Cannabis Use Among Middle-Aged and Older Americans Is Higher Than Previously Thought | Research

The takeaway

Nearly 1 in 5 middle-aged adults and 1 in 17 older adults in the US used cannabis in the past year, with smoking as the primary method and limited medical oversight.

Geriatricians, primary care physicians, public health planners, cannabis policy makers

What the researchers found

Past-year cannabis use: 18.5% of middle-aged (50-64) and 5.9% of older adults (≥65). Smoking was primary consumption method in both groups. About 25% of middle-aged and 20% of older cannabis users consumed for medical purposes, but only ~20% of medical users had a prescription or recommendation. Over 75% viewed medical use as acceptable; older adults were more likely to see cannabis as a gateway drug.

Why it matters

Older adults are especially vulnerable to cannabis side effects including falls, cognitive impairment, and drug interactions. The finding that most older medical users lack prescriptions means they're self-medicating without clinical guidance.

The numbers in context

18.5% of ages 50-64 and 5.9% of ≥65 used cannabis past year. ~25% of middle-aged users and ~20% of older users consumed medically. ~20% of medical users had prescriptions. >75% of both groups viewed medical use as acceptable.

How the study worked

Analysis of Health and Retirement Study data (N=1,324) with weighted prevalence calculations and multivariable logistic regression adjusting for sex, race/ethnicity, household income, and employment. Results stratified by age groups (50-64, 65-74, ≥75) and sex.

What this study cannot tell us

Self-reported data likely underestimates true prevalence. Cross-sectional design. HRS sample may not perfectly represent all middle-aged and older adults. 'Medical use' was self-defined, not clinically verified.

How to read the evidence

Nationally representative survey with validated measures, limited by self-report and cross-sectional design.

When this study was published

Published 2026 using Health and Retirement Study data.

The bigger picture

The aging of the baby boom generation — which came of age during the cannabis era — means healthcare systems need to prepare for a wave of older cannabis users with complex medication regimens and age-related vulnerabilities.

Questions still open

Are healthcare providers asking older patients about cannabis use? What drug interactions are most dangerous for older cannabis users? Should geriatric medicine incorporate cannabis screening protocols?

Common questions

How common is cannabis use among older adults?

More common than most people think — nearly 1 in 5 Americans aged 50-64 and about 1 in 17 aged 65+ used cannabis in the past year, rates higher than previously reported in state and national studies.

Are older cannabis users getting medical guidance?

Mostly not — while about 20-25% of older cannabis users say they use it medically, only about 20% of those have a prescription or recommendation from a healthcare provider.

Read the original research

Epidemiology of Cannabis Use Among Middle-Aged and Older Adults in the U.S.

American journal of preventive medicine, 70(3), 108149

View on PubMed ↗Publisher’s paper ↗

Citation

Livne, Ofir; Stohl, Malka; Gilman, Jodi; Goldberg, Terry E; Wall, Melanie M; Hasin, Deborah S. (2026). Epidemiology of Cannabis Use Among Middle-Aged and Older Adults in the U.S.. American journal of preventive medicine, 70(3), 108149. https://doi.org/10.1016/j.amepre.2025.108149