CBD Use Among Older Adults: What This National Survey Really Shows

CBD use among older adults is no longer a niche phenomenon. This large national survey does not tell us whether CBD is working, but it does tell us who is using it, how often that use overlaps with cannabis, and why clinicians should be asking much more specific questions when older patients say they take “CBD.”

This paper is a cross-sectional epidemiologic analysis of the 2022 National Survey on Drug Use and Health, focused specifically on adults age 50 and older. Its main contribution is not proving benefit or harm, but showing that past-year CBD use is common in later life, especially notable in adults 65 and older, where reported CBD use exceeded reported cannabis use. It also shows that CBD use strongly clusters with both medical and nonmedical cannabis use, and that different health and substance-use correlates appear in the 50 to 64 and 65-plus groups. The biggest limitation is built into the design: self-reported associations cannot tell us why people used CBD, what products they actually took, how much they took, or whether CBD caused any of the patterns seen.

For clinicians, this paper matters because older adults are often assumed to be either cautious nonusers or simple “medical” users. This dataset suggests the real-world picture is more layered. A meaningful share of older adults report CBD use, many also report cannabis use, and some of that use sits alongside mental health burden, chronic illness, or other substance-use problems. That makes routine medication reconciliation and cannabinoid history-taking more important than many standard visits currently reflect.

For lay readers, the study is useful because it pushes back on two familiar distortions. One is the idea that CBD is so benign and wellness-adjacent that it barely deserves medical discussion. The other is the opposite assumption, that any CBD use in older adults automatically signals misuse or danger. The paper supports neither simplification. It shows common use, meaningful overlap with cannabis, and enough complexity to justify careful, individualized conversation.

At a public-health level, this study also highlights a surveillance problem. Consumers may think they are taking one thing while actually taking variable or mislabeled hemp-derived products, and large surveys still do not capture dosage, frequency, product chemistry, or motivation with enough precision. In other words, older adult CBD use is becoming more visible faster than the evidence base or product oversight is catching up.

CBD use among older adults is common and often travels with cannabis use, but this paper does not show that CBD is treating disease, reducing medication burden, or causing the health patterns linked with it. It supports better screening and better counseling, not bigger claims.

The authors used 2022 NSDUH data to examine self-reported past-year CBD use in U.S. adults age 50 and older. They split the sample into ages 50 to 64 and ages 65 and older, then modeled how CBD use related to medical cannabis use, nonmedical cannabis use, chronic illness count, mental illness, nicotine dependence, alcohol use disorder, psychotherapeutic medication misuse, illicit drug use, and several sociodemographic variables. Importantly, this was not a study of prescribed CBD, verified product chemistry, clinical response, or longitudinal outcomes. It was a study of reported use patterns and reported health associations.

Past-year CBD use was reported by 18.3% of adults age 50 to 64 and 14.3% of adults age 65 and older. In the older group, CBD use was more common than cannabis use, which was reported by 8.0%. In adjusted models, both medical and nonmedical cannabis use were strongly associated with CBD use in both age groups, with incidence rate ratios above 4 in each group. In adults 50 to 64, CBD use was also associated with more chronic illnesses, mild and moderate to severe mental illness, and illicit drug use. In adults 65 and older, CBD use was significantly associated with disordered psychotherapeutic drug use, while physical health burden was not a significant correlate after adjustment. The paper also found lower reported CBD use among several minoritized groups relative to non-Hispanic white respondents.

It does not show that CBD improves pain, sleep, anxiety, mood, or any chronic disease in older adults. It does not show that CBD caused the higher rates of certain mental health or substance-use problems seen in some groups. It does not show that over-the-counter CBD products were accurately labeled, contaminant-free, or chemically uniform. And it does not tell us whether CBD reduced the use of opioids, benzodiazepines, alcohol, or other drugs in this sample.

This is a good descriptive paper about a real and growing phenomenon. It tells us that reported CBD use is common in adults over 50, especially striking in those over 65, and that it frequently overlaps with cannabis use and certain markers of health complexity. It does not settle debates about benefit, substitution, or safety. Its best use is to sharpen clinical curiosity, improve patient interviewing, and keep interpretation disciplined.

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