Changes in and correlates of cannabis-involved substance use treatment admissions age 50 and older, 2000-2021

Cannabis use among U.S. older adults has risen rapidly over the past two decades. This study examined the changes in and correlates of cannabis-involved substance use treatment admissions among this demographic.

Using the 2000-2021 concatenated Treatment Episode Data Set-Admissions (TEDS-A) age 50+ (N=5,593,004), we fitted joinpoint regression models to examine changes in the percent of cannabis-involved admissions of all substance use admissions. We used multinomial and binary logistic regression models to examine the demographic and treatment-related correlates of cannabis-primary admissions and cannabis-secondary/tertiary admissions.

During the study period, the number of cannabis-involved admissions increased substantially, while their share of all admissions increased and then decreased as other drug-related admissions increased. The annual percentage changes (APC) show that the shares of cannabis-involved admissions of all admissions between 2000 and 2012 increased for the 50-64 age group and then decreased between 2012 and 2021. In the 65+ age group, the shares increased between 2000 and 2016 (APC=5.2) and then plateaued. Compared to no-cannabis admissions, the likelihood (relative risk ratio) of all cannabis-involved admissions was higher among males, black people, residents of states where medical or recreational cannabis use was legal, and referrals from healthcare providers and court/criminal legal systems. The likelihood (adjusted odds ratio [AOR]) of cannabis-primary admissions was higher among those age 65+ (aOR=1.04, 95%CI=1.00-1.08), black people (aOR=1.34, 95% CI=1.32-1.36), Hispanic people (aOR=1.26, 95% CI=1.23-1.29), residents of states with medical cannabis laws, and those who were referred by healthcare providers and legal systems.

Cannabis-involved admissions are projected to continue to increase as cannabis use continues to increase. More effective regulations and enforcement of delta-9-tetrahydrocannabinol potency and research on cannabis harms and poly-substance use are needed to protect the health of older adults who turn to cannabis for its purported health benefits. Increased availability and accessibility of treatment infrastructure are also needed.