title: The Increasing Use of Cannabis Among Older Americans: A Public Health Crisis or Viable Policy Alternative?
abstract: Cannabis use among older Americans is increasing. Although much of this growth has been attributed to the entry of a more tolerant baby boom cohort into older age, recent evidence suggests the pathways to cannabis are more complex. Some older persons have responded to changing social and legal environments and are increasingly likely to take cannabis recreationally. Other older persons are experiencing age-related health care needs, and some take cannabis for symptom management, as recommended by a medical doctor. Whether these pathways to recreational and medical cannabis are separate or somewhat tangled remains largely unknown. There have been few studies examining cannabis use among the growing population of Americans aged 65 and older. In this essay, we illuminate what is known about the intersection between cannabis and the aging American population. We review trends concerning cannabis use and apply the age-period-cohort paradigm to explicate varied pathways and outcomes. Then, after considering the public health problems posed by those who misuse or abuse cannabis, we turn our attention to how cannabis may be a viable policy alternative in terms of supporting the health and well-being of a substantial number of aging Americans. On the one hand, cannabis may be an effective substitute for prescription opioids and other misused medications; on the other hand, cannabis has emerged as an alternative for the undertreatment of pain at the end of life. As intriguing as these alternatives may be, policy makers must first address the need for empirically driven, representative research to advance the discourse.
authors.affiliation: Department of Health Management and Policy, College of Public Health, University of Iowa.
authors.forename: Brian
authors.initials: B
authors.lastname: Kaskie
authors.affiliation: Department of Health Management and Policy, College of Public Health, University of Iowa.
authors.forename: Padmaja
authors.initials: P
authors.lastname: Ayyagari
authors.affiliation: Department of Health Management and Policy, College of Public Health, University of Iowa.
authors.forename: Gary
authors.initials: G
authors.lastname: Milavetz
authors.affiliation: Department of Health Management and Policy, College of Public Health, University of Iowa.
authors.forename: Dan
authors.initials: D
authors.lastname: Shane
authors.affiliation: Department of Health Management and Policy, College of Public Health, University of Iowa.
authors.forename: Kanika
authors.initials: K
authors.lastname: Arora
mesh_terms: D000368:Aged; D000529:Complementary Therapies / Q000379:methods; D000076064:Drug Misuse; D011307:Drug Prescriptions; D005260:Female; D006291:Health Policy; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D000074609:Marijuana Use / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D011634:Public Health / Q000331:legislation & jurisprudence / Q000379:methods / Q000706:statistics & numerical data; D012940:Social Problems / Q000517:prevention & control / Q000523:psychology; D014481:United States / Q000453:epidemiology
keywords: Alternative and complementary medicine/care/therapy; Health care policy; Medications/prescriptions/OTC drugs/pharmacology; Pain management; Public policy