Cannabis treatment entries rose significantly from 2004/2005 to 2013/2014, but there has been limited investigation into why this increase has occurred. The purpose of this paper is to evaluate the plausibility of different explanations within the English context and identifies gaps in the literature. Explanations have been categorised under: misreporting, increased probability of entering treatment and increased incidence of cannabis use disorder (CUD). The explanations are evaluated through published literature, data in the public domain and interview data. Interview participants included four practitioners, one senior manager, one commissioner, one journalist, one academic and one clinician. Plausible and influential explanations are that an expanding treatment offer occurred alongside an expanding cohort of people needing support for CUD. The evidence suggests increased prevalence in the 1990s to early 2000s, and an increase in high-potency cannabis, led to a significant rise in need for cannabis treatment. Minor explanations relating to funding formulas, criminal justice referrals and the emergence of synthetic cannabinoids could also cumulatively have a substantial effect on the data. Due to the dearth of research in use and attitudes towards cannabis, there are some explanations which cannot be ruled out. More research is needed on user perceptions of cannabis harms and how intensively people are using cannabis. Wider implications are that a genuine and increasing need for support relating to cannabis within the English population requires an appropriate response from national bodies, commissioners and service providers. A more comprehensive understanding of why this new cohort is emerging can inform better service provision and commissioning.
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