Age Differences in Cannabis Consumption Patterns and in Associations Between Delta-9-Tetrahydrocannabinol Intake and...

Cannabis use has risen disproportionately among middle-aged and older U.S. adults, groups particularly vulnerable to adverse effects, including cannabis use disorder (CUD). Consumption patterns have diversified in recent years. The quantity of cannabis use, historically measured in limited ways (e.g., number of joints), is now considered a key risk factor for CUD. However, age-related differences in consumption patterns and their relationships with CUD remain understudied. This study investigated age-related differences in consumption patterns and examined the relationship between quantity of use-measured by milligrams of THC (mgTHC)-and self-reported CUD in individuals with regular cannabis use.

A total of 4134 U.S. adults (ages 18+; 45.9% male, 54.1% female) who reported daily cannabis use completed an online survey assessing cannabis consumption patterns and self-reported Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition's CUD criteria. Pearson's chi-square tests and one-way analysis of variance examined differences in sex, reasons for use, methods of consumption, CUD severity, criteria count, and mgTHC with comparisons across three age-groups (18-49, 50-64, 65+). Regression models, adjusted for sex and reasons for use, analyzed age-specific associations between mgTHC and CUD.

Overall, over 70% reported using cannabis for both medical and recreational purposes. Middle-aged adults were more likely to report medical use than younger ones (18.1% vs. 13.7%; p < 0.001) and older adults (14.1%; p = 0.027). Older adults were more likely to report recreational-only use compared with middle-aged adults (15.8% vs. 10.5%; p = 0.002). Smoking buds was the most common consumption method across age-groups, while high-potency concentrate use declined with age. In the overall sample, daily mgTHC was associated with CUD severity, and middle-aged and older adults endorsed fewer CUD criteria than younger adults at all levels of mgTHC; however, age effects were not statistically significant.

Among daily cannabis consumers, middle-aged and older adults differed from younger consumers in methods of consumption and reasons for use. While both groups consumed lower quantities than their younger counterparts, no age-related differences were observed in the relationship between mgTHC consumption and CUD, contrasting with evidence suggesting that older cannabis consumers may be more vulnerable to cannabis-related negative outcomes.