Cannabis use has risen sharply among U.S. adults age 65 and older, study finds

More and more older American adults are using cannabis (marijuana), according to a study published this week in the journal JAMA Internal Medicine.

The proportion of adults aged 65 and older who said they had used cannabis in the previous year increased from 2.4 percent in 2015 to 4.2 percent in 2018 — a jump of 75 percent, the study found.

That’s also up a whopping 950 percent from the 0.4 percent of older adults who reported in 2006 that they had used cannabis during the previous 12 months.

The increase has occurred, of course, during a period when many states, including Minnesota, have legalized the use of cannabis for medical purposes, and when a few have legalized it for recreational use as well.

As Dr. Benjamin Han, a co-author of the study and a geriatrician and health services researcher at New York University (NYU), told STAT reporter Shafaq Zia that older adults are not typically associated with high levels of drug use.

“Cannabis use was very stigmatized in the past but now we have all these new laws passing about medical use of cannabis, so people are curious to see if it is something that can be used to treat their chronic disease,” he said.

That increased interest in — and use of — cannabis among older adults comes with health concerns, however. As researchers reported in 2018, evidence for the effectiveness of cannabis in the treatment of various medical symptoms among older adults is “scanty,” while “the risk of known and potential adverse effects is considerable.” Of particular concern are the drug’s potential harmful effects on older people’s cognitive abilities, cardiovascular health and risk of falling.

Specific subgroup trends

For the current study, Han and his co-author, Joseph Palamar, an associate professor of population health at NYU, analyzed data collected from a nationally representative group of almost 15,000 individuals aged 65 and older who took part in National Survey on Drug Use and Health between 2015 and 2018. Fifty-five percent of those participants were men and 77 percent were white. None lived in a nursing home or other type of institution.

The survey asked the participants whether they had either smoked or ingested marijuana, hashish, pot, grass or hash oil during the previous year.

In addition to an overall upward climb in cannabis use among older adults, the data also revealed significant increases in cannabis use among several demographic subgroups:

• Women. Although older men use more cannabis than older women, the increase in the drug’s use has been greater among women. Between 2015 and 2018, the use of cannabis among older women rose from 1.5 percent to 2.9 percent, an increase of 93 percent. That compares with a 58 percent increase among older men, from 3.6 percent to 5.7 percent.
• Racial and ethnic minorities. In 2015, older whites were more likely to use cannabis (2.8 percent) than older people of other races and ethnicities (1.5 percent). No longer. In 2018, 4.0 percent of older whites used the drug (a 43 percent increase), while 4.8 percent of other races and ethnicities did (a 336 percent increase).
• Higher incomes. In 2015, older adults with annual household incomes under $75,000 were less likely to use cannabis than those in their age group with lower incomes. That is no longer true. In 2018, 5.5 percent of older adults with household incomes of $75,000 or more reported using cannabis within the previous year, up from 2.4 percent in 2015, which is a 129 percent increase. That’s a higher proportion than in any other income group.
• Married people. Between 2015 and 2018, cannabis use among older married people rose twice as fast as among older unmarried people (100 percent versus 45 percent). Older married people are now as likely to report using cannabis as their unmarried peers (4.2 percent within each group).

Other findings

Han and Palamar also wanted to see if the increase in cannabis use among older adults was related to having chronic conditions. They found that it was. Older people with heart disease, diabetes, high blood pressure and cancer were more likely to report using cannabis in 2018 than in 2015.

The biggest increase — 180 percent — was among people with diabetes.

But the rise in cannabis use was more than three times higher among older people with one or no chronic conditions than among those with two or more (96 percent compared with 29 percent).

The study also found an increase in cannabis use among older adults who use alcohol — a finding that is particularly troubling, Han and Palamar point out, because the health risk associated with co-using cannabis and alcohol is higher than the risk of using either drug alone.

“Older adults are especially vulnerable to potential adverse effects from cannabis,” the researchers stress, “and with their increase in cannabis use, there is an urgent need to better understand both the benefits and risk of cannabis in this population.”

FMI: You’ll find the study on the JAMA Internal Medicine website, but it’s behind a paywall.