Not very long ago, we published a post about the use of cannabis (marijuana) among older adults, and it was one of our more popular posts when we published it. Perhaps now we know the reason why. According to new research published in JAMA Internal Medicine, marijuana usage among older adults has surged in the past few years. 7% of adults aged 65 and older report recent usage of cannabis, which is a 46% increase in the last two years. Several trends in usage were noted. First, cannabis usage grew more among those older adults living in states where medical marijuana is now legal (39 states and the District of Columbia now permit cannabis use for medical reasons, and 24 of those 39 also permit recreational use) and usage among higher-income older adults showed a marked increase, as did usage by older women (although older men still outnumber women among users). There was also a significant increase in usage by older adults with chronic disease, including heart issues, diabetes, hypertension, and COPD. This is perhaps a worrisome sign, as it may make it harder to treat and manage these diseases. Furthermore, a new study published in the journal Heart shows a correlation between cannabis use and the risk of dying from heart disease or the risk of stroke. According to this new research, cannabis use may double the risk of dying from heart disease and increase the risk of stroke by 20%. While more data is needed to better understand this correlation, there is mounting evidence that cannabis is associated with a greater likelihood of heart problems among users, and older adults and those with underlying chronic diseases are at particular risk. Experts consider the existing evidence sufficient to caution older adults with heart problems to limit their use of marijuana and to use as low a THC concentration as possible.

More cannabis use among older adults also means the potential for more cannabis use disorder (CUD) among this population, which is a type of substance use disorder that can cause distress or interfere with daily activities. Those afflicted with CUD are unable to stop using cannabis even if it’s causing problems in their social lives or affecting their health. A recent study of older veterans published in JAMA Network Open found that more than one in ten veterans aged 65-84 used cannabis in the previous month, and 36% of this group of users met the criteria for CUD. The reasons for this high cannabis use among older veterans ranged from self-reported troubles with pain, sleep, or mental health. With older adults generally becoming the fastest-growing age group to use cannabis in the US, there will likely be a rise in CUD among older adults across the spectrum. In a recent study published in The Journal of Addiction Medicine, it was reported that diagnoses of CUD rose substantially across all age and ethnic groups from 2000-2020, but the fastest growth was among those over age 65, especially for those in that group living with HIV. It is thought that up to 30% of the 55 million US adults who use cannabis will develop CUD, especially now that 3 out of 4 Americans live in a state where cannabis is legal for medicinal or recreational purposes.

So, not only are older users at risk for cannabis use disorder and exacerbated heart problems, but more generally, older adults have aging brains that are more sensitive to psychoactive substances, raising concern that there is growing harm to accompany the growing cannabis use among older adults. Geriatricians are becoming more concerned, and even long term care facilities are having to grapple with residents who want to use cannabis in their facilities. While there is still much to be studied and learned about the effects of cannabis use on older adults, to many experts, it feels as though usage is outpacing our knowledge of harms. As one expert cautioned, “If you view cannabis as a medicine, you should be open to the idea that there are groups who probably shouldn’t use it and that there are potential adverse effects from it. Because that is true of all medicines.” So, for those of you indulging in a gummy or smoke, go slow and be careful, as there is much we don’t yet know.