Cannabis Use Among People Aged 65 and Older: Results From an Intercept Survey in New York City

BACKGROUND: Cannabis use among older adults has increased in recent years. Age-related physiological changes, socio-ecological factors, and medications may exacerbate potential adverse effects of cannabis and complicate the detection of cannabis use disorder (CUD) in older adults. However, current estimates of cannabis use are largely limited to national surveys, which may have age-related surveying challenges. METHODS: We conducted an intercept survey of 315 adults aged ≥ 65 in New York City, primarily in public parks and immediately outside older adult centers. The survey asked primarily about drug use with a focus on past-year cannabis use, reasons for use, adverse effects, and CUD. We examined reported cannabis use and delineated correlates of use and of having CUD. RESULTS: 22.2% of participants (n = 70) reported past-year cannabis use, and among them, 11.1% (n = 35) reported past 24-h use. Older [adjusted odds ratio (aOR) = 0.90, 95% CI: 0.84-0.95] and female participants were at lower odds for use (aOR = 0.35, 95% CI: 0.17-0.73), and those who smoked cigarettes were at higher odds (aOR = 3.73, 95% CI: 1.65-8.48). Cannabis was most often used to get high (60.0%), relieve tension (55.7%), sleep (52.9%), or relieve chronic pain (30.0%). Dry mouth (41.4%) and drowsiness (18.6%) were the most reported adverse effects. Nearly a third (32.9%) who used cannabis had CUD, with 5.7% having severe CUD. CONCLUSIONS: Findings suggest that cannabis use among older adults may be more common and clinically significant than suggested by prior evidence. Improved screening, clinician education, and harm reduction strategies are needed to confront emerging risks in this population.