Dr. Benjamin Han, a geriatrician and addiction medicine specialist at the University of California, San Diego, shares a cautionary story with his students about a 76-year-old patient struggling with insomnia. Like many older adults, the patient had difficulty falling asleep and would often wake up during the night. In an attempt to help, her daughter brought her sleep gummies containing cannabis.
Initially, the woman took one gummy after dinner and waited 30 minutes, but felt no effects. She then took three more gummies over the next few hours, each containing 10 milligrams of THC, the psychoactive ingredient in cannabis.
Dr. Han advises patients to “start low, go slow,” suggesting they begin with products containing just 1 to 2.5 milligrams of THC. However, this patient exceeded that recommendation. Soon, she experienced intense anxiety and heart palpitations. Although young people might have brushed off these symptoms, the woman, who had hypertension and atrial fibrillation, became frightened and went to the emergency room.
After lab tests and a cardiac evaluation ruled out a heart attack, the woman was sent home, with her only lingering symptom being embarrassment. Dr. Han, however, warned of the potential risks: what if the patient had fallen or injured herself while dizzy? He noted that some of his patients have been injured in falls or while driving after using cannabis, and that drug interactions with prescriptions could pose additional dangers.
“As a geriatrician, it gives me pause,” Dr. Han said. “Our brains are more sensitive to psychoactive substances as we age.”
With cannabis now legal for medical use in 39 states and the District of Columbia, and recreational use permitted in 24 of those states, the number of older adults using cannabis is rising. Dr. Han explained that while the benefits of cannabis for older adults remain unclear, there is growing evidence of potential harms. Recent studies show an increase in cannabis-related emergency room visits and hospitalizations among older users. One Canadian study even linked such incidents to a higher risk of dementia.
Older adults are more likely than younger people to try cannabis for therapeutic reasons, such as managing chronic pain, insomnia, or mental health issues. However, experts emphasize that the evidence supporting cannabis as an effective treatment for these conditions is limited.
A recent study published in the journal JAMA found that cannabis use among adults aged 65 and older has increased significantly. In 2023, 7 percent of respondents in this age group reported using cannabis within the last 30 days, up from 4.8 percent in 2021. Back in 2005, fewer than 1 percent of older adults reported using cannabis in the past year.
This rise in cannabis use among seniors is driven in part by the widespread legalization of cannabis. States where cannabis is legal tend to have higher usage rates among older adults. Additionally, public perception of cannabis has shifted, with more people believing it is safer than smoking cigarettes. A 2021 national survey found that 44 percent of Americans thought smoking cannabis daily was less risky than smoking cigarettes, although this view does not align with existing scientific evidence.
The cannabis industry is also targeting older adults with marketing efforts. Some dispensaries, like Trulieve, offer discounts to customers over 55, while others, such as RISE Dispensaries, have hosted educational programs for seniors.
Despite the growing use of cannabis, not all older users are experiencing positive results. Liz Logan, 67, a freelance writer from Bronxville, New York, struggled with sleep and anxiety for years, particularly as her husband battled Parkinson’s disease. “I’d frequently be awake until 5 or 6 in the morning,” she said. “It makes you crazy.” Logan turned to cannabis to help manage her symptoms and found some relief, but not all older adults have had the same experience.
As cannabis use among older adults increases, experts are urging caution, especially when it comes to dosage and potential health risks. Dr. Han’s advice remains clear: “Start low; go slow.”
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