ORIGINAL RESEARCH article
Front. Public Health
Sec. Substance Use Disorders and Behavioral Addictions
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1592551
This article is part of the Research TopicImproving and Implementing Addiction CareView all 3 articles
Changes in and Correlates of Cannabis-involved Substance Use Treatment Admissions Age 50 and Older, 2000-2021
Provisionally accepted
- 1The University of Texas at Austin, Austin, United States
- 2Philadelphia College of Osteopathic Medicine (PCOM), Philadelphia, Pennsylvania, United States
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Background and Aims: 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.Methods: 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 cannabisinvolved 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.Results: 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 2012-2021. 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 cannabisinvolved 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.Implications: 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.
Keywords: older adults, Cannabis use Disorder, Cannabis use treatment, Cannabis legalization, Substance use treatment
Received: 12 Mar 2025; Accepted: 12 Jun 2025.
Copyright: © 2025 Choi, Marti and Choi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Namkee G. Choi, The University of Texas at Austin, Austin, United States
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