TOPLINE

Nearly 9% of US adults aged 65 years or older reported using cannabis in the past year, and among them, about 1 in 9 met the diagnostic criteria for cannabis use disorder (CUD), a study showed. Almost a quarter of the CUD cases were moderate or severe. 

METHODOLOGY

• Investigators conducted a secondary cross-sectional analysis using data from noninstitutionalized US adults (unweighted n = 21,189) aged 65 years or older, obtained from the 2021-2024 National Survey on Drug Use and Health.
• Researchers analyzed cannabis use in terms of recency (past 12-month and past 30-day use) and frequency (≥ 300 days or < 300 days per year). 
• Modes of use, medical cannabis recommendation, and the use of cannabidiol or hemp products were assessed only in 2022-2024 (unweighted n = 15,751). 
• Data on sociodemographic factors, other substance use, chronic health conditions, and cannabis use patterns were also analyzed.
• CUD was identified as meeting at least two out of 11 criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Severity of CUD was classified as mild (meeting 2-3 criteria), moderate (meeting 4-5 criteria), or severe (meeting 6-11 criteria).

TAKEAWAY

• A total of 8.9% and 6.0% of older adults used cannabis in the past year or past 30 days, respectively. Among past-year cannabis users, 11.4% met the criteria for CUD: 76.0% had mild, 20.1% had moderate, and 3.9% had severe CUD. The most commonly met CUD criteria were time spent obtaining/using/recovering (74.4%), craving (67.5%), and tolerance (48.3%).
• Among past-year cannabis users, smoking (65.8%), eating or drinking (40.5%), and vaping (15.4%) were the most common modes of cannabis use; only 19.9% of users reported having a medical recommendation of cannabis. 
• Individuals who used cannabis for 300 days or more per year had an increased risk for CUD (relative risk [RR], 3.70; 95% CI, 2.30-5.96) compared with those using cannabis for less than 300 days per year.
• Older men had a higher risk for CUD than older women (RR, 1.69; 95% CI, 1.12-2.55), as did those with a lifetime arrest and booking history vs those without (RR, 1.59; 95% CI, 1.07-2.37) and those with past-year mental illness vs those without (RR, 2.93; 95% CI, 1.85-4.65). Past-year use of tobacco (RR, 1.52; 95% CI, 1.04-2.20) or drugs other than cannabis (RR, 3.22; 95% CI, 2.15-4.84), smoking as a mode of cannabis use (RR, 4.94; 95% CI, 2.39-10.23), and the use of cannabidiol or hemp products in the past 30 days (RR, 1.70; 95% CI, 1.12-2.57) were each linked to a higher risk for CUD. An annual income of $50,000-74,999 (RR, 0.46; 95% CI, 0.24-0.87) or ≥ $75,000 (RR, 0.35; 95% CI, 0.19-0.64) vs less than $20,000, and a past-year cancer diagnosis (RR, 0.40; 95% CI, 0.18-0.89) were each linked to a lower risk for CUD.

IN PRACTICE

"It is important to recognize that any psychoactive substance, including cannabis, can lead to a harmful pattern of use, including among older adults," lead author Benjamin H. Han, MD, associate professor, University of California San Diego School of Medicine, said in a press release.

"Cannabis use screening, cannabis use disorder treatment, and additional intervention to prevent worsening severity are needed to minimize cannabis-related harms among older US adults," the authors wrote.

SOURCE

The study was published online on September 28 in Addiction.

LIMITATIONS

The study was limited by reliance on self-reported cannabis use leading to potential bias, reliance on self-reported criteria for CUD rather than structured diagnostic interviews, potential survey fatigue among older respondents, exclusion of institutionalized older adults, inability to distinguish narrower age subgroups (eg, 65-74 years vs 75 years or older), and lack of power to identify certain correlates of CUD. 

DISCLOSURES

The study was funded by UC San Diego Sam and Rose Stein Institute for Research on Aging and the National Institute on Drug Abuse. One author reported consulting for the Washington-Baltimore High Intensity Drug Trafficking Areas program; the other authors reported no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.