Edible Cannabis and Pain, Sleep, and Mental Health Management in Older Adults

Importance: Older adults are the fastest-growing group of cannabis consumers in the US, seeking relief from age-related ailments (eg, pain or difficulty sleeping) and improved quality of life. However, little is known about the motivations and factors that influence their use of edible cannabis and product choice. Objectives: To explore the motivations of older adults in Colorado purchasing edible cannabis products to improve sleep, pain, or mental health concerns, and to understand how they perceive the benefits and drawbacks of different cannabinoid profiles: cannabidiol (CBD)-dominant, tetrahydrocannabinol (THC)-dominant, or a THC-CBD combination product. Design, Setting, and Participants: This community-based, qualitative study was study conducted in Colorado from November 2021 to November 2023 as part of a larger clinical trial. Individual interviews were audio-recorded, transcribed, and analyzed. Participants were a convenience sample of adults aged 60 years or older who were interested in using edible cannabis for sleep, pain, or mental health symptoms. Participants completed an in-person interview prior to purchasing 1 of 3 edible product types. Exposure: Use of edible cannabis products. Main Outcomes and Measures: The primary outcomes were self-reported motivations for cannabis use and perceived benefits and drawbacks of different cannabinoid profiles, assessed through semistructured interviews conducted before product purchase. Results: Among 169 participants (mean [SD] age, 70.8 [5.8] years, 89 female [54%]), 96 (57.5%) selected a THC and CBD combination product, 48 (28.7%) selected a CBD-dominant product, and 23 (13.8%) selected a THC-dominant product. Primary motivations for cannabis use included avoiding pharmaceuticals, exhausting other options, new or increasing problems, and evidence or claims of benefits. Evidence or claims of associated outcomes were seen as a benefit for all 3 product types. The most common drawback for THC and combination products was concern about getting high or being impaired, while limited efficacy was the most common drawback for CBD products. Combination products were perceived to offer dual benefits of THC-CBD, yet determining the ideal ratio was seen as a challenge. Conclusions and Relevance: In this qualitative study, older adults were motivated to use cannabis as an alternative approach to address health concerns. These findings highlight the importance of physician awareness of older adults' motivations and concerns to support informed counseling and resources.