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Journal Article

Citation

Perez-Vilar S, Freyria Duenas P, Radin R, Akhtar S, Wernecke M, Kelman JA, Graham DJ. JAMA Netw. Open 2024; 7(6): e2417634.

Copyright

(Copyright © 2024, American Medical Association)

DOI

10.1001/jamanetworkopen.2024.17634

PMID

38888925

Abstract

An increasing number of US states and territories have enacted laws allowing adult and/or medical use of marijuana (cannabis).1 As expanded access coincides with increased prevalence of medical and nonmedical cannabis use,2 we characterized trends in health care encounters with cannabis-related disorders among Medicare beneficiaries aged 65 years or older by state or territory cannabis legal status. ....

The eligible population included 55 941 880 unique beneficiaries during the study. Rates of health care encounters with cannabis-related disorders increased from 2017 through 2022, irrespective of state or territory cannabis legal status (Figure 1). Rates were greatest in states or territories with both adult and medical use legalization (45.4 [95% CI, 45.1-45.7] per 10 000 beneficiaries in 2022), followed by states or territories with medical legalization (41.5 [95% CI, 41.2-41.8] per 10 000 beneficiaries in 2022), and states or territories where cannabis use was illegal (27.7 [95% CI, 27.4-28.0] per 10 000 beneficiaries in 2022). We noted the greatest increasing trends in nonemergency department (ED) outpatient settings across all legalization categories (Figure 1). We observed higher average annual increases among beneficiaries enrolled in MA than those enrolled in FFS (Figure 2).

Discussion

Rates of cannabis-related disorder encounters increased from 2017 through 2022 among US Medicare-insured older adults. We observed the highest rates in states or territories that legalized adult and medical use of cannabis. Our results also suggest higher average annual increases in states or territories that legalized medical cannabis. The observed increases in rates were driven by non-ED outpatient encounters irrespective of the cannabis legal status. We observed larger upward trends in rates among MA enrollees than among those in FFS. Overall, data suggest that increasing rates of health care encounters documenting cannabis-related disorders among older adults might be associated with the type of cannabis legalization. However, differences in cannabis use patterns and perception of risk may influence policy changes and present challenges to causal inference. ...


Language: en

Keywords

Humans; Aged; Female; Male; Middle Aged; United States/epidemiology; Aged, 80 and over; Cannabis; Legislation, Drug; *Marijuana Abuse/epidemiology

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