Is It Safe for Older Adults to Use Cannabis?

If you’re using cannabis, and are in your 60s or older, you’re not alone. Older adults are using cannabis more than ever, and it’s largely for medical reasons. They most commonly use it to help with pain, sleep problems, and anxiety. 

Older adults can generally use cannabis safely, with few side effects. But you may need to take some precautions. This is especially true if you have a chronic condition, are taking certain medications, or have anxiety. 

Here’s what to know about the benefits and risks of using cannabis as an older adult. 

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Must be 21 years or older to purchase. Cannabis is not recommended for women who are pregnant or nursing or those who are suffering from bipolar disorder or schizophrenia. Cannabis use may increase risk of falls. Always consult with your doctor before beginning any new medical treatment.

What is cannabis?

The term cannabis generally refers to products that come from the Cannabis plant. These products include: 

• Dried plant material (“buds” or “flower”)

• Oils

• Vape pens

• Edible products

Cannabis can contain a variety of active ingredients, known as cannabinoids. These include tetrahydrocannabinol (THC) and cannabidiol (CBD). Here are the differences between them:

• THC is one of the plant’s main cannabinoids. It’s psychoactive, meaning it can cause a “high.” 

• CBD doesn’t cause a high, though. But it can have a calming effect on your mood, so it’s still technically a psychoactive compound.

Cannabis products can contain a variety of cannabinoids in different amounts. Typically, you’ll find three main types, with different concentrations of THC and/or CBD: 

1. High THC

2. High CBD

3. Equal amounts of CBD and THC (1:1 balance)

Each type has different effects — as well as risks and side effects — to be aware of.

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Common uses of cannabis in older adults

There’s been a significant increase in the number of older adults in the U.S. who’re using cannabis. Among adults age 65 and older who use cannabis, almost two-thirds tried it for the first time after age 60. 

One reason for the increase is that many states have legalized cannabis for personal use. That has led to cannabis being more available — and accepted from a cultural perspective.

Another factor is that older adults are more likely to have chronic conditions. So, they may be using cannabis as an alternative to medications. One review found that more than three-quarters of those who use cannabis say they do so strictly for medical purposes.

The leading medical reasons that older adults use cannabis include:

• Pain and arthritis

• Sleep disturbances

• Anxiety

• Depression 

Other uses of cannabis in older adults include:

• Helping relieve cancer pain

• Treating side effects of chemotherapy

• Treating Parkinson’s disease

• Treating multiple sclerosis

• Palliative (end-of-life) care

Keep in mind that there’s limited research on the effectiveness of cannabis on many of these conditions. There’s evidence that it can provide some relief for chronic pain and symptoms of multiple sclerosis. And studies have found that cannabis can improve sleep in people with health problems, like multiple sclerosis, post-traumatic stress disorder (PTSD), or chronic pain. 

How does cannabis affect blood pressure

You may have heard that cannabis can lower — and raise — blood pressure. Both may be true, so looking at the details is important.

There’s some evidence that people who use cannabis regularly have lower blood pressure, but the research is inconsistent. One theory is that the CBD in cannabis causes blood vessels to relax, which may help reduce blood pressure. An analysis of a large database in the U.K. found that longtime use of cannabis in heart-healthy adults was linked to lower blood pressure. 

On the other hand, your blood pressure may increase right after using cannabis high in THC. This is likely because the high THC may narrow (constrict) your blood vessels. 

If you have a heart condition, talk to your healthcare professional about whether cannabis is safe for you.

Does cannabis have special risks for older people?

Cannabis can often be taken safely. But for older people, there may be risks when using cannabis, such as:

• A greater chance of injury and falls

• Interactions with medications

• An increased risk of heart attack and stroke 

It’s a good idea to talk to your healthcare professional to weigh your personal benefits with the following risks of using cannabis.

Injuries and falls

Using cannabis has been linked to a greater chance of injury and a higher rate of ER visits from serious injuries. That may be because THC can slow reaction time and affect your attention. 

When choosing a cannabis product, look for products with:

• CBD 

• A 1:1 balance of CBC to THC

That may help lower your risk of falls or injury.

Medications

There’s limited research when it comes to interactions between cannabis and prescription medications. But cannabis may interact with certain medications that older adults are more likely to take. And older people are more likely to take multiple medications for chronic conditions. One example is that cannabis may affect the potency of the blood thinner warfarin (Coumadin, Jantoven). 

