One Third of Older Veterans Who Use Cannabis Have CUD

Medscape

3 days ago

About 36% of older veterans who recently used cannabis screened positive for cannabis use disorder (CUD), with a higher risk observed among younger respondents, individuals with anxiety, and frequent users, a new analysis showed. Investigators said the findings suggest asking about cannabis use during all routine health exams could help identify patients for treatment.
METHODOLOGY:
This cross-sectional study included data of 4503 older adults (weighted mean age, 73.3 years; 85% men; 78% non-Hispanic White individuals) from the Veterans Health Administration in the United States using interviews and medical records (2020-2023).
Participants were assessed for the use of cannabis in different forms (smoking, vaping, dabbing, or edibles) in the past 30 days and screened for CUD, defined as meeting at least two criteria from the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) .
. Covariates included sociodemographic and health variables.
TAKEAWAY:
Overall, 57% of participants reported lifetime cannabis use, with 29% citing medical reasons, with pain management the most common reason for medical use.
Cannabis use in the past 30 days was reported by 10.3% of participants, with 52% using cannabis for at least 20 days in a month.
Among those with past 30-day use, 36% screened positive for CUD, with higher odds among men, respondents younger than 76 years, individuals with anxiety, and individuals who reported any illicit drug use or frequent cannabis use. Compared with any recreational use, lifetime cannabis use for exclusively medical reasons was associated with lower odds of any CUD.
Past 30-day use of inhaled cannabis was associated with higher odds of CUD than that of edibles only (adjusted odds ratio, 3.56; 95% CI, 1.12-11.26).
IN PRACTICE:
'Older veterans may be at risk for THC intoxication. Prevention of problematic cannabis use and CUD is also crucial in older veterans due to the elevated risk of suicide ideation and exacerbation of mental health concerns experienced by aging populations. Routine health screening for cannabis use in Veterans Health Administration clinical settings is necessary to identify older adults with cannabis use,' the investigators wrote.
SOURCE:
The study was led by Vira Pravosud, PhD, MPH, MS, Center for Data to Discovery and Delivery Innovation, San Francisco Veterans Affairs Health Care System, San Francisco. It was published online on May 14 in JAMA Network Open .
LIMITATIONS:
The study was limited by its cross-sectional design, low generalizability, reliance on self-reported data, and potential recall and social desirability bias.
DISCLOSURES:
The study received support from National Institutes of Health and Tobacco Related Disease Research Program. One author declared receiving nonfinancial support from the San Francisco VA Health Care System during the study. Another received nonfinancial support from the New York State Psychiatric Institute during the study and research support from Syneos Health outside the submitted work.