A 34-year-old married man presents for psychiatric evaluation after almost hitting someone with his car while driving under the influence of marijuana. He reports he was prompted to seek treatment by his wife, with whom he has had several conflicts over the past few years about his ongoing marijuana use. He has continued to smoke marijuana daily since the event. He says he has smoked marijuana since he was a teenager, and now it is legal in some states. He does not see what the problem is. What is the appropriate diagnosis?

Choice A reason: Cannabis dependence was a term used in earlier diagnostic frameworks such as DSM-IV. It has since been replaced by the broader and more clinically accurate term “cannabis use disorder” in DSM-5, which encompasses both abuse and dependence. Choice B reason: Cannabis abuse disorder is also an outdated term from DSM-IV. DSM-5 integrates abuse and dependence into a single diagnosis—cannabis use disorder—based on severity and symptom criteria. Choice C reason: Cannabis use disorder is the correct DSM-5 diagnosis. It includes patterns of problematic use leading to significant impairment or distress, such as continued use despite interpersonal problems, legal issues, and risky behaviors like driving under the influence. The patient’s daily use, denial of the problem, and conflict with his spouse meet criteria for this diagnosis. Choice D reason: Unspecified cannabis-related disorder is used when symptoms are present but do not meet full criteria for a specific diagnosis. In this case, the patient clearly meets criteria for cannabis use disorder, making this option inappropriate.