In an analysis of older adults treated through the Veterans Health Administration (VHA), past 30-day cannabis use was reported in approximately 10% of respondents. Study findings were reported in JAMA Network Open. 

The cross-sectional analysis was conducted as part of the Veterans Affairs Cannabis and Aging Study. The analysis included community-dwelling adults aged 65 to 84 years who were receiving care through the VHA and who participated in telephone interviews between February 5, 2020, and August 29, 2023. 

Interviews addressed forms and frequencies of lifetime, last-year, and past 30-day cannabis use by study participants, in addition to duration of lifetime cannabis smoking. The analysis had outcomes of self-reported past 30-day cannabis use (including smoking, vaping, dabbing, or ingesting edibles) and 12-month cannabis-use disorder (CUD) among patients with past 30-day cannabis use.

The study included 4503 respondents who had a weighted mean age of 73.3 years (95% CI, 73.0-73.5 years). The majority were men (85.4%; 95% CI, 83.6%-87.2%), were retired (73.3%; 95% CI, 70.9%-75.8%), and were married (62.6%; 95% CI, 59.9%-65.3%). 

More than half (57.4% [95% CI, 54.6%-60.3%]) of respondents reported ever using cannabis through smoking, vaping, dabbing, or ingesting edibles. Of respondents with data evaluable on forms of lifetime cannabis use, 28.9% (95% CI, 26.0%-31.8%) reported use for medical reasons. The most common reasons given for medical use included pain (56.4%; 95% CI, 50.9%-61.9%), mood or mental health concerns (18.4%; 95% CI, 14.7%-22.1%), sleep difficulties (16.0%; 95% CI, 11.9%-20.0%), and arthritis (11.3%; 95% CI, 8.0%-14.6%).

Past 30-day cannabis use was reported by 10.3% (95% CI, 8.9%-11.7%) of respondents. The most common forms of cannabis they reported using were smoking (72.4%; 95% CI, 65.4%-79.3%) and ingesting edibles (36.9%; 95% CI, 29.8%-43.9%). Among respondents with past 30-day use, 52.4% (95% CI, 45.4%-59.4%) were considered to use cannabis frequently.

A weighted multivariable analysis indicated that past 30-day cannabis use, compared with no past 30-day use, was associated with several variables. Some of these factors included younger age (65 to 75 years), economic hardship, current tobacco use, recent illicit drug use, and residing in a state in which recreational cannabis was legal. 

A finding of 12-month CUD was identified in 36.3% (95% CI, 30.1%-42.6%) of respondents who reported past 30-day cannabis use and had data available for CUD diagnosis. CUD was found to be more likely among younger respondents, men, those reporting anxiety, those reporting at least 1 deficit in activities of daily living, and those reporting frequent cannabis use or illicit drug use in the past month. Past 30-day cannabis use involving inhaled cannabis was linked to a higher odds of CUD in comparison with using edibles only (adjusted odds ratio, 3.56; 95% CI, 1.12-11.26). 

“Findings from past research and our study highlight a potential need to include screening for cannabis use in clinical settings and to reinforce efforts to prevent CUD among veterans 65 years or older,” the investigators wrote in their report.