Cannabis Use Disorder Rises Among Older Adults, Study Finds

Prevalence Climbs Across Older Age Groups

Cannabis use disorder rates among adults 50 and older rose substantially between 2015 and 2025, with the steepest increases concentrated in the 50-64 age cohort. Researchers analyzed national survey data tracking substance use patterns and clinical diagnoses across demographic segments.

Medical cannabis programs now operate in 38 states. Recreational markets serve consumers in 24 jurisdictions. Older adults represent the fastest-growing segment of new cannabis users, driven by interest in pain management, sleep aids, and anxiety treatment.

Cannabis use disorder—defined by DSM-5 criteria including tolerance, withdrawal, and inability to reduce use despite negative consequences—affects an estimated 10-30% of regular cannabis users across all age groups, according to prior epidemiological research.

Clinical and Economic Implications

The rise in disorder diagnoses among older adults carries direct implications for healthcare systems already managing chronic conditions and polypharmacy risks in aging populations. Cannabis interacts with common medications including blood thinners, antidepressants, and opioids, complicating treatment protocols.

Emergency department visits related to cannabis use among seniors have doubled since 2019, according to CDC data. Presenting symptoms include cardiovascular events, falls, and acute psychiatric episodes.

The intersection of cannabis use disorder and Medicare-eligible populations creates a coverage gap, as federal prohibition prevents reimbursement for cannabis-related treatment under most insurance plans.

That coverage barrier leaves older adults navigating disorder treatment largely out-of-pocket, even as medical cannabis itself remains ineligible for insurance coverage or HSA reimbursement under IRS rules.

Legalization and Access Dynamics

State-level legalization correlates with increased cannabis initiation among older adults, particularly in markets with established medical programs and dispensary networks. Dispensaries in mature markets like California, Colorado, and Washington report growing sales to customers over 55, with topicals, tinctures, and low-dose edibles leading category growth.

Medical cannabis patient registrations among seniors have grown 300% since 2020 in states with active programs. Common qualifying conditions include chronic pain, arthritis, insomnia, and PTSD.

Increased access doesn't automatically translate to disorder risk, the study's authors note, but normalization and availability remove traditional barriers that historically limited older adult use.

Screening and Diagnosis Gaps

Primary care physicians report low rates of cannabis use screening among older patients, creating underdiagnosis of use disorders in this demographic. Standard substance abuse screening tools often focus on alcohol and prescription medications, omitting cannabis-specific questions.

Key diagnostic challenges include:

• Patients' reluctance to disclose cannabis use to physicians due to stigma or legal concerns
• Lack of standardized screening protocols for cannabis in geriatric care settings
• Physicians' limited training on cannabis pharmacology and disorder criteria
• Overlap between cannabis withdrawal symptoms and age-related health conditions

The American Geriatrics Society has called for updated clinical guidelines addressing cannabis use assessment and disorder treatment in older populations.

Treatment and Harm Reduction

Evidence-based treatments for cannabis use disorder—including cognitive behavioral therapy and contingency management—remain underutilized among older adults, who face age-specific barriers to accessing behavioral health services. No FDA-approved pharmacotherapies exist for cannabis use disorder, unlike alcohol or opioid use disorders.

Harm reduction approaches tailored to older adults focus on:

1. Reducing frequency and quantity of use
2. Switching to lower-THC products or CBD-dominant formulations
3. Addressing polypharmacy risks through medication reviews
4. Screening for cognitive and motor impairment

For complete context on cannabis use disorder prevalence, diagnostic criteria, and treatment options, see the CannIntel topic hub on cannabis use disorder.

The next research priority: longitudinal studies tracking older adults' cannabis use trajectories and health outcomes as cohorts age into Medicare eligibility and encounter changing regulatory environments.