One in Ten Older Veterans Used Cannabis, and Over a Third of Users Screened Positive for Cannabis Use Disorder

Of 4,503 veterans aged 65-84, 58.2% had ever used cannabis. Past 30-day use was 10.3%, with 52.4% of users consuming on 20+ days per month. Smoking (72.4%) and edibles (36.9%) were most common. Among current users, 36.3% screened positive for cannabis use disorder (CUD). Inhaled use (vs edibles only) was associated with 3.56-fold higher odds of CUD. Pain (56.4%), mood/mental health (18.4%), and sleep (16.0%) were the top medical reasons.

Cross-sectional study of 4,503 community-dwelling veterans aged 65-84 using Veterans Health Administration care, interviewed February 2020-August 2023. Cannabis use disorder assessed using DSM-5 criteria (2+ criteria). Weighted multivariable logistic regressions examined factors associated with use and CUD. Published in JAMA Network Open.

Cannabis use among older adults has been underexplored. This JAMA study reveals that use prevalence among older veterans rivals tobacco use, and the high rate of CUD screening, particularly among smokers, suggests many older users may be developing problematic use patterns that go undetected without routine screening.

As cannabis legalization expands and the population ages, the number of older adults using cannabis is growing rapidly. This study challenges the assumption that older adult use is low-risk: over a third of current users met CUD criteria, and the strong association between smoking route and CUD suggests that how cannabis is consumed matters as much as whether it is consumed.

Veteran population (overwhelmingly male) may not represent general older adult population. Cross-sectional design cannot establish causation between route and CUD. CUD screening criteria may perform differently in older adults. Self-reported use may underestimate actual consumption.