A new study documents increasing cannabis-related disorders among older adults in recent years, as an increasing number of US states and territories have enacted laws allowing adult medical and nonmedical use of marijuana (cannabis).

As expanded access coincides with increased prevalence of use, researchers looked at trends in healthcare encounters with cannabis-related disorders among Medicare beneficiaries ages 65 years or older by state or territory cannabis legal status.

For the study, researchers analyzed Medicare enrollment records, fee-for-service claims, and Medicare Advantage encounter data yearly, from 2017 to 2022. After excluding long-term nursing home residents and beneficiaries receiving dialysis, they identified healthcare encounters with cannabis-related disorders using the ICD-10-CM diagnosis codes and stratified by encounter claim setting and by Medicare type.

A total of 55,94, 880 unique beneficiaries were included in the study. Researchers found that rates of healthcare encounters with cannabis-related disorders increased from 2017 through 2022, irrespective of state or territory cannabis legal status.

However, rates in 2022 were greatest in states or territories with both medical and nonmedical use legalization (45.4 per 10,000 beneficiaries), followed by states or territories with medical legalization (41.5 per 10,000 beneficiaries), and states or territories where cannabis use was illegal (27.7 per 10,000 beneficiaries).

The greatest increasing trends were in nonemergency department outpatient settings across all legalization categories. Higher average annual increases were observed among beneficiaries enrolled in Medicare Advantage compared to fee-for-service.

"Overall, data suggest that increasing rates of healthcare encounters documenting cannabis-related disorders among older adults might be associated with the type of cannabis legalization," the authors wrote. However, they noted, "differences in legality may lead to differences in the disclosure of cannabis use as well as in the detection, diagnosis, and recording of cannabis-related disorders."

To download the study, published in JAMA Network Open, click here