Older Adults' Use of Cannabis and Attitudes Around Disclosing Medical Cannabis Use to Their Healthcare Providers in California: A Mixed Methods Study.

Background: The rapidly changing policy climate related to cannabis legalization has led to drastic changes in cannabis use in the United States (US). Medical cannabis use is increasing overall, but at a faster rate among older adults compared to other age groups.

Objective: The aim was to investigate older adults' cannabis use behaviors and attitudes around disclosing medical cannabis use to their primary healthcare providers (HCPs).

Methods: Nineteen older adults (ages 65+ years) with self-reported medical cannabis use were recruited from flyers posted in ambulatory clinics in San Diego, CA. Surveys and semi-structured interviews on cannabis use were completed. A multi-methods approach was used to analyze data.

Results: Participants' mean age was 75.3 years; 52.6% identified as women, and 89.5% as White. Cannabis was used by all participants to treat pain and by 75% for insomnia, with 25-33% reductions in use of prescription medications to treat these symptoms. Approximately 89% reported their primary HCPs were aware of their cannabis use, and 84.2% felt very comfortable/comfortable talking to HCPs about cannabis. Common themes from interviews included participants (1) being motivated to disclose cannabis use to their HCPs to seek medical advice on dosing, side effects, and benefits of cannabis, (2) feeling comfortable disclosing cannabis use as legalization has eased the stigma around cannabis use, and (3) perceiving mostly neutral attitudes from HCPs on their cannabis use.

Conclusion: The study emphasizes the pivotal role of HCPs as educators in addressing patient inquiries about cannabis, underlining the need for equipping healthcare professionals with evidence-based knowledge through education and training initiatives.