WHY IT MATTERS: Older adults currently using cannabis for sleep, pain, or anxiety should discuss their use openly with their physician, because the risk-benefit calculation shifts meaningfully with age, existing medications, and overall health status. CLINICAL OVERVIEW: Research exploring the relationship between cannabis use and mental health outcomes in older adults adds an important layer to how clinicians should approach geriatric care, where the interplay between substances and cognitive or emotional health is particularly complex. Older adults metabolize cannabinoids differently than younger populations, face greater polypharmacy risks, and may be more vulnerable to psychiatric side effects including anxiety, dysphoria, and cognitive disruption.