Age Differences in Patterns of Cannabis Use Among U.S. Adults Who Consume Cannabis Frequently

TL;DR

This study explores how cannabis use patterns differ among U.S. adults of different ages, focusing on medical and recreational use and the risk of cannabis use disorder.

Contribution

The study identifies age-specific differences in cannabis consumption patterns and their association with cannabis use disorder among frequent users.

Findings

Middle-aged adults reported higher medical use compared to younger and older adults.

Older adults more frequently reported recreational-only use compared to middle-aged adults.

Daily THC consumption was positively linked to cannabis use disorder severity, but middle-aged and older adults had fewer disorder criteria than younger users.

Abstract

Cannabis use has risen disproportionately among middle-aged and older U.S. adults, groups vulnerable to adverse effects, including cannabis use disorder (CUD). While consumption patterns have diversified, age-related differences in such patterns remain understudied. This study examined variations in cannabis behaviors and the relationship between quantity—measured in milligrams of THC (mgTHC)—and CUD in regular users. A total of 4,134 U.S. adults who reported daily cannabis use completed an online survey assessing consumption patterns and DSM-5 CUD criteria. Comparisons across sex, reasons for use, methods of consumption, CUD severity, criteria count, and mgTHC were conducted 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. Over 70% of participants used cannabis for both medical and recreational purposes. Middle-aged adults reported medical use more frequently than younger (18.1% vs. 13.7%; p < 0.001) and older adults (14.1%; p = 0.027), while older adults more often reported recreational-only use than middle-aged adults (15.8% vs. 10.5%; p = 0.002). Smoking buds was the most common method, with high-potency concentrate use declining with age. Daily mgTHC was positively associated with CUD severity, though middle-aged and older adults endorsed fewer CUD criteria than younger users at all mgTHC levels, with no significant age effects. Findings highlight age-related differences in consumption and reasons for use. Despite consuming less than younger users, older adults remain at risk, underscoring the need for targeted prevention strategies.