NYU study seeks to understand the prevalence of use in older adults
The recent legalization of recreational marijuana (cannabis) use in California, Colorado, and Washington reflect the sweeping changes in the attitudes and perceptions towards marijuana use in the United States. Eight states have voted in favor of legal recreational marijuana and 26 states in total allow medicinal marijuana.
There is a common misperception that widespread marijuana use is limited to younger generations. However, the Baby Boomer generation has reported higher rates of substance use than any preceding generation.
“Given the unprecedented aging of the U.S. population, we are facing a never before seen cohort of older adults who use recreational drugs,” says Benjamin Han, MD, MPH, a geriatrician and health services researcher at the Center for Drug Use and HIV Research (CDUHR) and in the Division of Geriatric Medicine and Palliative Care at NYU Langone Medical Center (NYU Langone).
“With the increased availability of legalized marijuana, there is an urgent need to understand the prevalence of its use and also its effects among older generations,” continued Dr. Han. “The paucity of knowledge in this area constrains the care for a changing demographic of older adults with higher rates of substance use.”
To address this, Dr. Han and his team led a study, “Demographic Trends among Older Cannabis Users in the United States, 2006-2013.” Published in Addiction, the study sought to determine the trends in the prevalence and patterns of cannabis use, attitudes towards cannabis use, and determine correlates of use among adults over the age of 50.
The researchers evaluated responses from 47,140 adults aged 50 and older in the United States through a secondary analysis of the National Survey on Drug Use and Health (NSDUH) from 2006 to 2013. The NSDUH provides national data on the use of tobacco, alcohol, illicit drugs and mental health in the United States.
The authors found a 71% increase in marijuana use among adults aged 50 and older between 2006 and 2013. Adults ages 65 and older had a significantly lower prevalence of marijuana use compared to those ages 50-64, but prevalence of use increased two and a half times over eight years. Overall, prevalence was higher among men than women through all years.
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“We found only five percent of these older users felt using marijuana once or twice a week was a great risk to their health” said Joseph J. Palamar, PhD, MPH, a CDUHR affiliated researcher and an assistant professor of Population Health at NYU Langone.
"I thought the perception of low risk was fascinating because, typically, we think of older generations as drug-adverse, and perceiving most drugs to be risky," said Dr. Palamar. "But apparently very few Baby Boomer users consider marijuana use risky. But after all, this was the generation who was there, in the late 1960s, when the counterculture revolution exploded marijuana into mainstream popularity."
The researchers note that the majority of self-reported marijuana users indicated they first started using before the age of 18. This means that most of the current users either continued use or have begun using again more recently. Research is needed to determine whether this is related to changes in local, state, and national acceptance.
“Personally, I don’t think we need to be very alarmed about most older people who are using marijuana,” notes Dr. Palamar, “as our results suggest that only 4% started use after age 35. It is probable that most older users are at least somewhat experienced and are hopefully at reasonably low risk of harming themselves or others after use.”
The results, however, give the researchers reason to believe the population may be at a particularly high risk for adverse health outcomes, as the concurrent use of multiple substances (marijuana, prescribed prescription drug, and even self-prescribed illicit drugs) all used in combination may make older adults further vulnerable to poor physical and mental health outcomes and certainly can impact their care.
Dr. Palamar notes that as a public health researcher, “for years we’ve been worried about the potential effects of marijuana on the developing brains of teens, but now we may need a bit more focus on their grandparents, who are increasingly more likely to be current users.”
“Older people may use marijuana for a variety of reasons—including medical reasons—however we need to make sure they are not using in a hazardous manner since older adults may be vulnerable to its possible adverse effects. One particular concern for older users is the risk of falls while using marijuana, however this has not yet been studied,” Dr. Han added.
This study underscores the need for further research on marijuana use and its effects in this population. More importantly, the research dispels the myth that older adults do not use recreational drugs. It is the researchers' hope that their study encourages cannabis use questions to become a part of older adults’ care plan screenings.
Researcher Affiliations: Benjamin H. Han1,2, Scott Sherman1,2,3, Pia M. Mauro4, Silvia S. Martins4, James Rotenberg1, Joseph J. Palamar 2,3
New York University School of Medicine, Department of Medicine, Division of Geriatric Medicine and Palliative Care
Center for Drug Use and HIV Research, New York University College of Nursing 3
New York University School of Medicine, Department of Population Health
Columbia University, Department of Epidemiology, Mailman School of Public Health
This project was funded, in part, by the NIH (K01 DA-038800, PI: Palamar).