More than one in nine U.S. adults aged 65 and older who used cannabis in the past year met diagnostic criteria for cannabis use disorder, according to a University of California San Diego study published in the journal Addiction. Researchers analyzed survey data from 21,189 older adults.
Cannabis consumption is increasingly common among senior citizens, but public health attention has largely focused on potential medical benefits or acute side effects rather than compulsive use. A comprehensive analysis of federal data now offers a look at how often older Americans develop problematic patterns of consumption.
National Survey Data Reveal the Scale Among Older Adults
Investigators from the UC San Diego School of Medicine examined responses from noninstitutionalized U.S. adults aged 65 and older using data from the 2021–2024 National Survey on Drug Use and Health. The findings show that roughly 8.9% of older Americans used cannabis over the past year. Among that group of past-year users, 11.4% met the clinical definition for cannabis use disorder.
When identifying individuals who meet the criteria, the evaluation relies on whether a person exhibits two or more behaviors out of 11 specific actions.
- Mild cannabis use disorder affected 76% of those who met criteria.
- Moderate cases accounted for 20.1% of the total.
- Severe cases made up 3.9% of affected older adults.
Researchers identified specific behavioral hallmarks among the diagnosed population. Nearly three-quarters — 74.4% — reported spending significant time obtaining, using, or recovering from the drug. Intense cravings were reported by 67.5% of those meeting criteria, while 48.3% experienced tolerance.
Daily Frequency and Smoking Routines Drive the Risk
The likelihood of developing cannabis use disorder rose sharply with consumption frequency. Older adults who used cannabis on 300 or more days during the prior year were nearly four times more likely to meet diagnostic criteria than less frequent users. Inhalation remains the dominant delivery method, with 65.8% of past-year consumers reporting smoking, 40.5% consuming edibles or beverages, and 15.4% vaping.
“While there is a lot of attention on how cannabis may help common chronic symptoms older adults experience or the possible acute adverse effects in this population, less focus has been on cannabis use disorder.”
Dr. Benjamin Han, lead author and associate professor at UC San Diego School of Medicine
Smoking cannabis was independently associated with the disorder, along with co-occurring factors such as past-year mental illness, tobacco use, and the consumption of other drugs. Additional statistical evaluations indicated that older men were more likely to use cannabis than females. Meanwhile, about 19.9% of older cannabis users stated that a doctor had recommended some or all of their usage.
Addiction Specialists Debate Legal Access and Diagnostic Criteria
The findings arrive amid ongoing public policy debates regarding recreational cannabis laws. Addiction specialists note that legal access through dispensaries provides regulated product safety and reduces stigma, making people better able to get help.
Some clinicians argue that standard diagnostic criteria may overstate the true prevalence of addiction among seniors. Because physiological reactions like tolerance and withdrawal naturally occur when using substances to manage chronic pain or insomnia, critics suggest that medical cannabis patients are sometimes incorrectly classified as having a disorder.
Researchers emphasized that older adults face elevated vulnerabilities due to concurrent prescription drug regimens that raise the risk of harmful interactions, falls, and cognitive impairment. Older adults who use cannabis and their families can consult qualified medical professionals to discuss consumption habits and medication regimens openly.
