New research has revealed troubling rates of problematic cannabis consumption amongst older American veterans, with more than one in three users meeting the clinical threshold for cannabis use disorder.

The research, published in JAMA Network Open, examined 4,503 veterans aged between 65 and 84 years through the Veterans Health Administration (VHA) system. Conducted between February 2020 and August 2023, the study uncovered that 10.3% of participants had used cannabis within the past 30 days, a figure now comparable to tobacco use rates within this demographic.

Dependency Rates Raise Concerns

Of those who reported recent cannabis consumption, 36.3% met the criteria for cannabis use disorder, with varying degrees of severity. The breakdown revealed 22.9% had mild cannabis dependency, 10.9% moderate cases, and 2.5% severe dependency.

“These findings highlight urgent needs for screening and prevention in an aging population,” researchers noted, emphasising that older adults remain particularly vulnerable to the adverse effects of cannabis, including impaired mobility and exacerbation of chronic health conditions.

Method of Consumption Matters

The study identified smoking as the predominant form of consumption, with 72.4% of recent users inhaling cannabis through smoking or vaping. Those who inhaled cannabis faced 3.56 times higher risk of developing cannabis use disorder compared to individuals who exclusively consumed edibles.

Edibles were used by 36.9% of recent consumers, and the research suggested that edible-only consumption appeared less harmful, presenting potential avenues for harm reduction strategies.

Pain Relief Drives Medical Use

Over half of older veterans using cannabis medicinally (56.4%) did so primarily for pain relief, far outpacing mental health concerns (18.4%) or sleep issues (16.0%) as reasons for consumption. Whilst 28.9% of the cohort reported using cannabis for medical purposes, the study found that recreational users faced higher odds of cannabis dependency than those using it exclusively for medical reasons.

More than half of recent users (52.4%) qualified as frequent consumers, defined as using cannabis on 20 or more days per month, further elevating their risk profiles.

Risk Factors Identified

Several key risk factors emerged from the research. Veterans at the younger end of the age range studied (65–75 years) showed higher vulnerability to cannabis use disorder compared to those aged 76–84 years. Individuals experiencing anxiety symptoms, those with functional impairments affecting daily activities, and participants with a history of illicit drug use also faced elevated risks.

Economic hardship played a notable role, with veterans struggling to afford basic necessities showing 60% higher likelihood of cannabis consumption, suggesting financial stress may drive self-medication behaviours.

Legalisation’s Impact

The influence of state cannabis policies proved significant. Veterans residing in states with recreational legalisation were twice as likely to use cannabis compared to those in non-legal states. Interestingly, states with medical-only legalisation showed no significant increase in usage rates.

“Living in a recreationally legal state doubled the likelihood of cannabis use,” the study authors observed, pointing to legalisation’s clear footprint on consumption patterns amongst older adults.

The prevalence of cannabis consumption amongst older Americans has surged dramatically, rising from just 0.4 to 0.7% in 2005-2006 to 8.4% in 2022 within the general population. The VHA cohort demonstrated even higher rates at 10.3%.

Call for Clinical Action

Researchers are advocating for routine screening in primary care settings, recommending the integration of validated assessment tools such as DSM-5 criteria or the Cannabis Use Disorder Identification Test–Revised (CUDIT-R) for older adults.

The study’s cohort was predominantly male (85.4%), White (78.4%), and retired (73.3%). Moreover, unmarried individuals and men were more likely to report recent consumption. However, this overrepresentation of men limits the ability to draw insights into gender-specific patterns of cannabis dependency.

Furthermore, whilst the cross-sectional design prevents drawing causal conclusions, the reliance on self-reported data may also underestimate the true prevalence. Nevertheless, the research still highlights serious public health challenges, especially as cannabis becomes increasingly accessible to older populations.

In addition, the findings reveal that most cannabis use disorder cases were mild in severity. Yet, despite this, the sheer scale of the issue — with over a third of older veteran users affected — underscores a critical need for greater awareness, improved screening protocols, and stronger prevention initiatives within healthcare systems serving ageing populations.

Source: News-Medical.net