A study using data from nearly 15,000 respondents to the National Survey on Drug Use and Health found that more individuals 65 years and older are using cannabis. These findings translate into a significant increase in reported past-year use from 2.4% to 4.2% from 2015 to 2018, reflecting a relative increase of 75%.
What’s striking about this marked increase in cannabis use in older adults is that many of these individuals may not be appropriately characterized as “patients” — at least not when it comes to chronic illnesses. Lead study author Benjamin Han, MD, MPH, of the division of geriatric medicine and palliative care at the New York University School of Medicine, told Cancer Therapy Advisor that he and his coauthor noted “a large increase in cannabis use among older adults who do not have multiple chronic medical conditions, suggesting that the increase in cannabis use by this population is from people who are not medically very ill.”
Although an increase in use could feasibly be correlated with the addition of new qualifying medical conditions being added to state-level medical marijuana programs, Dr Han noted the increases were seen for conditions that already appeared on these lists — and were also seen for conditions that do not appear on official lists of conditions that qualify individuals to be certified for formal medical marijuana programs. “A common qualifying condition for cannabis in states with medical cannabis laws is cancer, and while we did see a slight increase among older adults with cancer in our study, this increase was not considered statistically significant,” Dr Han said.
In fact, increased use in older adults did not appear to correspond at all with updates to state rules. “Interestingly, the chronic disease that saw a large and significant increase was older adults with diabetes, which is not usually a qualifying condition.” In adults with diabetes, there was a 180% relative increase in use from 2015 to 2018. This may suggest that individuals with diabetes who report an increase in use may be procuring cannabis outside of certified supply channels, although the authors “did not specifically examine sources of cannabis for this study.”
In addition, there was a large increase in cannabis use among those who receive mental health treatment. In older individuals, use of cannabis for this reason went from 2.8% in 2015 to 7.2% in 2018. Some mental health conditions, such as post-traumatic stress disorder, are listed as qualifying conditions for use in certain states.
The researchers also noted an increase in cannabis use among adults 65 years and older who also used alcohol in the past year — in other words, older adults who drank alcohol in the past year had an increase in past-year cannabis use. They added, “While we were unable to know the number of people who used cannabis and alcohol at the same time, the use of both substances has health implications, especially for older adults.”
The researchers also found significant increases in cannabis use among women, among college-educated individuals and those with a higher socioeconomic standing (individuals making $75,000 or higher per year), and among married individuals. The authors warned that because older adults are “especially vulnerable to potential adverse effects from cannabis,” an increase in use in this group presents an “urgent need” to better understand the risks and benefits of cannabis.
Han BH, Palamar JJ. Trends in cannabis use among older adults in the United States, 2015-2018 [published online February 24, 2020]. JAMA Intern Med. doi: 10.1001/jamainternmed.2019.7517