Cannabis and older adults: Poll shows current use patterns, beliefs and risks

Whether they’re using it for recreational or medical reasons, a sizable percentage of people in their 50s and older have smoked, eaten, drunk or applied to their skin at least one form of cannabis in the past year, a new poll shows.

In all, 21% of people age 50 and older said they used a form of cannabis that contains the psychoactive compound THC at least once in the past year, according to new findings from the University of Michigan National Poll on Healthy Aging. The poll report focuses on use of cannabis products with psychoactive amounts of THC, not CBD-only products.

More than half of those who used a cannabis product did so frequently: 12% of adults aged 50 and older said they did so at least once a month. Those aged 50 to 64, and those who are in fair or poor physical health, or in lower income households were more likely to report using cannabis at least monthly.

As for the reasons older adults use cannabis, many cited sleep (68%), help with pain (63%) or mental health (53%), and/or to relax or feel good (81%).

The poll also reveals potential risky behaviors related to cannabis use.

Among those who use cannabis at least once a year, 20% said they had driven a vehicle within two hours of consumption; many experts recommend waiting two or even three times that long. And the rate of such driving was even higher – 27% – among those who use cannabis at least once a month.

In addition, nearly half of older adults who use cannabis products at least monthly had not discussed their use with their health care provider. And more than 20% reported at least one sign of potential dependence on cannabis.

The poll is based at the U-M Institute for Healthcare Policy and Innovation, and supported by AARP and Michigan Medicine, U-M’s academic medical center.

Erin E. Bonar, Ph.D., a U-M addiction psychologist who worked with the poll team on the report, says the findings suggest a need for action at the policy, clinical and community levels to identify those who may need treatment for cannabis addiction and to discourage driving or other risky behaviors after consumption.

“With some form of cannabis use now legalized in 38 states and on the ballot this November in several others, and the federal rescheduling process under way, cannabis use is likely to grow,” she said. “But as this poll shows, it is not risk-free, and more attention is needed to identify and reduce those risks.” 

Bonar is a member of IHPI, the U-M Addiction Center and the U-M Injury Prevention Center as well as a professor in the Medical School Department of Psychiatry.

In addition to the national poll report, the team compiled data for Michigan adults age 50 and older; a summary is available at https://michmed.org/JYJer and an interactive data visualization is available at https://michmed.org/4e2KW.

Cannabis potency and addiction: Views of all older adults

The poll team also asked all older adults – including those who don’t use cannabis – about their views of cannabis. The results suggest a need for more public awareness efforts, Bonar says.

People in their 50s and beyond may have familiarity with cannabis from decades ago, whether through direct use or indirect knowledge during a time when it was illegal for any use in all states. Because of this, the poll team asked whether they believe cannabis is stronger today than it was 20 to 30 years ago.

The vast majority – 79% -- of older adults said they thought this was true. But Bonar notes that this means 21% aren’t currently aware of the major increases in THC levels found in cannabis available today, compared with levels in the 1990s and before.

Meanwhile, 72% of all older adults said they believe people can become addicted to cannabis. But, Bonar notes, this means more than a quarter of older adults aren’t currently aware that research has shown conclusively that cannabis addiction is real and can affect someone’s life and health just as addiction to other substances can.

Importance of discussing with health care providers

For those who use cannabis, especially those who use it often, poll director Jeffrey Kullgren, M.D., M.P.H., M.S. says the poll findings show the importance of communicating with their health care provider about their use.

In all, 56% of those who use cannabis with THC at least monthly said they had spoken with their regular health care provider about their use. Most of them said they had brought the topic up.

Talking openly with a provider about use could help identify risky drug interactions, and spot those experiencing signs of cannabis dependence or addiction.

In all, 22% of those who use cannabis at least monthly said in the past year they had had to use more cannabis to feel the effect they wanted, and 21% said using the same amount of cannabis had less of an effect on them than it had before, while 17% said they had increased the amount or frequency of their cannabis use. Another sign of potential addiction – strong desires or cravings to use cannabis with THC – was reported by 13% of those who use cannabis at least monthly.

“Even if your doctor, nurse practitioner or pharmacist doesn’t ask if you’re using cannabis products, it’s important to offer this information, no matter whether you’re using it to address a physical or mental health concern, or simply for pleasure,” says Kullgren, a primary care physician at the VA Ann Arbor Healthcare System and associate professor of internal medicine at U-M. “Many prescription medications and over-the-counter drugs, as well as alcohol, can interact with cannabis and cause unexpected or unwanted effects. And there are only a few conditions where we have good evidence of a medical benefit from cannabis, though this could change with time.”

The current process at the federal level to change how cannabis is listed on the schedule of controlled substances may free more researchers to do studies of cannabis-derived products in clinical trials involving human volunteers. Right now, such research is very limited because of federal restrictions.

The poll report is based on findings from a nationally representative survey conducted by NORC at the University of Chicago for IHPI and administered online and via phone in February and March 2024 among 3,379 adults ages 50 and older. The sample was subsequently weighted to reflect the U.S. and Michigan populations. Read past National Poll on Healthy Aging reports and about the poll methodology.