The social anxiety–metacognitive recovery disruption (SAMR-D) model: integrating metacognition, motivation, and recovery processes in cannabis use disorder

Background Individuals with Social Anxiety Disorder (SAD) experience greater cannabis-related consequences than non-anxious individuals despite similar levels of cannabis use. Evidence indicates that this relationship reflects genuine clinical vulnerability rather than measurement bias. However,the mechanisms linking social anxiety to cannabis-related harm and return-to-use vulnerability remain insufficiently understood.Objectives This narrative theoretical review proposes the Social Anxiety – Metacognitive Recovery Disruption (SAMR-D) Model, a framework integrating social anxiety, metacognitive dysfunction, motivational processes, and recovery-oriented mechanisms to explain cannabis-related consequences in Cannabis Use Disorder (CUD).Methods A narrative theoretical synthesis was conducted drawing on literature concerning social anxiety and cannabis use, metacognitive models of addiction, motivational theories of behavior change, and the SID-CAN CRAVES recovery framework. Evidence was integrated to develop a mechanistic model linking social anxiety to cannabis-related harm.Results The SAMR-D model proposes that social anxiety activates maladaptive metacognitive beliefs that promote threat monitoring, rumination, avoidance, and coping-oriented cannabis use. These processes disrupt recovery domains including coping, responsibility, advice-seeking, values alignment, empathy, and self-efficacy, contributing to motivational erosion, cannabis-related consequences, and increased vulnerability to return to use.Conclusions The SAMR-D model extends existing metacognitive addiction frameworks by incorporating recovery-oriented mechanisms specific to CUD and offers testable propositions for future research and intervention development.