Cannabis or Drug Screening and Discussions With Clinicians Among Older Adults Who Use Cannabis in the U.S., 2021-2023.

Abstract

As cannabis use among older adults increases, clinicians engaging people in screening and brief interventions is central to reducing cannabis-related harms. Information is needed about cannabis or drug screening among older adults and targeted cannabis-related discussions. The 2021-2023 National Survey on Drug Use and Health included N=14,387 U.S. adults aged ≥65 years self-reporting any past-year healthcare visit. Weighted generalized logistic models conducted in 2025 identified characteristics associated with any cannabis or illegal drug use screening. Those reporting past-year cannabis use self-reported discussions with clinicians about cannabis or other drugs. Adjusted multinomial logistic regressions estimated the characteristics associated with cannabis discussions, screening only, or no screening/discussions. Among older adults encountering the healthcare system, 36.83% reported cannabis or illegal drug screening. Screening was higher in people with ≥2 chronic conditions, moderate/severe mental illness, cannabis use, alcohol use, and higher income but lower among Hispanic/Latine people. Among the 8.1% who self-reported past-year cannabis use (n=1,194), 19.18% discussed cannabis use with clinicians; discussions (versus no screening/discussions) were more likely among those with ≥2 chronic conditions (adjusted RRR=1.78, 95% CI=1.15, 2.75) or mild mental illness (adjusted RRR=2.62, 95% CI=1.18, 5.78) and less likely among Hispanic/Latine (adjusted RRR=0.23, 95% CI=0.08, 0.66) and other racial groups than among White older adults or those reporting alcohol use. Approximately 1 in 3 older adults reported any cannabis or drug screening; screening was even lower for Hispanic/Latine older adults. Fewer than 1 in 5 who used cannabis discussed their use with clinicians. Removing barriers to screening and discussions is needed to prevent negative cannabis-related consequences in older adults.