JAMA Netw Open
Older adults turn to cannabis for sleep, pain, and mood
Clinical Takeaway: Older adults are increasingly using cannabis for symptom management, and clinicians should consider initiating conversations about cannabis use to support informed decisions, even where evidence is limited.
Cannabis use is rising faster among adults 60 and over than in any other demographic, yet little is known about why they start, which products they choose, or how they decide. This qualitative study interviewed 169 adults aged 60 to 85 immediately before they purchased cannabis edibles for the first time, asking what motivated them and how they chose between products.
Most participants were not seeking recreational effects. The leading motivations were avoiding pharmaceuticals (32%), having exhausted other options (27%), new or worsening age-related symptoms (24%), and anecdotal evidence of benefit from friends, family, or media (21%).
Sleep was the most targeted symptom (57%), followed by pain (50%) and mental health concerns (25%). Discussions with medical providers rarely factored into the decision-making process.
Most participants (58%) chose combination THC-CBD products, viewing them as a "Goldilocks option" offering benefits of both cannabinoids. Another 29% chose CBD-dominant products, and 14% chose THC-dominant products. Combination products were selected most often across all three symptom categories; those older adults targeting pain were more likely to choose THC-dominant products.
THC products were valued for psychoactive and therapeutic effects, but raised concerns about impairment, cognitive harm, dependency, and lethargy. CBD products were valued for their lack of impairment but were viewed as less reliably effective and relatively expensive. Combination products drew interest for complementary effects and dosing flexibility but prompted consideration around identifying the right THC-to-CBD ratio.
The findings reflect a decision-making process taking place largely outside clinical care. Older adults rely on advertising, anecdotal accounts, and personal networks, sources that may emphasize benefits over limitations and leave patients without information about dosing, drug interactions, or efficacy. Edible products carry particular risks for this population, including delayed onset, dosing uncertainty, and potential interactions with prescribed medications. The study was conducted in Colorado, where recreational cannabis is legal, and the sample was predominantly white, highly educated, and drawn from the Denver-Boulder area.
"For the most part, we found that these folks aren't really interested in getting high. They just want to feel better," said senior author Angela Bryan, PhD, professor of psychology and neuroscience at the University of Colorado Boulder.
Source: Delaney RK. JAMA Netw Open. 2026 May 8. Edible cannabis and pain, sleep, and mental health management in older adults