drug‐specificity using post‐hoc logistic regressions. Models reliably predicted use as indicated by satisfactory prediction error statistics, and contained psychosocial features common to both sexes. However, males and females exhibited distinct brain predictors that failed to predict use in the opposite sex or predict binge drinking in independent samples of same‐sex participants. Collapsed across sex, genetic variation on catecholamine and opioid receptors marginally predicted use. Using machine learning techniques applied to a large multimodal dataset, we identified a risk profile containing psychosocial and sex‐specific brain prognostic markers, which were likely to precede and influence cannabis initiation.     

Impact of substance use on the physical health of patients with bipolar disorder

Garcia‐Portilla MP, Saiz PA, Benabarre A, Florez G, Bascaran MT, Díaz EM, Bousoño M, Bobes J. Impact of substance use on the physical health of patients with bipolar disorder. Objective: To describe the impact of tobacco, alcohol and cannabis on metabolic profile and cardiovascular risk in bipolar patients. Method: Naturalistic, cross‐sectional, multicenter Spanish study. Current use of tobacco, alcohol and cannabis was determined based on patient self‐reports. Metabolic syndrome was defined using the National Health and Nutrition Examination Survey 1999–2000 and the American Heart Association/National Heart, Lung and Blood Institute criteria, and cardiovascular risk using the Framingham and the Systematic Coronary Risk Evaluation functions. Results: Mean age was 46.6 years, 49% were male. Substance use: 51% tobacco, 13% alcohol and 12.5% cannabis. Patients who reported consuming any substance were significantly younger and a higher proportion was male. After controlling for confounding factors, tobacco was a risk factor for coronary heart disease (CHD) (unstandardized linear regression coefficient 3.47, 95% confidence interval 1.85–5.10). Conclusion: Substance use, mainly tobacco, was common in bipolar patients. Tobacco use negatively impacted CHD risk.     

Comparaison de l’efficacité de la MultiDimensional Family Therapy (MDFT) versus la Treatment As Usual Explicité (TAU) dans le traitement de l’abus et de la dépendance au cannabis chez l’adolescent : présentation du protocole INCANT

In France, cannabis is the illicit substance most tested and consumed by the teenagers. In the United States, a therapy appeared particularly effective in this field: MultiDimensional Family Therapy (MDFT), taking as a starting point systemic and cognitive techniques. To validate the effectiveness of this therapeutic method, it seemed paramount to place it in the French framework and context by comparing it with what is usually done in France in the catch in charge problematic consumption of cannabis. Thus, since October 2006, two health care centres of Paris and its suburbs take part in this protocol of research with the prospect to include 150 teenagers, old from 13 to 18 years, presenting a diagnosis of abuse or dependence to the cannabis. This longitudinal study is carried out in partnership with four other European countries and should be completed at the end of 2009. This project, supported by Interdepartmental Mission of Fight against Drugs and Drug-addiction (MILDT), is integrated within the framework of a programme of care and prevention towards the problems of consumption into adolescence. Its objective is double: (1) to validate a therapeutic method in the context European, and more particularly French, effective in the field of the addictions to adolescence; (2) to develop means of evaluation of psychotherapies.     

Up the Ladder of Concern: Youth and Young Adult Cannabis Use

This paper aims to review patterns of cannabis (i.e., marijuana and hashish) use among high-risk Israeli youth and young adults based on research conducted by the Ben-Gurion University, Regional Alcohol and Drug Abuse Research Center. A total of 1074 Israeli youth (67.0% male, 33.0% female) were studied from 2004 to 2016. The youth and young adults included those placed in residential programs for learning and/or behavior problems (youth villages) and were school dropouts referred to a 90-day treatment facility for drug abuse. Country of origin, determined by mother’s birthplace, revealed 42.4% of the youth was of Israeli origin and 57.6% from other countries—mostly the former Soviet Union and Ethiopia. About “village” youth, no gender or religious status (secular/non-secular) differences were found for lifetime and last month cannabis use. Immigrant origin youth, than those with Israeli status, reported more lifetime and last month use as well as cannabis availability. Youth from families with low socio-economics status reported a higher rate of last month cannabis use than those with better economic conditions. Among school dropouts, no gender or religious status differences were found for lifetime and last month cannabis use and availability. For all study youth, binary logistic regression results indicated six factors significantly predicted last month cannabis use: male gender, age, last month binge drinking, illicit drug selling, reduced relations with friends, and cannabis availability. In terms of policy and service provision, high-risk youth (e.g., those in residential programs, whether for learning and/or behavior problems) should be priority for drug prevention efforts.     

