Cannabis use among older adults has risen sharply in recent years, often for reasons that sound more medical than recreational. People may turn to it for pain, sleep problems, anxiety, or other symptoms, sometimes after discussing it with a healthcare provider.
But a large new study suggests there’s another side of cannabis use in this age group that may be receiving far less attention.
Researchers at the University of California San Diego School of Medicine analyzed nationally representative data from more than 21,000 Americans aged 65 and older. Among older adults who had used cannabis during the previous year, 11.4% met the criteria for cannabis use disorder, meaning their cannabis use had begun causing problems or interfering with daily life.
That works out to more than one in nine older cannabis users.
Most cases were classified as mild, but researchers also uncovered patterns that could help identify who is more likely to develop problems, including how frequently cannabis is used, how it is consumed, and whether other mental health or substance-use issues are present.
The findings don’t mean cannabis use inevitably leads to dependence, or that every older adult who uses it medicinally is at high risk. Instead, they provide a clearer picture of what problematic cannabis use can look like later in life.
Here are seven findings from the research that older cannabis users and their families may want to know.
1. Cannabis Use Among Older Adults Is Rising Fast
A 2025 analysis in JAMA Internal Medicine found that past-month cannabis use among Americans aged 65 and older climbed from 4.8% in 2021 to 7% in 2023, a rise of nearly 46% in just two years. Cannabis use is increasing among older adults alongside regulations allowing medical and recreational consumption, increases in THC potency of cannabis products, and declining public perceptions of cannabis-related risks. More older Americans are using cannabis than at any point in recorded survey history, which means the question of who develops a problematic relationship with it has become genuinely urgent for clinicians and families alike.
The disorder study was published on September 28, 2026, in the journal Addiction. The research, titled “Cannabis use and cannabis use disorder among older adults in the USA,” analyzed data from the 2021 – 2024 National Survey on Drug Use and Health, covering 21,189 adults aged 65 and older. That scale gives the findings statistical weight that smaller surveys can’t match. The 11.4% disorder rate among cannabis users in this age group isn’t a fringe outcome – it represents a substantial share of what is already a growing population.
“While there is a lot of attention on how cannabis may help common chronic symptoms older adults experience or the possible acute adverse effects in this population, less focus has been on cannabis use disorder,” said Benjamin Han, MD, assistant professor at UC San Diego School of Medicine and lead author of the study. That gap between clinical attention and clinical reality is precisely what the new findings expose. For years, conversations around older adults and cannabis have centered almost entirely on potential benefits – managing pain, improving sleep, easing anxiety – without an equal reckoning with the risk of dependency.
2. Most Cannabis Use Disorder Cases Were Mild
Cannabis use disorder is defined as a pattern of cannabis use that causes problems or interferes with daily life. The diagnostic criteria, drawn from the DSM-5 (the standard clinical reference used by mental health professionals), include a spectrum of severity – and the new data show that most older adults who qualify fall toward the lower end of that spectrum.
Among those who met criteria for cannabis use disorder, 76% had a mild case, 20.1% had moderate disorder, and 3.9% had severe disorder. The predominance of mild cases might seem reassuring, but mild disorder still signals that use has crossed a threshold where it’s affecting a person’s functioning or well-being in identifiable ways. For older adults managing multiple medications and chronic health conditions, even a “mild” disruption in cognitive clarity, motivation, or daily routine carries real consequences.
People with severe cannabis use disorder often reach clinical attention through crisis. Those with mild disorder frequently don’t recognize it – or don’t disclose it to a doctor – because the problems it causes are easy to attribute to aging itself. Craving, loss of time, and a gradual increase in how much is needed to feel the same effect are all easy to dismiss individually. Together, they describe a dependency that has taken hold.
3. Frequent Cannabis Use Was One of the Strongest Warning Signs
How often someone uses cannabis matters far more than most people realize. Older adults who used cannabis on at least 300 days in the past year were almost four times more likely to meet the criteria for cannabis use disorder than those who used it less frequently. Previous studies have linked cannabis use among older adults to increased risk for chronic diseases, cognitive impairment, falls, cannabis poisoning, and cannabis-related emergency health care visits.
Three hundred days per year is essentially daily use – and for many older adults, that daily pattern develops gradually under the logic that cannabis is “natural” or that they’re using it therapeutically. The near-fourfold increase in disorder risk among daily users makes frequency the single most useful clinical variable. A person who uses cannabis occasionally faces a very different risk profile than one who uses it every day, even if the dose per session looks similar.
The majority of older adults who use cannabis report choosing it for medical purposes, most commonly to target symptoms of pain, insomnia, anxiety, and depression. According to a 2024 National Poll on Healthy Aging, 44% of older adults who used cannabis at least monthly had not discussed their use with their healthcare providers. When frequency goes unexamined in clinical settings, a creeping pattern of daily use can go unaddressed until disorder criteria are already met. For anyone using cannabis regularly, mentioning it directly to a physician – including how often and in what form – is the starting point for honest risk assessment.
4. The Most Common Warning Signs Aren’t Always Obvious
Cannabis use disorder is described as a pattern of cannabis use that causes problems or interferes with daily life – but in practice, the specific symptoms that appear most often in older adults aren’t the dramatic ones people might expect.
The most common criterion met among older adults with the disorder was spending substantial time obtaining, using, or recovering from cannabis’s effects, reported by 74.4% of those with cannabis use disorder. Craving was the second most common sign, reported by 67.5%. Tolerance – meaning needing more cannabis to achieve the same effect – was reported by 48.3%.
