Among Americans 65 and older who said they used cannabis in the previous year, 11.4% met the clinical criteria for cannabis-use disorder, according to a national survey analysis led by UC San Diego researchers. The study, published Monday in the journal Addiction, offers a sharper measure of problematic use in an age group whose cannabis consumption has risen but whose risks are often discussed only in general terms.
Cannabis-use disorder means use has produced problems or interfered with daily life; it is not simply a count of how often someone consumed cannabis. Researchers applied the diagnostic criteria to responses from 21,189 adults in the 2021 through 2024 National Survey on Drug Use and Health. An estimated 8.9% of adults 65 and older reported past-year cannabis use. The one-in-nine figure applies to that user group, not to every older adult.
Severity also matters. Of the users who met the criteria, 76% were classified as having mild disorder, 20.1% moderate and 3.9% severe. The most commonly reported signs were spending substantial time obtaining cannabis, using it or recovering from its effects, at 74.4%; craving, at 67.5%; and tolerance, at 48.3%. Those details show why a screening conversation can reveal more than a yes-or-no question about use.
Frequency had the clearest relationship. People reporting cannabis use on at least 300 days in the prior year were almost four times as likely to meet the disorder criteria as less frequent users. Smoking was also strongly associated with disorder. Across all older past-year users, 65.8% reported smoking, 40.5% ate or drank a cannabis product and 15.4% vaped; respondents could report more than one route.
About 19.9% said a physician had recommended some or all of their use. That does not mean the remaining use was necessarily illicit or that a recommendation prevents harm. Older adults are more likely than younger people to manage chronic conditions and multiple prescriptions, while age-related changes can alter how drugs affect balance, thinking and metabolism. The UC San Diego release points to earlier research linking cannabis use in older adults with falls, poisoning, cognitive problems and emergency care, but the new analysis was designed to estimate disorder and associations, not to prove those outcomes were caused by cannabis.
The same caution applies to the links with mental illness, tobacco and other drug use. Cannabis-use disorder was more common among respondents reporting those conditions or behaviors, yet a cross-sectional survey cannot determine which came first or isolate every confounding factor. Self-reported answers can also be affected by memory and willingness to disclose use. Because the sample is nationally representative, the percentages should not be read as a San Diego County prevalence estimate.
Lead author Benjamin Han, an assistant professor at UC San Diego School of Medicine, said attention to possible therapeutic benefits and acute side effects has left less focus on harmful patterns of use. The large majority of identified cases were mild, which the research team describes as an opportunity for earlier intervention rather than a reason to dismiss them. A brief discussion can address frequency, route, medication interactions, cravings and whether use is disrupting obligations or relationships.
For clinicians, the result argues for placing cannabis alongside alcohol, tobacco and prescriptions in routine medication review instead of treating it as a separate cultural question. For patients, it supplies a more useful threshold than moral labels: whether use is becoming harder to control or is beginning to cost time, safety or function. The study does not tell any individual to start or stop. It identifies where a more specific conversation should begin.