The study, which was recently published in the prestigious journal JAMA Internal Medicine, offers a granular look at how the landscape of drug use is evolving alongside the legal and social shifts occurring across the nation. Beyond the raw increase in numbers, the findings reveal a surprising transformation in the socioeconomic and demographic characteristics of older users. The data suggests that the typical older adult using cannabis today is frequently college-educated, married, and identifies as female—groups that were previously less likely to engage with the substance. Furthermore, the researchers noted a pronounced uptick in use among those with higher household incomes, suggesting that the rising costs associated with legal, regulated cannabis may be influencing who has the means to access it.
Joseph Palamar, PhD, MPH, an associate professor of population health at the NYU Grossman School of Medicine and the study’s senior author, emphasized that the trend is not merely a statistical anomaly but a sustained upward trajectory. While cannabis use has been increasing across nearly all age brackets in the U.S. over the last two decades, the rate of growth among the elderly is particularly striking. Palamar noted that while the overall numbers continue to climb, the internal shifts within the demographic are what truly define this new era of use. The changing profile of the user suggests that the stigma once associated with marijuana is rapidly evaporating, replaced by a new level of social acceptability that transcends traditional socioeconomic barriers.
To arrive at these conclusions, the research team analyzed a massive cache of data from the National Survey on Drug Use and Health, focusing specifically on the period between 2021 and 2023. This survey is a critical tool for public health officials, providing a representative snapshot of substance use patterns across the American population. For this specific study, the researchers focused on respondents aged 65 and older, specifically looking for "current" use, which is defined as use within the past 30 days.
Benjamin Han, MD, MPH, an associate professor and associate chief of research in the Division of Geriatrics, Gerontology, and Palliative Care at the University of California San Diego, highlighted the technical significance of this study’s methodology. Han, who served as the study’s first author, explained that this research marks the first time scientists have been able to reliably examine "current" use among the 65-plus population. In previous years, the number of older adults reporting marijuana use was so small that researchers were forced to look at "past-year" use to obtain a statistically significant sample. The fact that there are now enough older users to track monthly consumption speaks volumes about how common the practice has become.
The trajectory of this growth is stark when viewed over a short timeline. In 2021, current cannabis use among older adults stood at 4.8 percent. By 2022, that number had ticked up to 5.2 percent. However, the jump to 7 percent in 2023 represents a nearly 46 percent increase in just a two-year window. When the researchers looked further back to provide historical context, the contrast became even more dramatic. In the mid-2000s—specifically 2006 and 2007—less than 1 percent of older adults reported using cannabis within the entire previous year. Today, seven times that amount are using it on a monthly basis.
The study identified specific subgroups of the elderly population that are driving this growth. While men still maintain a higher overall prevalence of cannabis use than women, the rate of increase among older women has been particularly steep. Similarly, white older adults, those with at least a college degree, and those living in households with an annual income of $75,000 or more saw sharper increases than their counterparts in other demographic categories. This socioeconomic shift is one of the most intriguing aspects of the research. In 2021, the highest-income group actually had the lowest prevalence of cannabis use among seniors. By 2023, the situation had completely reversed, with the highest-income group reporting the highest prevalence of use.
Dr. Palamar suggested that this economic flip-flop is likely tied to the logistics of the legal market. As more states move toward legalization, the primary point of access has shifted from the illicit market to licensed dispensaries. These legal products are often subject to high taxes and premium pricing, which may make them more accessible to those with greater discretionary income. Furthermore, the researchers found that the growth in use was significantly more pronounced in states where medical marijuana is legal compared to states where it remains prohibited. This correlation underscores the influence of state-level policy on individual behavior; when a substance is legalized for medical purposes, it not only becomes more available but also gains a "halo effect" of perceived safety and therapeutic legitimacy.
The medical aspect of the trend is perhaps the most critical for public health officials to monitor. The researchers found significant increases in cannabis use among older adults suffering from chronic diseases. This includes individuals managing multiple concurrent conditions such as heart disease, diabetes, hypertension, cancer, and chronic obstructive pulmonary disease (COPD). As the American population ages, the prevalence of these chronic conditions naturally increases, and many seniors appear to be turning to cannabis as a potential tool for symptom management, whether for pain, insomnia, or anxiety.
However, this trend toward self-medication or supplemental therapy comes with a set of unique risks for the geriatric population. Dr. Han, speaking from his perspective as a geriatrician, expressed concern about the potential for adverse effects. He noted that while more of his patients are expressing interest in cannabis to treat their health symptoms, the substance can complicate the management of complex chronic diseases. Aging brings about physiological changes—such as a slower metabolism, changes in body composition, and decreased organ function—that can make older adults much more sensitive to psychoactive substances than younger users. There is also the significant risk of drug-to-drug interactions, as many seniors are already taking a regimen of several prescription medications.
The study authors also pointed out a "cohort effect" that likely contributes to these rising numbers. The generation currently entering the 65-and-older bracket—the Baby Boomers—came of age during a period when marijuana was more culturally visible than it was for the generations that preceded them. As these individuals age, they may be carrying their previous experiences with cannabis into their later years, or they may be more open to returning to the drug now that legal and social barriers have been lowered. In essence, the increase is partly driven by people who were already comfortable with cannabis "aging into" the demographic studied.
Regardless of the underlying reasons, the researchers are calling for a proactive response from the medical community. They recommend that clinicians incorporate routine screening for cannabis use into their evaluations of older patients. This is not necessarily for the purpose of discouragement, but rather to ensure that patients are educated on the potential risks and how cannabis might interact with their existing health conditions and medications. Education is paramount, as many seniors may operate under the assumption that "natural" or "legal" necessarily means "risk-free," a misconception that can lead to complications in a population already vulnerable to falls, cognitive impairment, and cardiovascular stress.
The research, which also involved co-authors Kevin H. Yang of UC San Diego and Charles Cleland of NYU Grossman School of Medicine, was supported by several grants from the National Institute on Drug Abuse (NIDA) and the UC San Diego Sam and Rose Stein Institute for Research on Aging. As the legal landscape continues to shift and more states consider recreational and medical legalization, the researchers expect that these numbers will only continue to rise. The study serves as a vital reminder that the conversation surrounding cannabis in America is no longer just about youth culture or criminal justice reform; it is increasingly a conversation about geriatric care, chronic disease management, and the evolving health needs of an aging nation.
