Somatic Motives and Affective Motives are Differentially Associated with Cannabis Protective Behavioral Strategies and Adverse Cannabis Outcomes Among Adults Aged 55 and Older

OBJECTIVE: Medical cannabis use is often motivated by somatic or affective concerns, and both are common among older adults. Protective behavioral strategies (PBS) are known to mitigate adverse outcomes associated with substance use. Goals of this study were to examine how somatic and affective use motives relate to use of PBS, cannabis use, and symptoms of cannabis use disorder. METHOD: The sample included 471 participants age 55+, recruited through social media, who self-reported legal medical cannabis use. Measures included cannabis use motives, subjective cannabis use patterns, the Protective Behavioral Strategies for Marijuana Scale (PBSM), Cannabis Use Disorder Symptoms questionnaire, Cannabis Use Disorder Identification Test-Revised (CUDIT-R). RESULTS: = 112.57). Somatic use justifications were associated with greater PBS use, less cannabis use, and lower CUDIT scores. Affective use justifications were associated with less PBS use, more cannabis use, and higher CUDIT scores. Indirect pathways linking both somatic and affective use justifications with CUDIT score through PBS were statistically significant. CONCLUSIONS: Findings indicate that somatic justifications for cannabis use among older adults are associated with use of protective behaviors that reduce the risk for CUD symptoms, while affective motives suggest higher risk for CUD symptoms. These findings support the common practice of referring older adults with mental health concerns for conventional treatment, including evidence-based psychotherapy. Training in PBS use may mitigate escalation of CUD symptoms in this vulnerable population, and future research should examine that hypothesis.