Epidemiology of Cannabis Use Among Middle-Aged and Older Adults in the United States.

Introduction: 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 US middle-age and older adults is of particular interest since they are especially vulnerable to the adverse effects of cannabis.

Methods: Health and Retirement Study data (n=1,324) was analyzed, calculating weighted prevalences 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, ≥65) and specified older age groups (65-74, ≥75) and sex. Associations with any cannabis use were evaluated using multivariable logistic regression, adjusting for sex, race/ethnicity, household income, and employment.

Results: 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.

Conclusions: 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.