Cannabis use and cannabis use disorder among older adults in the USA.

Han B.; Eschliman E.; Palamar J.; Triguero Roura M.; Mauro P. · Addiction (Abingdon, England) · 2026

**Background & Methods** This secondary analysis examined cannabis use and cannabis use disorder (CUD) among older adults (≥65 years) using 2021-2024 National Survey on Drug Use and Health data, a nationally representative cross-sectional survey of noninstitutionalized US residents. The study assessed prevalence of past 12-month and past 30-day cannabis use, DSM-5 CUD criteria, severity classification, and modalities of use among 21,189 older adults. **Key Findings** • An estimated 8.9% of older adults used cannabis in the past 12 months, with 11.4% of cannabis users meeting criteria for CUD (76.0% mild, 20.1% moderate, 3.9% severe); approximately one in nine older cannabis users had CUD. • Smoking was the most common modality (65.8%), followed by eating/drinking (40.5%) and vaping (15.4%); spending time obtaining/using cannabis (74.4%) and craving (67.5%) were the most prevalent individual CUD criteria. • Higher CUD risk was associated with male sex (RR=1.69), past-year mental illness (RR=2.93), other drug use (RR=3.22), smoking as route of administration (RR=4.94), and frequent use ≥300 days/year (RR=3.70); arrests/booking and tobacco use also increased risk. **Dosage & Administration** Not reported. The study documented modalities of use but did not specify dosages or frequency patterns beyond categorizing use as less than or greater than 300 days annually. **Safety & Adverse Effects** Not reported. The study focused on characterizing cannabis use patterns and CUD prevalence rather than documenting adverse effects or safety outcomes in this population. **Evidence Quality** This review/secondary analysis provides descriptive epidemiological data on a nationally representative sample, offering generalizable prevalence estimates for US older adults. Limitations include reliance on self-reported data, inability to establish causality, exclusion of institutionalized populations, and lack of clinical outcome measures. The cross-sectional design prevents assessment of temporal relationships or long-term health consequences, and DSM-5 CUD criteria may not fully capture age-specific harms relevant to older adults. Evidence quality is moderate for prevalence estimation but limited for understanding clinical significance or causal mechanisms.

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