Communication Gaps: Cannabis Use in Older Adults' Healthcare

As cannabis use among older adults increases, clinicians engaging people in screening and brief interventions is central to reducing cannabis-related harms. Information is needed about cannabis or drug screening among older adults and targeted cannabis-related discussions. The 2021-2023 National Survey on Drug Use and Health included N=14,387 U.S. adults aged ≥65 years self-reporting any past-year healthcare visit. Weighted generalized logistic models conducted in 2025 identified characteristics associated with any cannabis or illegal drug use screening. Those reporting past-year cannabis use self-reported discussions with clinicians about cannabis or other drugs. Adjusted multinomial logistic regressions estimated characteristics associated with cannabis discussions, screening only, or no screening/discussions. Among older adults encountering the healthcare system, 36.83% reported cannabis or illegal drug screening. Screening was higher in people with 2+ chronic conditions, alcohol use and higher income, but lower among Hispanic/Latine people. Among the 8.1% who self-reported past-year cannabis use (N=1,194), 19.18% discussed cannabis use with clinicians; discussions (vs. no screening/discussions) were more likely among those with 2+ chronic conditions (aRRR=1.78, 95% CI=1.15, 2.75) or mild mental illness (aRRR=2.62, 95% CI=1.18, 5.78) and less likely among Hispanic/Latine (aRRR=0.23, 95% CI=0.08, 0.66), other racial groups compared to white older adults, or reporting alcohol use. One in three older adults reported any cannabis or drug screening; screening was even lower for Hispanic/Latine older adults. Fewer than one in five who used cannabis discussed their use with clinicians. Removing barriers to screening and discussions is needed to prevent negative cannabis-related consequences in older adults.