#77 Strong Clinical Relevance
High-quality evidence with meaningful patient or clinical significance.
Clinicians need to understand evolving cannabis use patterns in older adults to screen for drug interactions, particularly with cardiovascular and CNS medications commonly used in this population. This demographic shift increases the likelihood that patients will disclose or require counseling about cannabis use during routine care, necessitating evidence-based guidance on efficacy and safety for conditions like chronic pain and sleep disorders. As medical cannabis use becomes more prevalent among geriatric patients, clinicians must stay informed about age-related pharmacokinetics and risks including falls, cognitive effects, and polypharmacy complications to provide appropriate patient counseling and monitoring.
A June 2025 study published in JAMA Internal Medicine found that medical cannabis use is rising significantly among older adults, driven largely by increasing access through legalization and growing physician acceptance of cannabis for chronic pain, insomnia, and other age-related conditions. The research from NYU and UC San Diego researchers documented usage patterns and demographic trends, revealing that older patients are increasingly turning to cannabis as an alternative or adjunct to traditional pharmaceuticals, particularly opioids and benzodiazepines. This shift has important implications for clinical practice, as geriatric patients may have altered pharmacokinetics, increased drug interaction risks, and potentially different efficacy and safety profiles compared to younger populations using cannabis. Clinicians should be aware that their older patients may already be using medical cannabis and should routinely screen for it during medication reconciliation and when evaluating treatment options for common geriatric conditions. Understanding the prevalence and patterns of cannabis use in this population enables physicians to provide better informed guidance on drug interactions, appropriate dosing, and monitoring for adverse effects including cognitive changes and fall risk. Healthcare providers caring for older adults should develop competence in discussing medical cannabis use and its alternatives, as this population’s growing adoption reflects both regulatory changes and a genuine clinical demand for additional therapeutic options.
“What we’re seeing in this JAMA Internal Medicine data is a real shift in utilization patterns among older adults, and that’s clinically significant because we now have a larger population to monitor for drug interactions and fall risk. The study gives us solid epidemiologic ground to work from, but we still need robust prospective data on long-term safety and efficacy in this specific age group before we can be confident about dosing strategies or patient selection criteria.”
🧓 The increasing prevalence of cannabis use among older adults documented in recent research underscores a growing clinical reality that practitioners must address in their patient populations. While some older adults may derive symptom relief for conditions like chronic pain or chemotherapy-related nausea where evidence is most robust, clinicians should recognize significant knowledge gaps regarding long-term safety in aging populations, potential drug interactions with polypharmacy, and risks such as cognitive impairment, falls, and cardiovascular effects that may be particularly concerning in this age group. The heterogeneity of cannabis products, variable THC and CBD concentrations, and lack of standardized dosing complicate evidence-based guidance. Given this landscape, primary care providers should routinely screen older patients for cannabis use during medication reviews, engage in nonjudgmental conversations about motivation and perceived benefits, and counsel patients on known risks while acknowledging the limitations of current evidence—particularly distinguishing between products with reasonable
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