More than 11% of adults aged 65 and older who used cannabis in the past year met clinical criteria for cannabis use disorder, with nearly a quarter presenting with moderate or severe cases.
RT’s Three Key Takeaways:
- High Disorder Prevalence: More than 11% of adults aged 65 and older who used cannabis in the past year met clinical criteria for cannabis use disorder, with nearly a quarter presenting with moderate or severe cases.
- Smoking as Primary Delivery Mode: Inhaled routes remain the most common method of cannabis consumption among seniors, with 65.8% reporting smoking and 15.4% reporting vaping.
- Routine Healthcare Screening: Researchers emphasized the importance of screening older patients for problematic cannabis use during routine medical visits, especially given the risks associated with age-related physiological changes, chronic diseases, and concurrent tobacco use.
More than 1-in-9 seniors who consume cannabis meet the criteria for cannabis use disorder (CUD), according to a study published in the journal Addiction.
Researchers from the UC San Diego School of Medicine evaluated data from 21,189 adults aged 65 and older in the 2021–2024 National Survey on Drug Use and Health (NSDUH). Investigators determined that an estimated 8.9% of this demographic used cannabis in the past year. Among those past-year users, 11.4% met the criteria for CUD, defined as a problematic pattern of cannabis consumption leading to impairment or distress in daily life.
Prior research has associated cannabis use in older demographics with elevated risks for chronic illnesses, cognitive impairment, falls, accidental poisonings, and cannabis-related emergency healthcare visits. Older adults face heightened vulnerability to adverse drug effects due to age-related physiological changes, multiple prescription medication regimens, and underlying medical conditions.
“While there is a lot of attention on how cannabis may help common chronic symptoms older adults experience or the possible acute adverse effects in this population, less focus has been on cannabis use disorder,” said Benjamin Han, MD, associate professor at UC San Diego School of Medicine and lead author of the study, in a news release. “It is important to recognize that any psychoactive substance, including cannabis, can lead to a harmful pattern of use, including among older adults.”
Inhalation Remains Most Common Consumption Route
Smoking was identified as the leading route of administration, reported by 65.8% of older adults who consumed cannabis in the past year. Ingesting edible or drinkable products ranked second at 40.5%, while 15.4% reported vaping.
The analysis revealed that smoking cannabis was strongly associated with developing CUD. In addition, approximately 19.9% of past-year cannabis consumers noted that a physician had recommended some or all of their cannabis use.
Consumption frequency also directly correlated with disorder risk. Individuals using cannabis on 300 or more days during the previous year were nearly four times more likely to meet the diagnostic criteria for CUD compared to less frequent users. Furthermore, CUD was more prevalent among older individuals who reported past-year mental illness, tobacco use, and the use of other non-cannabis substances.
Screening and Clinical Intervention
Among seniors who met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for CUD, 76% presented with mild severity, 20.1% had moderate disorder, and 3.9% had severe disorder.
The most frequently cited diagnostic criteria included spending substantial time obtaining, using, or recovering from the effects of cannabis (74.4%), experiencing cravings (67.5%), and developing tolerance (48.3%).
Because the vast majority of identified cases were mild, the researchers indicated that routine healthcare screening provides a valuable window for early clinical intervention. As cannabis availability expands and senior usage increases for symptom management, clinicians should incorporate structured substance use assessments into regular clinical evaluations.
