The Relationship between Method of Cannabis Use and Cannabis Use Disorder Among Older Adults

Background and Purpose: Cannabis use has been increasing among older adults and represents unique health risks for this population. The routes and preferences of cannabis administration have been examined in adolescent and young adult populations; however little research has been conducted among older adult cannabis users. Therefore, the purpose of this study was to examine how method of cannabis use (e.g. smoking, vaping, eating) is related to cannabis use disorder (CUD) among older adults.

Methods: Data came from the 2023 National Survey on Drug Use and Health (NSDUH), an annual survey of adolescents and adults. The sample for this study included adults 50 and over who had used cannabis in the past year, which lead to a total sample size of n=1,369. A categorical variable was created to represent whether all past-year cannabis use had been administered via smoking, vaping, via mouth (e.g. food/drink, pills, lozenges), “dabbing” (e.g. cannabis concentrates), or via skin (e.g. patch). Additionally, a binary variable representing past-year cannabis use disorder was created by asking respondents questions which aligned with criteria found in the fifth edition of The Diagnostic and Statistical Manual of Mental Disorders. A logistic regression model was estimated to examine the relationship between method of cannabis administration and past-year CUD, while accounting for sex, income, race/ethnicity, past-month binge drinking, and multiple chronic health conditions.

Results: Around 13% of older adults had used cannabis in the past year. Among past-year cannabis users aged 50 and over, 18% met criteria for a past-year cannabis use disorder. Additionally, around 39% of the sample had only smoked cannabis, 27% had only vaped, 14% had only ingested via mouth, 15% had only used concentrates/dabbed, and 5% had only used via skin. Method of cannabis use administration and past-year cannabis use disorder were significantly related at the bivariate level (X² (4) = 738.19, p < 0.001). Compared to older adults who had only ingested cannabis via mouth, only smokers (AOR= 1.74, p < 0.05, CI= 1.06 – 2.85), only vapers (AOR= 2.37, p < 0.05, CI= 1.33 – 4.20), only concentrates users (AOR= 6.99, p < 0.05, CI= 3.13 – 15.62), and only skin (AOR= 2.11, p < 0.05, CI= 1.08 – 4.11), were significantly more likely to have a CUD, while accounting for sociodemographic and clinical variables.

Conclusion and Implications: Results from this study suggest that the method of administration of cannabis is significantly related to increased likelihood of having a past-year cannabis use disorder among older adults, with individuals who had only ingested via edible cannabis (food, drinks, pills, lozenges, etc.) having the lowest likelihood of having a past-year CUD. As cannabis use continues to rise in older adults, understanding and addressing the risks associated with different administration routes can support prevention of CUD.