The dispensary visit

By Susan Lehmann, MD, Johns Hopkins Medicine

An 82-year-old patient told me that he went to a local medical marijuana dispensary and spoke to an employee about possibly getting a cannabis product to help with his anxiety and depression. The patient shared that when he asked about whether he should be concerned about potential interactions with his long list of prescription medications, the employee, without knowing his medical conditions or medications, stated confidently that there were none. Ultimately, the patient left the dispensary without making a cannabis purchase, but I was thankful he shared this encounter with me as it gave me the opportunity to talk to him further about cannabis.

Cannabis and older adults

Cannabis use and cannabis use disorder among older adults has significantly increased over the past 10 years. Older adults often turn to cannabis for distressing symptoms that may not have been fully remediated by traditional pharmacologic agents, including pain, insomnia, and anxiety. They often assume that cannabis is safer than prescription medications because it’s derived from a plant. However, studies have found that cannabis use in older adults poses risks for harmful interactions with prescription medications, as well as risks for mental confusion, falls, and cognitive impairment. While access to medical or recreational cannabis is legal in most states, it remains an unregulated industry with no oversight regarding product safety, potency, or efficacy.

A recent 2026 study by Han et al. adds to our understanding of potential harms of cannabis use by focusing on the risk of developing cannabis use disorder among individuals aged 65 and older. The researchers did a secondary analysis of the 2021-2024 National Survey of Drug Use and Health (NSDUH). The NSDUH is an annual cross-sectional survey of a nationally representative sample of noninstitutionalized people, ages 12 and up, living in the United States. They found that 8.9%, or one in 11 older adults, used cannabis in the previous 12 months and of these individuals, 11.4%, or one in 9 people, met criteria for cannabis use disorder. While most people had mild cannabis use disorder, 24% had moderate or severe use. Notably, the study found that there was a higher risk for cannabis use disorder among older adults who vaped cannabis compared with those who smoked cannabis or consumed it through food or drink. Additionally, only a fourth of older individuals who used cannabis in the past 30 days had done so for medical purposes recommended by a clinician.

Talking with older adults about cannabis

This study highlights the importance of talking to older patients about cannabis and to screen for unhealthy cannabis use and cannabis use disorder. Yet, cannabis use disorder, like alcohol use disorder, can be harder to detect in older adults and may be overlooked by clinicians. Older adults might not tell clinicians about their use of cannabis and might not recognize problematic use in themselves. Interventions to treat cannabis use disorder include behavioral and psychological approaches, such as motivational enhancement therapy and cognitive behavioral therapy, to encourage patients to decrease use and prevent harms. As with all discussions about patients’ behavior and choices, it’s important to maintain a respectful and nonjudgmental stance. Listening to patients share why they use cannabis can prompt helpful exploration about other ways to better manage chronic symptoms.

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.