These three markers form a recognizable pattern: a person’s day increasingly revolves around cannabis, they think about it when they’re not using it, and the amount they need to feel the same effect keeps creeping upward. Individually, each symptom might be rationalized. Together, they describe a dependency that has taken root. For family members or caregivers, noticing that an older loved one seems to spend a lot of time “around” their cannabis use – planning it, using it, or feeling off afterward – is a more actionable early signal than waiting for obvious impairment.
5. Smoking Was the Most Common Way Older Adults Used Cannabis
Smoking was the most common method of cannabis use among older adults, reported by 65.8% of users, and it was also strongly associated with cannabis use disorder in this population. About 40.5% of older cannabis users ate or drank cannabis products, while 15.4% reported vaping.
The association between smoking and cannabis use disorder makes physiological sense. Inhaled cannabis delivers THC to the bloodstream almost immediately, producing a fast-onset effect that is more tightly linked to reinforcement – the neurological mechanism behind habit formation and dependency. Edibles and other ingested forms act more slowly, which changes how the brain responds to and encodes the experience.
Research on cannabis and older adults consistently flags the interaction risk with other medications as a serious concern. A December 2025 longitudinal cohort study published in Age and Ageing found that cannabinoids interact with multiple drugs – including anticoagulants – with some interactions carrying significant clinical effects. For older adults who smoke cannabis specifically because it feels faster or more controllable than edibles, the research suggests that speed of onset comes with a real trade-off in dependency risk. Discussing consumption method with a physician is not a peripheral consideration – it directly affects the risk profile.
6. Mental Health and Other Substance Use Were Linked to Higher Risk
Cannabis use disorder in older adults doesn’t emerge in a vacuum. The disorder was more common among older adults with past-year mental illness, tobacco use, and use of drugs other than cannabis. These associations don’t prove that any one factor causes the disorder, but they map out the population where risk clusters most densely.
Among older adults who use cannabis, frequently endorsed motives for consumption include relaxation (81%), sleep (68%), enjoyment or celebration (64%), pain (63%), and mental health and mood (53%). Many of the people using cannabis for mental health reasons – anxiety, depression, low mood – are also the most likely to develop a disordered pattern of use. Self-medicating an existing mental health condition with cannabis can mask symptoms while deepening dependency, creating a cycle that’s difficult to untangle without professional support.
Tobacco use as a co-occurring risk factor is also worth noting. Older adults who still smoke cigarettes may be more habituated to the behavioral pattern of repeated inhalation and may find it easier to extend that pattern to cannabis – or to smoke the two together. The overlap between tobacco use and cannabis use disorder in this age group points toward the importance of comprehensive substance conversations in clinical care, not siloed assessments.
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7. Cannabis Can Affect Older Bodies Differently
Older adults may be at greater risk for some harms associated with cannabis use because of age-related changes in the body, as well as the higher prevalence of chronic diseases and use of prescription medications in this population. This isn’t a theoretical concern – it’s a pharmacological reality confirmed in multiple clinical reviews.
As the body ages, the liver and kidneys process substances more slowly, meaning THC and its metabolites stay in the system longer. Body fat distribution shifts, and since THC is fat-soluble, it can accumulate differently in older adults than in younger ones. The endocannabinoid system – the network of receptors throughout the brain and body that cannabis interacts with – also changes with age. Combined, these shifts mean a dose that feels manageable to a younger adult may produce stronger, longer-lasting effects in someone over 65.
Research has linked cannabis use among older adults to increased risk for chronic diseases, cognitive impairment, falls, cannabis poisoning, and cannabis-related emergency health care visits. The fall risk alone is significant. Falls are already the leading cause of injury in adults over 65, and any substance that affects balance, reaction time, or spatial awareness compounds that danger – especially when combined with other medications that have similar effects. A 2025 review of drug-drug interactions involving medical cannabis in older adults identified six categories of potentially problematic medication combinations, including central nervous system drugs, cardiovascular agents, and antihistamines – all commonly prescribed in this age group.
Read More: 7 Surprising Side Effects of Cannabis After 50
Talking to Your Doctor Is the First Step
The most important finding isn’t that cannabis suddenly becomes dangerous at age 65. It’s that problematic cannabis use can occur in older adults, including people who may have originally started using it for medical reasons.
Among older adults who had used cannabis in the previous year, more than one in nine met criteria for cannabis use disorder. Most had mild cases, and the most commonly reported signs weren’t necessarily dramatic. Spending substantial amounts of time obtaining, using, or recovering from cannabis, experiencing cravings, and developing tolerance were among the most common symptoms.
Frequency also stood out. Older adults using cannabis on 300 or more days per year were almost four times as likely to meet criteria for cannabis use disorder as less-frequent users.
That doesn’t mean someone using cannabis regularly necessarily has a disorder. Cannabis use disorder is diagnosed based on a pattern of symptoms and consequences, not simply how many days someone uses it.
But the findings give older adults, families, and healthcare providers some useful things to pay attention to: whether use is becoming more frequent, whether increasingly larger amounts are needed, whether cravings are developing, and whether cannabis is beginning to occupy more of someone’s time or interfere with everyday life.
And there’s another important reason for older adults to discuss cannabis openly with a healthcare provider. Medications, chronic health conditions, fall risk, and the way cannabis is consumed can all affect its overall risk profile.
As cannabis use becomes increasingly common among older adults, asking not only whether someone uses it, but how often, why, and whether that relationship is changing may become increasingly important.
Disclaimer: This information is not intended to be a substitute for professional medical advice, diagnosis, or treatment and is for information only. Always seek the advice of your physician or another qualified health provider with any questions about your medical condition and/or current medication. Do not disregard professional medical advice or delay seeking advice or treatment because of something you have read here.
AI Disclaimer: This article was created with the assistance of AI tools and reviewed by a human editor.
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