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Some users may experience an episode of acute psychosis, which usually abates after six hours, but in rare instances, heavy users may find the symptoms continuing for many days.[53] A reduced quality of life is associated with heavy cannabis use, although the relationship is inconsistent and weaker than for tobacco and other substances.[54] It is unclear, however, if the relationship is cause and effect.[54]
According to DSM-V criteria, 9% of those who are exposed to cannabis develop cannabis use disorder, compared to 20% for cocaine, 23% for alcohol and 68% for nicotine. Cannabis abuse disorder in the DSM-V involves a combination of DSM-IV criteria for cannabis abuse and dependence, plus the addition of craving, minus the criterion related to legal troubles.[117]
Cannabis use started to become popular in the United States in the 1970s.[252] Support for legalization has increased in the United States and several U.S. states have legalized recreational or medical use.[282] A 2018 Social Science Research study found that the main determinants of such changes in attitudes toward marijuana regulation since the 1990s were changes in media framing of marijuana, a decline in perception of the riskiness of marijuana, a decline in overall punitiveness, and a decrease in religious affiliation. [283]