Before trying cannabis, have a healthcare professional review your medication list. They may be able to advise you on what ratio of CBD to THC is best for you. Or they can let you know if you should avoid cannabis altogether.

Cardiovascular risks

Another concern for older adults is that cannabis may increase the risk of heart attack and stroke. A study found that using cannabis increased the risk of having these heart-related problems. That was true for all types of cannabis use: smoking, eating or drinking, and vaping. And the more people used cannabis, the greater the risks. Daily users were 25% more likely to have a heart attack than non-users. 

Smoking cannabis may be the riskiest way to consume it. That’s because when you smoke cannabis, you inhale particulate matter. In fact, research has shown that smoking cannabis carries many of the same heart hazards as smoking tobacco. 

Still, that doesn’t mean that consuming edibles is without risk. All cannabis products carry a risk for heart problems. 

Anxiety

Many older adults say that cannabis provides relief from anxiety. But others say it increases their anxiety. 

In people of all ages, cannabis can raise the risk of anxiety and panic attacks. That’s particularly true for products that are high in THC. 

Cannabis safety tips for older adults

Cannabis comes in a variety of strains, doses, and ratios. But you may not always know what you’re getting. What’s more, the same cannabis dose can affect people in different ways. 

Your experience with cannabis can depend on several factors:

• How often you use cannabis

• Whether you’re smoking it or consuming it as an edible

• How much THC or CBD is in the product

Your genetics and your gender can also impact how you feel from using cannabis. For example, women have reported more dizziness than men due to cannabis.

It’s important to know the type, potency, and balance of THC and CBD when using cannabis. Below are some tips for using cannabis safely.

Understand THC vs. CBD

When buying cannabis, make sure to look at how much THC and CBD is in the product. There’s a big difference in how they can make you feel:

• THC is the element in the cannabis plant that can cause a “high.” It tends to have more potent effects than CBD, so a little goes a long way. THC may have helpful effects, such as lessening nausea and reducing pain. But it also has side effects like slowing your reaction time. High doses of THC are more likely to cause anxiety and can sometimes increase pain sensations.

• CBD, on the other hand, doesn’t get you high. Popular uses of CBD are for inflammation and anxiety. If CBD is added to a cannabis product, it tends to reduce THC’s psychoactive effects. 

Which product you choose depends on what you’re using it for. It’s usually a good idea to start with a product that contains more CBD than THC. And keep in mind that CBD products sold outside of a state-licensed dispensary aren’t regulated.

Know the THC concentration 

If you haven’t used cannabis in decades, you may be in for a surprise. THC concentrations in cannabis products have increased substantially over the past few decades, making it much stronger. 

This rise in potency may be linked to an increased risk of side effects. And it could explain the rise in ER visits among older adults. Edibles may be adding to the problem. They can take longer to kick in, and people may end up consuming more as they wait for the effects to kick in.

It’s important to know how much THC is in the cannabis you’re consuming. When using cannabis, here are a few things to keep in mind:

• Start slowly if you’re new to cannabis or are trying it again for the first time in many years. 

• If you’re using edibles, you may want to start with high-CBD products that contain 2.5 mg or less of THC. 

• Be aware that the labeling on edibles can be misleading. If a package says 100 mg of THC, that could be what's in the entire package. Or it could be the amount in each dose. Read the labels carefully and talk to someone at the dispensary if the dose isn’t clear. 

Buy cannabis from a regulated dispensary

It’s a good idea to purchase cannabis from a state-regulated dispensary. This ensures the products are tested for contaminants and that the dosages are accurate. 

You’ll also be more likely to find cannabis products that:

• Are high in CBD 

• Have a balanced ratio

The amount of CBD and/or THC clearly should be clearly stated on the packaging. 

The staff usually know about strains and strengths. They can help guide you to products and doses that are best for your needs

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Written by:

Hilary Macht

Hilary Macht is a longtime health writer and former health editor whose work has appeared in dozens of media outlets including Everyday Health, The New York Times, Prevention, Civil Eats, and the Columbia Journalism Review. Her work is distributed by the National Center for Health Research and the Foundation for Informed Medical Decision Making.

Edited by:

Laurie Tarkan

Laurie Tarkan is a senior health editor for general health and well-being at GoodRx. She has an extensive background in health journalism, and wrote regularly for The New York Times for a decade.

Reviewed by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

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