Cannabis use among older adults—aged 65 and older in the United States—has surged in recent years. While many seniors report using cannabis to address chronic pain, sleep disturbances, anxiety, and other age-related symptoms, the safety profile for this demographic remains an area of evolving science.
Reported Benefits and Therapeutic Claims
Multiple surveys and observational studies suggest that older individuals who initiate cannabis use—often after age 60—report improvements in pain management, sleep quality, and mental health wellness. A growing body of data also shows that medical cannabis use in older patients is associated with a reduction in prescription drug use, particularly opioids. Small trials and anecdotal cases further highlight improvements in agitation and insomnia among patients living with dementia when using low-dose THC combined with CBD.
Risks and Potential Harms in Seniors
Aging introduces physiological changes such as slower metabolism, altered drug clearance, and increased sensitivity to medication—all of which can influence how seniors respond to cannabinoids. Adverse effects like dizziness, confusion, sedation, impaired coordination, and short-term memory issues are more common in this group and can increase the risk of falls and emergency room visits.
Cardiovascular concerns are also relevant, as cannabis can elevate heart rate and blood pressure, which may pose risks for seniors with underlying heart conditions. While much of the long-term research on cannabis-related cognitive decline and psychiatric issues stems from younger populations, seniors may be especially vulnerable when using high-THC products or consuming cannabis frequently.
Clinical Guidance and Practical Considerations
Geriatric healthcare professionals often recommend a cautious approach to cannabis for seniors: start low and go slow. Products high in CBD and low in THC are generally preferred for older patients due to their milder psychoactive effects. Non-inhalable methods such as tinctures and capsules are considered safer than smoking or vaping, particularly for those with respiratory concerns.
Edibles require extra caution, as the delayed onset can lead to accidental overconsumption. In addition, seniors are more likely to be on multiple medications, raising the potential for cannabis to interact with drugs metabolized by the liver, especially those involving the cytochrome P450 enzyme system.
A significant concern is that many older adults do not disclose their cannabis use to their primary care providers. Open communication between patients and clinicians is essential to prevent adverse effects, monitor interactions, and ensure that cannabis is used safely and effectively.
In Review
Cannabis may provide therapeutic benefits for seniors coping with pain, sleep disorders, anxiety, or age-related conditions. However, its use carries unique risks for this population due to physiological changes, polypharmacy, and potential for cognitive or cardiovascular effects. Individual assessment and careful dosing are key to safe use.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Patients and caregivers should always consult with a licensed healthcare professional before beginning or altering cannabis use.