Pravosud Vira, Lum Emily, Vali Marzieh, Cohen Beth E, Hoggatt Katherine J, Byers Amy L, Austin Peter C, Walter Louise C, Hasin Deborah, Zaman Tauheed, Keyhani Salomeh
Center for Data to Discovery and Delivery Innovation, San Francisco Veterans Affairs (VA) Health Care System, San Francisco, California.
Northern California Institute for Research and Education, San Francisco.
JAMA Netw Open. 2025 May 1;8(5):e2510173. doi: 10.1001/jamanetworkopen.2025.10173.
Little is known about patterns (forms, frequency, and reasons) and factors associated with cannabis use in older veterans (aged ≥65 years).
To examine factors associated with past 30-day cannabis use and cannabis use disorder (CUD) in older veterans.
DESIGN, SETTING, AND PARTICIPANTS: In this cross-sectional study, community-dwelling adults aged 65 to 84 years who used Veterans Health Administration care were interviewed between February 5, 2020, and August 29, 2023.
Sociodemographic, behavioral, and health-related characteristics.
Past 30-day cannabis use (smoking, vaping, dabbing, or edibles) and any CUD (≥2 criteria based on Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition]) were assessed using weighted multivariable logistic regressions.
Of the 4503 participants (weighted mean age, 73.3 years [95% CI, 73.0-73.5 years]; 85.4% [95% CI, 83.6%-87.2%] men), 58.2% (95% CI, 55.3%-61.0%) had ever used cannabis, 28.9% (95% CI, 26.0%-31.8%) of whom reported using cannabis for medical reasons, most commonly for pain (56.4%; 95% CI, 50.9%-61.9%), mood or mental health (18.4%; 95% CI, 14.7%-22.1%), and sleep (16.0%; 95% CI, 11.9%-20.0%). More than 1 in 10 reported past 30-day cannabis use (10.3%; 95% CI, 8.9%-11.7%), with 52.4% (95% CI, 45.4%-59.4%) of these using cannabis for 20 days or more; smoking (72.4%; 95% CI, 65.4%-79.3%) and edibles (36.9%; 95% CI, 29.8%-43.9%) were the most common forms of use. Characteristics associated with past 30-day use included younger age (65-75 years), economic hardship, tobacco and illicit drug use, and residing in a state with recreationally legal cannabis. Among those with past 30-day cannabis use, 36.3% (95% CI, 30.1%-42.6%) screened positive for CUD, with higher odds among younger respondents, those reporting anxiety, those with 1 or more deficits in activities of daily living, those with illicit drug use, those with frequent cannabis use, and those using cannabis recreationally. Past 30-day inhaled cannabis use, compared with edibles only, was associated with increased odds of any CUD (adjusted odds ratio, 3.56; 95% CI, 1.12-11.26).
In this cross-sectional study of cannabis use in older veterans, use was common, and more than one-third who used in the past 30 days had any CUD. The prevalence of past 30-day cannabis use was close to tobacco use prevalence, and risk factors for cannabis use were similar to those observed in other populations. Frequent and inhaled cannabis use was associated with higher odds of any CUD. Routine health screening for cannabis use in Veterans Health Administration clinical settings is necessary to identify older adults with cannabis use.
关于老年退伍军人（年龄≥65岁）使用大麻的模式（形式、频率和原因）以及相关因素，我们了解甚少。
研究老年退伍军人过去30天使用大麻及大麻使用障碍（CUD）的相关因素。
设计、背景和参与者：在这项横断面研究中，于2020年2月5日至2023年8月29日期间对使用退伍军人健康管理局医疗服务的65至84岁社区居住成年人进行了访谈。
社会人口统计学、行为和健康相关特征。
使用加权多变量逻辑回归评估过去30天使用大麻（吸烟、吸电子烟、涂抹或食用含大麻食品）及任何CUD（基于《精神疾病诊断与统计手册》[第五版]的≥2条标准）情况。
在4503名参与者中（加权平均年龄73.3岁[95%CI，73.0 - 73.5岁]；85.4%[95%CI，83.6% - 87.2%]为男性），58.2%（95%CI，55.3% - 61.0%）曾使用过大麻，其中28.9%（95%CI，26.0% - 31.8%）报告因医疗原因使用大麻，最常见的原因是疼痛（56.4%；95%CI，50.9% - 61.9%）、情绪或心理健康（18.4%；95%CI，14.7% - 22.1%）以及睡眠（16.0%；95%CI，11.9% - 20.0%）。超过十分之一的人报告过去30天使用过大麻（10.3%；95%CI，8.9% - 11.7%），其中52.4%（95%CI，45.4% - 59.4%）使用大麻达20天或更长时间；吸烟（72.4%；95%CI，65.4% - 79.3%）和食用含大麻食品（36.9%；95%CI，29.8% - 43.9%）是最常见的使用形式。与过去30天使用大麻相关的特征包括年龄较轻（65 - 75岁）、经济困难、使用烟草和非法药物以及居住在大麻娱乐使用合法的州。在过去30天使用过大麻的人群中，36.3%（95%CI，30.1% - 42.6%）CUD筛查呈阳性，在年轻受访者、报告有焦虑的人、日常生活活动有1项或更多缺陷的人、使用非法药物的人、频繁使用大麻的人以及娱乐性使用大麻的人中，CUD的几率更高。与仅食用含大麻食品相比，过去30天吸入大麻与任何CUD的几率增加相关（调整后的优势比，3.56；95%CI，1.12 - 11.26）。
在这项关于老年退伍军人使用大麻的横断面研究中，大麻使用很常见，过去30天使用大麻的人中超过三分之一患有任何CUD。过去30天使用大麻的患病率接近烟草使用率，大麻使用的风险因素与在其他人群中观察到的相似。频繁和吸入式大麻使用与任何CUD的几率较高相关。在退伍军人健康管理局临床环境中对大麻使用进行常规健康筛查对于识别使用大麻的老年人是必要的。
