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

The takeaway

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.

Geriatricians; primary care physicians caring for older adults; public health researchers studying cannabis in aging populations.

Cannabis users had higher rates of coronary disease, stroke, MI, and injuries vs matched controls

What the researchers 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).

Why it 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 numbers in context

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 the study worked

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).

What this study cannot 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.

How to read the evidence

Moderate: matched cohort design with electronic health record data and an ethnically diverse sample, though limited by observational design and potential confounders.

When this study was published

Published in 2022, covering 2016-2020.

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.

Questions still open

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?

Common 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 the original research

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

View on PubMed ↗Publisher’s paper ↗

Citation

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