What You’ll Learn in This Post

? Why cannabis use in older adults is rising faster than most realize

? What the latest JAMA study revealed—and what it carefully avoided

? How assumptions about harm are often louder than actual data

? Why the silence of healthcare providers may be more dangerous than cannabis itself

? What policymakers, physicians, and patients can do to move forward smarter

What the Study Says—and What It Doesn’t

A recent study published in JAMA Internal Medicine set off a wave of headlines: “Cannabis use is up among older adults.”

This 2025 analysis builds on past research—but it’s the first to offer nationally representative, post-pandemic data using the NSDUH’s updated methodology. The numbers came from the National Survey on Drug Use and Health (NSDUH), analyzing patterns from 2021 to 2023. What they found wasn’t minor—it was seismic.

The numbers came from the National Survey on Drug Use and Health (NSDUH), analyzing patterns from 2021 to 2023. What they found wasn’t minor—it was seismic.

In just two years, past-month cannabis use among U.S. adults aged 65 and over rose from 4.8% to 7.0%. That’s a 45% relative increase. On the surface, that’s the story. But it gets more interesting when you zoom in.

The most pronounced increases were seen among:

• Women

• People with multiple chronic conditions

• Adults with COPD

• Wealthy, college-educated seniors

Translation? Cannabis use in older adults isn’t just increasing—it’s shifting demographically. This isn’t fringe behavior. This is your neighbor, your patient, your retired professor uncle with high blood pressure and a jazz collection.

So, how did the authors frame it? With a phrase that should give us all pause:

“Cannabis use may complicate chronic disease management.”

That may be true—but what’s striking is how little the study actually did to support that claim. No symptom data. No adverse events. No health outcomes. Just one number: cannabis use is rising.

The real story here isn’t just that older adults are using cannabis. It’s that we still don’t seem to know what to do with that fact.

What They Measured—And What They Didn’t

The JAMA Internal Medicine study on cannabis use in older adults did exactly what it claimed to: it counted. Specifically, it measured past-month cannabis use based on self-report in a national survey of U.S. adults 65 and older. Nothing more.

So what did they not measure?

They didn’t ask:

• Why are older adults using cannabis?

• What symptoms are they managing—or avoiding?

• Are they using high-THC products or just a few milligrams of CBD before bed?

• How often? How much? For how long?

They didn’t check for health outcomes. No change in pain levels, sleep quality, polypharmacy reduction, or day-to-day function. Not even a whisper about how cannabis might be replacing—or compounding—other medications.

In fact, the study offered no data on harm. There were no spikes in emergency department visits (OR 1.03; 95% CI, 0.75–1.40). No documented overdoses. No measurable clinical chaos.

Yet despite this absence of outcome data, the authors leaned into a cautious frame:

“Cannabis may complicate chronic disease management.”

That’s like saying a growing number of seniors are learning to use smartphones and concluding: “May cause confusion and social withdrawal.” It could—but it also might help them text their grandchildren and order groceries with dignity.

Framing matters. And when cannabis is involved, framing often comes from fear, not from facts.

Rising Use Is a Signal, Not a Scandal

If cannabis use in older adults is climbing, we should ask:

What does this tell us about the state of modern medicine?

It might suggest frustration. Or curiosity. Or unmet needs that conventional tools haven’t solved.

It’s hard to ignore that many of the people driving this trend—women, the well-educated, the chronically ill—are often those who’ve already spent years, if not decades, navigating complex medical systems. They’re not impulsive. They’re informed. They’re careful. And they’re tired of being told there’s nothing left to try except another pill, another sedative, another shoulder shrug.

The numbers are telling a story:

• Older adults with two or more chronic illnesses nearly doubled their cannabis use.

• Those with COPD went from 6.4% to 13.5% in just two years.

• High-income seniors, historically the least likely to use, are now the most likely to do so.

This doesn’t look like recklessness. It looks like self-directed care.

So maybe the rise in cannabis use among older adults isn’t a red flag. Maybe it’s a signal—one we should have seen coming. A signal that people are seeking gentler, more adaptive options to manage pain, anxiety, sleep, inflammation, appetite, mood.

And yet, the healthcare system has largely responded with silence—or suspicion. That’s not leadership. That’s abdication.

The Real Danger Isn’t the Weed—It’s the Vacuum

Let’s be clear: cannabis isn’t without risk. No medicine is. Especially when used without guardrails.

But here’s the deeper concern—not that cannabis use in older adults is increasing, but that physicians aren’t part of the conversation. That vacuum? It’s where real harm starts.

When seniors experiment in isolation—without support, without education, without anyone asking how they’re using it or why—we shouldn’t be surprised if they misfire. Not because cannabis is inherently dangerous, but because guesswork is.

We’re watching a public shift unfold in real time, yet much of the medical establishment is still stuck on mute. And that silence has consequences.

• It forces patients to rely on the budtender instead of the physician.

• It reinforces stigma that prevents honest discussion in the exam room.

• It breeds misinformation, overcorrection, or worst of all—indifference.

Imagine if this were insulin. Or antidepressants. Or blood pressure meds. Would we shrug and say, “They’ll figure it out on their own”? Of course not.

The rise of cannabis use in older adults is an invitation—one that most of medicine has yet to RSVP to.

We don’t need more panic. We need participation.

If cannabis use in older adults is rising—and it is—then the challenge isn’t to stop it. The challenge is to support it smartly.

Here’s what that looks like.

For Clinicians:

It starts with asking. Not assuming. Not avoiding.

Ask your patients if they’re using cannabis. Ask how. Ask why.

Then, get curious. Brush up on cannabinoid pharmacology. Learn how THC and CBD interact with other medications. Understand why someone might be reaching for cannabis at 68 with arthritis, insomnia, and too many prescriptions to manage.

Meet your patients where they are—not where textbooks left off.

? Learn at CED as a fellow

? Learn in CED’s Medicine Lab

For Policymakers:

Legalization is not the endpoint. It’s the on-ramp.

Access without education is a recipe for inequity and confusion.

We need real-time clinical research in older populations. We need data on dosing, safety, interactions, and long-term outcomes.

And we need it from voices that understand patients, not just policy.

Cannabis care is public health. Treat it like it.

For Patients:

You’re not wrong for being curious. You’re not wrong for experimenting.

But you deserve guidance. Not just from online forums and friends—but from professionals who understand your medications, your diagnoses, your fears, and your hopes.

Track what works. Stay open. Ask questions. And push for better answers.

You’re not a problem to be solved—you’re a story to be heard.

Final Thoughts: The Headline We Missed

Cannabis use in older adults is rising. That’s not speculation. It’s not media spin. It’s data.

And the response from the healthcare system? For the most part: a collective shrug—or worse, an eyebrow raise.

But here’s the thing: rising use isn’t the danger. The real danger is when medicine sees a shift in patient behavior and fails to respond. Not with panic. Not with dogma. But with curiosity, humility, and care.

What we’re witnessing isn’t just a rise in cannabis use. It’s a referendum on what patients do when their needs aren’t being met.

When people feel dismissed, they adapt. When they’re told to wait, they move forward without us.

The real headline should have been:

“Older Adults Are Turning to Cannabis—And the Medical System Still Hasn’t Shown Up.”

Let’s change that.

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