Some Americans aged 65 and older who used cannabis in the past year met the criteria for cannabis use disorder, according to a UC San Diego study published September 28, 2026, in the journal Addiction. Most of those cases were mild. People who used cannabis on 300 or more days a year were nearly four times as likely to qualify.
If you or an older parent uses cannabis, especially most days, this study gives you two things to check. First, look for the two signs that showed up most often: craving it, and spending a lot of time getting it, using it and getting over its effects. Second, bring it up with a doctor alongside your other prescriptions. The study does not say anyone should stop. Whether cannabis is right for a given person’s pain or sleep, and how it fits with their other medicines, is a conversation for their doctor. Cannabis is not the only product older adults reach for at night, and how well the over-the-counter sleep and mood remedies actually work is its own question.
Key takeaways
- 8.9% of adults 65 and older used cannabis in the past year, and 11.4% of them met criteria for cannabis use disorder.
- 76% of those cases were mild, 20.1% moderate and 3.9% severe.
- About 1 in 5 older users (19.9%) said a doctor had recommended some or all of their cannabis use.
What the study found
The team, led by Benjamin Han, MD, of UC San Diego School of Medicine, analyzed the 2021 to 2024 National Survey on Drug Use and Health, a nationally representative survey. The analysis included 21,189 adults 65 and older living in the community.
An estimated 8.9% had used cannabis in the past 12 months. Among them, 11.4% met two or more of the DSM-5 criteria that doctors use to diagnose cannabis use disorder.
The most common criteria were spending time obtaining, using and recovering from cannabis (74.4% of those with the disorder) and craving (67.5%).
Smoking was the most common way to use it (65.8%), followed by edibles and drinks (40.5%) and vaping (15.4%).
Several groups carried a higher risk of the disorder:
- Near-daily use: using on 300 or more days a year meant nearly 4 times the risk of using less often (relative risk 3.70). The true figure is very likely between about 2.3 and 6 times.
- Smoking it: about 5 times the risk (relative risk 4.94).
- Other drug use: about 3.2 times the risk (relative risk 3.22).
- Mental illness in the past year: nearly 3 times the risk (relative risk 2.93).
- Men: about 69% higher risk than women (relative risk 1.69).
Dr. Kumar’s take
One in five older users said a doctor recommended cannabis. With a doctor’s blessing, it is easy to see cannabis as medicine and forget it can also become a habit. As Dr. Han put it, “any psychoactive substance, including cannabis, can lead to a harmful pattern of use, including among older adults.”
The older brain is also a different setting. The researchers point to age-related changes in the body, more chronic disease and more prescription medications in this age group. Earlier studies have tied cannabis use in older adults to cognitive impairment, falls, cannabis poisoning and emergency visits. Falls are a real concern at this age, and which fall prevention programs actually work turned out to have a surprising answer.
Two caveats. This is a survey, so it relies on what people report, and it shows who has the disorder, not what caused it. Near-daily users may use heavily because they already have the disorder, not the other way around.
The encouraging part is the severity split. Three quarters of cases were mild. The researchers note that this suggests an opportunity for early intervention. Mild is the stage where a pattern is easiest to notice and change.
What it means for you
- Check the signs honestly. Craving, spending a lot of time getting and using cannabis, and needing more for the same effect were the most common criteria.
- Count the days. Using on 300 or more days a year carried nearly 4 times the risk.
- Put it on your medication list. Tell your doctor what you use, how often and how you take it, so it can be weighed against your other prescriptions.
- Do not change a prescribed plan on your own. If cannabis was recommended for pain or sleep, talk through alternatives with the doctor who recommended it.
Cannabis research does not all point one way. A recent trial found it lowered extra heartbeats, the opposite of what researchers expected. Benefits and risks can both be real, and how often you use it matters.