Testing the role of the posterior cingulate cortex in processing salient stimuli in cannabis users: an rTMS study

The posterior cingulate cortex (PCC) and precuneus are hubs in the default mode network and play a role in processing external salient stimuli. Accordingly, activation in these regions has been associated with response to salient stimuli using drug cue‐reactivity paradigms in substance using populations. These studies suggest that the PCC and precuneus may underlie deficits in processing salient stimuli that contribute toward the development of substance use disorders. The goal of this study was to directly test this hypothesis using repetitive transcranial magnetic stimulation (rTMS). Using a double‐blind, placebo‐controlled design, we used rTMS to target the PCC and precuneus with a double‐cone coil at 10 Hz (high frequency) and 1 Hz (low frequency) in 10 adult cannabis users and 10 age‐ and sex‐matched non‐using controls. Electroencephalography data were collected before and after rTMS during a modified oddball paradigm with neutral, oddball, self‐relevant, and cannabis‐related stimuli. Cannabis users exhibited increased amplitude in P3 and faster latencies in the P3, N2, and P2 components in response to self‐relevant stimuli compared to controls during baseline that normalized after rTMS. These results suggest that cannabis users exhibited heightened salience to external self‐relevant stimuli that were modulated after rTMS. PCC dysfunction in cannabis users may be related to abnormalities in processing salient stimuli, such those during cue‐reactivity, and provides a potential target for cannabis use disorder intervention.     

Cannabis use and callosal white matter structure and integrity in recent-onset schizophrenia

Adolescent-onset cannabis use, compared with adult-onset use, has been associated with a higher risk for developing symptoms of schizophrenia-like psychotic disorders. To test the hypothesis that onset of cannabis use in early adolescence in male schizophrenia patients is associated with abnormalities in white matter structure and integrity, we used high resolution structural and diffusion tensor brain images to compare three groups of patients: those who started regular use of cannabis (1) before the age of 15 years (early-onset cannabis users, n = 10) or (2) at the age of 17 years or later (late-onset cannabis users, n = 8), and (3) those who were cannabis naïve (n = 8). To verify patient findings, we also compared white matter integrity of the three patient groups with that of a healthy control group (n = 10). Cannabis naïve patients showed reduced white matter density and reduced fractional anisotropy, an indicator for white matter integrity, in the splenium of the corpus callosum compared with patients with early-onset cannabis use. In the same brain area, cannabis naïve patients showed reduced fractional anisotropy compared with healthy controls. Our results suggest that the age of onset of cannabis use is not an identifying characteristic for white matter abnormalities in schizophrenia patients; however, our results might indicate a more vulnerable brain structure in cannabis naïve schizophrenia patients.     

Les outils de repérage pour les troubles de l’usage du cannabis et leur adaptation au DSM-5 : une revue de littérature

ObjectivesCannabis use is widespread in France, particularly among adolescents and young adults, and can induce severe somatic, psychiatric and social consequences. Early identification and appropriate care of cannabis use disorders thus constitute a major public health issue. Standardized questionnaires based on patient self-reporting are recognized as the best option for identifying cannabis use disorders because of their reliability and simplicity.MethodsWe conducted a narrative literature review on cannabis use assessment tools on PubMed and selected cannabis-specific questionnaires, validated for adolescent and/or adult populations, from scientific articles in English or French between 1995 and 2010.ResultsSixteen questionnaires were found according to the inclusion criteria. The CAGE-cannabis, the CAST, the CUDIT and its revised version the CUDIT-R, the PUM and the SDS are the only ones that have good characteristics for a short screening tool adapted to daily clinical practice, namely to be brief (fewer than 10 questions) and quick handover (less than 10 minutes). Only the CAST has been validated in French, and the CUDIT-R is currently being validated. In the DSM-5, diagnoses of abuse or addiction have been grouped into a single diagnosis of cannabis use disorders with different levels of severity. It is relevant that tools used for screening take into account these new diagnostic concepts. The CUDIT-R is currently the only one to be validated based on DSM-5 diagnostic criteria.ConclusionAmong the many questionnaires available, few are suited for daily clinical practice in France because of their complexity, their long duration or the absence of a validated French translation. The CUDIT-R has good psychometric characteristics, is simple to use, and has been validated according to the criteria of DSM-5. These questionnaires are obviously not a substitute for a clinical diagnosis and must be followed by a specialist's evaluation. However, they remain an interesting mediation, encouraging a patient's awareness and commitment to care.