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Over one-tenth of US veterans aged 65–84 reported cannabis use in the past 30 days, listing pain, mental health symptoms, and sleep issues as top motives.

According to a study published by JAMA Network Open, more than one in ten US veterans aged 65–84 reported cannabis use in the past 30 days, listing pain, mental health symptoms, and sleep issues as top motives. Among these users, over half consumed cannabis on at least two‑thirds of those days.

“To our knowledge, this was the first large national study that used combined EHR (electronic health records) and participant interview data to examine factors associated with current cannabis use and CUD among older veterans,” wrote study author Vira Pravosud, PhD, MPH, MS, San Francisco VA Medical Center, and colleagues. “Cannabis use was common and similar to estimates reported in younger populations; more than one-third of the participants with past 30-day use had any CUD.”

Background & Objectives

To examine factors associated with past 30-day cannabis use and CUD in older veterans, the researchers conducted a cross-sectional study using telephone interviews linked to Veterans Health Administration (VHA) records. The team assessed 4,503 community‑dwelling veterans aged 65–84 years (February 2020–August 2023). The study quantified past‑30‑day cannabis use, identified CUD via Diagnostic and Statistical Manual of Mental Disorders (DSM‑5) criteria, and evaluated sociodemographic, behavioral, and health‑related correlates.

Prevalence & Correlates of Use

Overall, 10.3 % of respondents—almost double the civilian rate for the same age group—reported recent cannabis exposure; 52 % used on at least 20 of the previous 30 days. The most commonly reported reasons for use were pain (56.4%), mental health symptoms (18.4%), and sleep (16.0%). Smoking was the most dominant route (72%), followed by edibles (37%). Multivariable models showed higher odds of use among veterans aged 65–75 years, those experiencing financial hardship, concurrent tobacco or illicit drug users, and residents of states where recreational cannabis is legal.

“The prevalence of past 30-day cannabis use was close to tobacco use prevalence, and risk factors for cannabis use were similar to those observed in other populations,” the authors observed.

Burden of CUD

Among current users, 36.3 % met DSM‑5 criteria for CUD. Risk was highest in younger seniors, individuals with anxiety, veterans with one or more deficits in activities of daily living, and those reporting past‑month illicit drug use. Inhaled administration—smoking, vaping, or dabbing—conferred a 3.56‑fold increase in adjusted odds of CUD compared with exclusive edible use, independent of frequency. Recreational, rather than medical, motivation further amplified vulnerability.

Need for Screening & Education

The authors noted several study limitations: the cross-sectional design, which precludes causal inference; the veteran-only EHR cohort, which restricts generalizability beyond older VHA patients; and reliance on self-reported telephone data, which is susceptible to recall and social-desirability bias, and may vary with state cannabis laws.

Nonetheless, the authors stated, “Given high rates of frequent cannabis use and CUD among older veterans, screening for cannabis use in clinical settings may be necessary, alongside referrals to appropriate specialty treatment.”

The team noted that current VA guidelines recommend that patients with CUD be offered referral to mental health services for evidence-based treatments: motivational interviews, contingency management, and cognitive behavioral therapy.

“However, if unidentified, patients cannot be offered existing evidence-based treatments,” the authors wrote. “Screening and informing older veterans about risks of cannabis use is critical because cannabis use may confer more health risks than benefits.^”