Older adults with cannabis use disorder endorsed fewer diagnostic symptoms, potentially masking problem severity
Adults 65+ with cannabis use disorder were significantly less likely to endorse hazardous use and withdrawal criteria compared to younger adults, suggesting current diagnostic tools may underdetect CUD in older populations.
Quick Facts
What This Study Found
For CUD, adults 65+ had dramatically lower odds of endorsing hazardous use (OR 0.04) and withdrawal (OR 0.39 and 0.16); for AUD, 7 of 11 criteria were endorsed less often by older adults.
Key Numbers
CUD: hazardous use OR 0.04 (95% CI 0.01-0.17); withdrawal A OR 0.39 (0.20-0.73); withdrawal B OR 0.16 (0.05-0.48); AUD: 7 of 11 criteria endorsed less often by 65+.
How They Did This
Cross-sectional analysis of 2021-2023 NSDUH (N=12,264 for CUD, N=17,494 for AUD); multivariable logistic regression for each DSM-5 criterion with age group as independent variable.
Why This Research Matters
If older adults systematically underreport key CUD criteria, they may be underdiagnosed, undermining treatment access.
The Bigger Picture
As cannabis use grows among older adults, diagnostic tools developed on younger populations may need age-specific adaptations.
What This Study Doesn't Tell Us
Self-reported endorsement may reflect true differences or bias; NSDUH may underrepresent severe disorders in elderly; cross-sectional design.
Questions This Raises
- ?Are older adults truly experiencing fewer symptoms or interpreting them differently?
- ?Should age-adapted CUD criteria be developed?
- ?Does retirement mask occupational impairment?
Trust & Context
- Key Stat:
- Older adults had 96% lower odds of endorsing hazardous cannabis use (OR 0.04)
- Evidence Grade:
- Large nationally representative sample with criterion-by-criterion analysis, but cannot distinguish true symptom differences from reporting differences.
- Study Age:
- Published 2025, data 2021-2023
- Original Title:
- DSM-5 Criteria for Alcohol and Cannabis Use Disorders: Are Older Adults Less Likely to Endorse Certain Criteria?
- Published In:
- International journal of environmental research and public health, 22(6) (2025)
- Authors:
- Choi, Namkee G(10), Morris, Jeffrey A, Marti, C Nathan(10)
- Database ID:
- RTHC-06217
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Do older adults show cannabis use disorder differently?
Yes. Adults 65+ were far less likely to report hazardous use and withdrawal symptoms, the two criteria with the largest age gaps.
Why might this matter?
If older adults experience or report fewer DSM-5 criteria, their CUD may be underdiagnosed or classified as less severe than it actually is.
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Cite This Study
https://rethinkthc.com/research/RTHC-06217APA
Choi, Namkee G; Morris, Jeffrey A; Marti, C Nathan. (2025). DSM-5 Criteria for Alcohol and Cannabis Use Disorders: Are Older Adults Less Likely to Endorse Certain Criteria?. International journal of environmental research and public health, 22(6). https://doi.org/10.3390/ijerph22060843
MLA
Choi, Namkee G, et al. "DSM-5 Criteria for Alcohol and Cannabis Use Disorders: Are Older Adults Less Likely to Endorse Certain Criteria?." International journal of environmental research and public health, 2025. https://doi.org/10.3390/ijerph22060843
RethinkTHC
RethinkTHC Research Database. "DSM-5 Criteria for Alcohol and Cannabis Use Disorders: Are O..." RTHC-06217. Retrieved from https://rethinkthc.com/research/choi-2025-dsm5-criteria-for-alcohol
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.