This specifier serves as an additional specifier for remission if the individual is both in remission and situated in a controlled environment. This applies to individuals in early remission within a controlled environment or those in sustained remission within a controlled environment. Examples of such environments include closely supervised and substance-free jails, therapeutic communities, and locked hospital units.

Cannabis Use Disorder Specified in a controlled environment

After meeting the full criteria for cannabis use disorder in the past, if none of the criteria for the disorder have been met for a period of at least 3 months but less than 12 months (except for Criterion A4, which relates to craving),

Cannabis Use Disorder Specified in early remission

After previously meeting the complete criteria for cannabis use disorder, if none of the criteria for the disorder have been met for a continuous period of 12 months or longer (excluding the presence of Criterion A4, which pertains to craving or a strong desire to use cannabis),

 Cannabis Use Disorder specified in Sustained Remission

Once an individual has met the complete criteria for cannabis use disorder, there are certain specifiers that are used to understand the characteristics of the disorder: 

- In early remission
- In sustained remission
- In a controlled environment

Alma College

A. A problematic pattern of cannabis use resulting in significant impairment or distress, as indicated by at least two of the following criteria occurring within a 12-month period:
1. Consumption of cannabis in larger amounts or over a longer duration than intended.
2. Persistent desire to reduce or control cannabis use, accompanied by unsuccessful efforts.
3. Devoting substantial time to obtaining cannabis, using it, or recovering from its effects.
4. Experiencing strong cravings or a compelling urge to use cannabis.
5. Repeated cannabis use leads to failure in fulfilling important obligations at work, school, or home.
6. Continuation of cannabis use despite persistent or recurring social or interpersonal issues caused or worsened by its effects.
7. Giving up or reducing significant social, occupational, or recreational activities due to cannabis use.
8. Engaging in cannabis use in physically hazardous situations.
9. Continued cannabis use despite being aware of persistent or recurring physical or psychological problems likely caused or exacerbated by it.
10. Development of tolerance, demonstrated by either: A) A need for significantly increased amounts of cannabis to achieve desired effects or intoxication. B) A noticeably reduced effect with the continued use of the same quantity of cannabis.
11. Experience withdrawal symptoms, either:  A) Meeting the criteria for cannabis withdrawal syndrome (refer to Criteria A and B of the withdrawal criteria).  B) Using cannabis or a closely related substance to relieve or avoid withdrawal symptoms

[DSM-5-TR] Diagnostic Criteria of Cannabis Use Disorder

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed., Text revision). https://doi.org/10.1176/appi.books.9780890425596

DSM-5-TR

Cannabis use disorder involves the problematic use of substances derived from the cannabis plant or synthetic compounds with similar effects. The primary psychoactive component responsible for addiction is delta-9-tetrahydrocannabinol (THC). Cannabis affects the brain by interacting with CB1 and CB2 cannabinoid receptors. Cannabis is consumed in various forms, including smoking (joints, pipes, blunts), vaporizing (vaping), dabbing (inhaling concentrated cannabis products), and ingestion (edibles, beverages). Cannabis potency varies greatly, and its potency has been increasing over time. Synthetic cannabinoids have unpredictable effects and can be more harmful than cannabis. 

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