Older Cannabis Users in Hawaii Had Higher Rates of Heart Disease, Stroke, and Pain

In a matched cohort of 550 adults over 50 in Hawaii, those with cannabis diagnoses had significantly higher rates of coronary heart disease, stroke, chronic pain, heart attacks, cyclic vomiting, and injuries over two years compared to matched controls.

Phillips, Kristina T et al.·Drug and alcohol dependence·2022·Moderate EvidenceRetrospective Cohort
RTHC-04148Retrospective CohortModerate Evidence2022RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Retrospective Cohort
Evidence
Moderate Evidence
Sample
N=275

What This Study Found

Cannabis-diagnosed patients had significantly greater risk of coronary heart disease, chronic non-cancer pain, stroke, myocardial infarction, cyclic vomiting, and injuries compared to age- and sex-matched controls. They also used more healthcare services across all settings (outpatient, inpatient, emergency).

Key Numbers

550 participants (275 cannabis, 275 control). Mean age: 62.8 years. Demographics: 47.8% White, 24.4% Asian, 19.3% Native Hawaiian/Pacific Islander. Cannabis group had significantly higher rates of: coronary heart disease, chronic pain, stroke, MI, cyclic vomiting, injuries. Higher healthcare utilization across all settings.

How They Did This

Matched cohort study using electronic health records from Kaiser Permanente Hawaii. 275 patients age 50+ with ICD-10 cannabis diagnoses were matched to 275 controls by age and sex. Health outcomes and healthcare utilization were tracked for two years following case identification (2016-2020).

Why This Research Matters

Most cannabis research focuses on younger users. This study in an ethnically diverse older population (19.3% Native Hawaiian/Pacific Islander, 24.4% Asian) provides data on a demographic where cannabis risks may compound with age-related health vulnerabilities.

The Bigger Picture

As the population of older cannabis users grows (baby boomers aging with continued use), understanding health outcomes in this demographic becomes critical. The diverse Hawaiian sample adds important data for populations typically underrepresented in cannabis research.

What This Study Doesn't Tell Us

Observational design cannot determine causation. Cannabis users may have other unmeasured risk factors. ICD-10 cannabis codes may miss casual users or capture more severe use patterns. Two-year follow-up may be insufficient for some chronic conditions.

Questions This Raises

  • ?Are the worse health outcomes in cannabis users due to cannabis itself, or do shared risk factors explain both cannabis use and poor health?
  • ?Would the results differ if cannabis use severity were taken into account?
  • ?How should geriatricians counsel older patients who use cannabis?

Trust & Context

Key Stat:
Cannabis users had higher rates of coronary disease, stroke, MI, and injuries vs matched controls
Evidence Grade:
Moderate: matched cohort design with electronic health record data and an ethnically diverse sample, though limited by observational design and potential confounders.
Study Age:
Published in 2022, covering 2016-2020.
Original Title:
Chronic health conditions, acute health events, and healthcare utilization among adults over age 50 in Hawai'i who use cannabis: A matched cohort study.
Published In:
Drug and alcohol dependence, 234, 109387 (2022)
Database ID:
RTHC-04148

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Looks back at existing records to find patterns.

What do these levels mean? →

Frequently Asked Questions

Is cannabis use dangerous for older adults?

In this study, older cannabis users had significantly higher rates of several serious health conditions compared to matched non-users. However, the study cannot determine whether cannabis caused these conditions or whether people with health problems are more likely to use cannabis.

What health problems were most common in older cannabis users?

Coronary heart disease, chronic non-cancer pain, stroke, heart attacks, cyclic vomiting (consistent with CHS), and injuries were all significantly more common in the cannabis group compared to age- and sex-matched controls.

Read More on RethinkTHC

Cite This Study

RTHC-04148·https://rethinkthc.com/research/RTHC-04148

APA

Phillips, Kristina T; Pedula, Kathryn L; Choi, Namkee G; Tawara, Kylee-Ann K; Simiola, Vanessa; Satre, Derek D; Owen-Smith, Ashli; Lynch, Frances F; Dickerson, John. (2022). Chronic health conditions, acute health events, and healthcare utilization among adults over age 50 in Hawai'i who use cannabis: A matched cohort study.. Drug and alcohol dependence, 234, 109387. https://doi.org/10.1016/j.drugalcdep.2022.109387

MLA

Phillips, Kristina T, et al. "Chronic health conditions, acute health events, and healthcare utilization among adults over age 50 in Hawai'i who use cannabis: A matched cohort study.." Drug and alcohol dependence, 2022. https://doi.org/10.1016/j.drugalcdep.2022.109387

RethinkTHC

RethinkTHC Research Database. "Chronic health conditions, acute health events, and healthca..." RTHC-04148. Retrieved from https://rethinkthc.com/research/phillips-2022-chronic-health-conditions-acute

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.