Marijuana use among older adults in the United States has reached unprecedented levels, marking a significant shift in both societal trends and public health considerations. According to a recent study led by the Center for Drug Use and HIV/HCV Research (CDUHR) at the NYU School of Global Public Health, approximately 7 percent of adults aged 65 and older reported using cannabis within the past month as of 2023. This surge is particularly notable given the traditionally low rates of cannabis use historically observed in this demographic, suggesting evolving attitudes and accessibility surrounding cannabis.
The study, published in JAMA Internal Medicine, reveals not only an increase in overall use but a transformation in the demographic profile of older cannabis users. In recent years, those engaging with marijuana in this age bracket are more frequently college-educated, married, female, and higher income earners. This change diverges from earlier patterns where younger, predominantly male populations comprised the majority of cannabis users. These trends point toward shifting social norms and the growing acceptance of cannabis as part of wellness or medical regimens among seniors.
This escalation in marijuana use among older adults is dramatically illustrated by the increase from 4.8 percent in 2021 to 7 percent in 2023βan approximate 46 percent rise in just two years. Such rapid growth warrants attention from clinicians and policymakers alike, given the unique physiological and pharmacological considerations of cannabis in an aging population. The study’s authors attribute part of this rise to the fact that earlier surveys could only effectively measure past-year use; the recent availability of more extensive data enabled an analysis of "past-month" or current use patterns, unveiling a more acute picture of usage frequency.
The increased prevalence of cannabis use among older adults is also influenced by legislative changes across the United States. Currently, most Americans reside in states where marijuana legalization permits medical, recreational, or both types of use. This expanded legal framework has likely contributed to enhanced availability, greater social acceptability, and reduced stigma, making cannabis more approachable to a traditionally conservative cohort. These factors collectively facilitate an environment in which older adults feel more comfortable exploring cannabis as a therapeutic or recreational option.
In addition to demographic shifts, the study highlights that cannabis use rose especially sharply among married seniors, white individuals, those with college degrees, and individuals earning $75,000 or more annually. Notably, older women demonstrated one of the most pronounced increases in cannabis use, although men in this age bracket remain more frequent users overall. These observations underscore a nuanced landscape in which social determinants such as marital status, education, race, and income interplay to influence patterns of substance use.
A particularly compelling aspect of the research is the marked increase in cannabis use among older adults managing chronic diseases. This includes individuals contending with multiple chronic conditions such as cardiovascular ailments, diabetes, hypertension, cancer, and chronic obstructive pulmonary disease (COPD). The uptick may reflect growing interest in cannabis as a potential palliative agent for symptom management, including pain relief and appetite stimulation, within this vulnerable subgroup. However, the biomedical implications demand careful scrutiny as cannabis can interact pharmacodynamically with other medications and may exacerbate certain health conditions if misused.
The research team cautions that some of the observed rise may also be attributed to a cohort effect, wherein individuals who used cannabis earlier in life have aged into the 65-plus demographic. Nonetheless, the steep and rapid escalation in usage percentages within a short timeframe suggests broader cultural and medical acceptance rather than a simple shift of users aging into the bracket. This pattern prompts calls for healthcare providers to more proactively screen for cannabis use and to educate older patients on the potential risks, especially given age-related changes in metabolism and drug sensitivity.
Physiological changes in older adults can significantly affect the metabolism and effects of psychoactive substances like cannabis. Alterations in liver function, changes in body composition, and decreased renal clearance can modify pharmacokinetics, potentially intensifying or prolonging the psychoactive and physiological impacts of cannabinoids. Therefore, the growing prevalence of cannabis use in the elderly necessitates updated clinical guidelines to ensure safe and informed consumption, particularly for patients with polypharmacy or multiple comorbidities.
Joseph Palamar, PhD, MPH, an associate professor at NYU Grossman School of Medicine and the study’s senior author, points to income-based disparities in cannabis use trends. While highest income groups initially displayed the lowest cannabis use prevalence in 2021, by 2023, this same group reported the highest usage rates. This shift may symbolize increased financial access to medical cannabis products, which can be costly and are often not covered by insurance. Consequently, affluence becomes a key determinant of who benefits from emerging cannabis therapies and legal markets.
Geographically, cannabis consumption patterns closely follow state-level regulatory environments. Older adults residing in states with legalized medical marijuana demonstrated higher rates of use than those in states where cannabis remains restricted. This geographic variability reflects the influence of legislative frameworks on drug accessibility and social acceptability. Moreover, it hints at how regulatory landscapes may shape public health outcomes as certain regions become hotspots for cannabis-related healthcare considerations in elderly populations.
From a clinical perspective, there is an urgent need for geriatricians and primary care practitioners to stay apprised of the evolving trends and risks associated with cannabis use in seniors. Benjamin Han, MD, MPH, associate professor at UC San Diego and the first author of the study, emphasizes that cannabis use can complicate the management of chronic diseases and entail risks if patients are uninformed about proper dosing, potential side effects, and drug interactions. As cannabis products diversify and legalization spreads, evidence-based clinical protocols to support aging patients are more critical than ever.
The research received support from the National Institute on Drug Abuse and the UC San Diego Sam and Rose Stein Institute for Research on Aging, underscoring the importance of dedicated funding for studies at the intersection of substance use and aging. Given the rapidly changing landscape of cannabis use and regulation, ongoing surveillance, longitudinal analyses, and in-depth biomedical research will be essential to fully characterize the benefits and risks for this expanding cohort of cannabis consumers.
As the older adult population continues to grow alongside increasing cannabis legalization, understanding the implications of this trend is vital. It poses opportunities for novel symptom management strategies but simultaneously demands cautious integration into clinical practice. The convergence of demographic shifts, legislative changes, and evolving public attitudes marks this phenomenon as a critical area for health policy, gerontology, and addiction medicine research moving forward.
Subject of Research: People
Article Title: Trends in Past-Month Cannabis Use Among Older Adults
News Publication Date: 2-Jun-2025
Web References:
- Center for Drug Use and HIV/HCV Research (CDUHR) at NYU β https://www.cduhr.org/
- National Survey on Drug Use and Health analysis β https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2025.1156
- Pew Research on marijuana legalization β https://www.pewresearch.org/short-reads/2024/02/29/most-americans-now-live-in-a-legal-marijuana-state-and-most-have-at-least-one-dispensary-in-their-county/
References: - JAMA Internal Medicine article DOI: 10.1001/jamainternmed.2025.1156
- Historical trends in older adult cannabis use: https://onlinelibrary.wiley.com/doi/10.1111/add.13670
Keywords: Cannabis, Substance abuse, Aging populations, Geriatrics, Older adults
