A large percentage of marijuana users around the world report signs of dependence, even as cannabis appears to be one of the safest and most commonly used drugs overall, according to the results of a survey released on Wednesday.

The findings are contained in the 2018 Global Drug Survey[1], a detailed questionnaire that compiled responses from more than 130,00 people in over 40 countries in the past year. One section of the survey used the “Severity of Dependence Scale[2],” or SDS, a popular tool that asks respondents five questions regarding impaired control over drug use and anxieties related to consumption and quitting.

Around 50,000 of the survey respondents reported having used marijuana in the last 12 months. Only alcohol and tobacco use were more common.

Of all cannabis users, 20.2 percent showed substantial signs of dependence, measured by affirmative answers to at least four of the five SDS questions. Crystal methamphetamine was the drug most closely associated with dependence, with nearly 25 percent of users scoring four or higher on the SDS.

A positive SDS score is not the same as a clinical diagnosis of dependence, Adam Winstock, a British addiction psychiatrist and founder of the Global Drug Survey, told HuffPost. But it does suggest that many marijuana users have considerable misgivings about their habits.

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