Epidemiology of Cannabis Use Among Middle-Aged and Older Adults in the U.S.

Abstract

The prevalence of medical cannabis use, consumption methods, other key cannabis behaviors, and attitudes toward use is understudied, and associations with any cannabis use among U.S. middle-age and older adults is of particular interest because they are especially vulnerable to the adverse effects of cannabis. Health and Retirement Study data (N=1,324) were analyzed, calculating weighted prevalence for cannabis measures, including past-year use, consumption methods, medical use, health conditions for which cannabis was used, healthcare provider recommendations, attitudes toward acceptability, risks, and legalization, by primary age groups (50-64 and ≥65 years) and specified older age groups (65-74 and ≥75 years) and sex. Associations with any cannabis use were evaluated using multivariable logistic regression, adjusting for sex, race/ethnicity, household income, and employment. Past-year cannabis use in the U.S. was reported by 18.5% and 5.9% of middle-age and older adults, respectively. Smoking was the primary consumption method in both groups. Approximately 25% of middle-aged adults and 20% of older adults who used cannabis consumed it for medical purposes, with ∼20% of those receiving a prescription or recommendation. Over 75% of individuals in both age groups viewed medical use as acceptable, and older adults were more likely to view cannabis as a gateway drug and to support restrictions of cannabis laws. Cannabis use among both middle-aged and older U.S. adults is higher than previously reported in state- and national-level studies, with many engaging in cannabis behaviors associated with increased harm. Greater public health and clinical efforts are needed for tailored prevention and intervention strategies.