Pia Mauro's team at Rutgers Health uncovered a troubling silence: fewer than 1 in 5 older adults who use cannabis have ever discussed the habit with their doctor. In a health landscape where cannabis use among people over 65 is quietly rising—10.5% reported past-year use in the 2024 National Survey on Drug Use and Health—this communication gap could leave millions of aging Americans vulnerable.
The disconnect matters because older bodies are different. Aging and the chronic diseases that often accompany it make people 65 and older far more susceptible to cannabis's harmful effects, from falls and confusion to dangerous drug interactions. Yet the Rutgers researchers, who analyzed nationally representative data from over 14,000 older adults, found that even screening is rare: just 1 in 3 older adults reported being asked about cannabis or drug use by a clinician in the past year.
"Cannabis use is on the rise; therefore it's crucial for physicians to facilitate important conversations about the potential consequences of cannabis, especially for older adults and those with chronic diseases," said Mauro, lead author of the study published in the American Journal of Preventive Medicine. The research didn't just identify the problem—it also revealed it's not inevitable. Clinicians already have the tools: single-item screening questions that are simple to implement during routine visits could transform how medicine addresses cannabis use in aging populations.
The barriers are real but surmountable. Some clinicians feel uncertain or uncomfortable discussing cannabis, and many want better education on its medical applications. But the solution, according to Mauro and her team, is straightforward: make screening for cannabis use part of routine medical care for all older adults. It's practical, available, and evidence-based.
What makes this research especially pressing is what it reveals about who's being left out. Older women and older Hispanic or Latine populations reported even lower rates of screening and discussion—a pattern that researchers attribute partly to lower rates of cannabis use among women and systemic barriers facing marginalized communities. Those gaps deserve attention and further study.
The stakes are personal. A 75-year-old using cannabis for chronic pain, or an older adult trying it for insomnia, may not realize how it interacts with their blood pressure medication, or how it increases their fall risk. Without a conversation with their doctor, they're making choices in isolation. The Rutgers study, drawing on data from 2021 to 2023, shows that these conversations simply aren't happening at scale.
Looking ahead, researchers are calling for deeper investigation into how state-level recreational cannabis laws shape these patterns, and for studies that could examine geographic and demographic variations with more precision. Until then, the path forward is clear: older adults deserve the same routine screening and honest dialogue that medicine already provides for other drugs. Cannabis use is no longer a fringe issue—it's affecting millions of older Americans, and it's time clinicians and patients talked about it.