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

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.

Livne, Ofir et al.·American journal of preventive medicine·2026·Moderate EvidenceCross-Sectional
RTHC-08437Cross SectionalModerate Evidence2026RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
N=1,324

What This Study 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.

Key Numbers

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 They Did This

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.

Why This Research 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 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.

What This Study Doesn't 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.

Questions This Raises

  • ?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?

Trust & Context

Key Stat:
Evidence Grade:
Nationally representative survey with validated measures, limited by self-report and cross-sectional design.
Study Age:
Published 2026 using Health and Retirement Study data.
Original Title:
Epidemiology of Cannabis Use Among Middle-Aged and Older Adults in the U.S.
Published In:
American journal of preventive medicine, 70(3), 108149 (2026)
Database ID:
RTHC-08437

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked 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 More on RethinkTHC

Cite This Study

RTHC-08437·https://rethinkthc.com/research/RTHC-08437

APA

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

MLA

Livne, Ofir, et al. "Epidemiology of Cannabis Use Among Middle-Aged and Older Adults in the U.S.." American journal of preventive medicine, 2026. https://doi.org/10.1016/j.amepre.2025.108149

RethinkTHC

RethinkTHC Research Database. "Epidemiology of Cannabis Use Among Middle-Aged and Older Adu..." RTHC-08437. Retrieved from https://rethinkthc.com/research/livne-2026-epidemiology-of-cannabis-use

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.