Walk into any primary care, urology, or pain management clinic today, and you’ll see a demographic shift that is impossible to ignore. America is aging.
According to 2020 U.S. Census data, adults over 65 are one of the fastest-growing segments of the population, projected to exceed 20 percent of Americans by 2030. But what’s less often discussed is that they are also one of the fastest-growing groups using cannabis medically. And they can’t afford to wait for policy to catch up.
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In clinical practice, I’ve seen patients from their 60s to 80s asking about medical cannabis. They’re trying to manage real medical issues, such as chronic pain, insomnia, anxiety, arthritis, and cancer-related symptoms, not experimenting recreationally or using it recklessly.
Data support what clinicians are seeing. Cannabis use among older adults has increased dramatically over the past decade, with studies showing adults over 65 reporting more than a five-fold increase in their past-year use. The reality is that policymakers must acknowledge that seniors are already using cannabis, often without medical guidance, oversight, or standardized dosing.
The Gap Between Medicine and Policy
Despite this growing demand, federal healthcare policy remains largely disconnected from clinical reality. Cannabis is still federally restricted, and Medicare does not cover cannabinoids, even non-intoxicating CBD products, despite widespread use.
This creates a dangerous gap with patients deciding to self-medicate, physicians lacking clear guidelines, and resulting in a wide variety of product quality.
As a physician, that’s not just frustrating, it’s concerning. Because the question is no longer if seniors are using cannabis. It’s whether we’re going to make it safer, smarter, and evidence-based.
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This is where the Centers for Medicare & Medicaid Services (CMS) pilot program, through the Innovation Center (CMMI), becomes critical. The CMMI is designed to test new models of care that improve outcomes and reduce costs. And cannabis, specifically CBD, may be uniquely positioned to do both.
A well-designed CMS pilot could evaluate cannabis as an adjunct or alternative to opioids. It will study real-world outcomes in chronic pain, sleep, or anxiety. It can help standardize dosing and product selection while tracking safety, drug interactions, and hospitalizations. And potentially, it may reduce polypharmacy, a major issue in older adults. In other words, it could bring cannabis out of the shadows and into structured, physician-guided, evidence-based care.
More Than Access, We Need Safety
One of the biggest misconceptions today is that this policy is about expanding access. But access already exists; walk into any dispensary in a legal state, and you’ll see seniors buying products often without medical guidance.
What’s missing in the medical system is clinical oversight, evidence-based protocols, product standardization, and, of course, integration into existing medical care models. Without these, we are essentially asking older adults, many with multiple medical conditions and medications, to navigate a complex therapeutic landscape alone. And that’s risky.
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There’s also a financial reality that policymakers should not ignore. Older adults are among the highest utilizers of healthcare resources. Chronic pain, insomnia, and anxiety contribute significantly to emergency room visits, falls and fractures, polypharmacy complications, and hospital admissions.
We need to find out if cannabinoid-based therapies can safely reduce medications such as opioids, sedatives (like benzodiazepines), and sleep medications. The downstream cost savings could be substantial. But we won’t know, unless we study it.
Right now, we are operating in two parallel systems. A real-world system where seniors are already using cannabis in a patchwork of state regulations and standards. And a policy system that is largely ignoring it. That disconnect is no longer sustainable. A CMS pilot program is about studying it responsibly in the population that is already using it.
A Smarter Path Forward
As a physician, I am a healthy skeptic. I don’t advocate for blanket adoption of any therapy, especially one as complex as cannabis. But I do advocate for evidence-based data, patient safety, clinical guidance, and oversight. And right now, we are missing all four at a federal level. If we truly want to support healthy aging, reduce healthcare costs, and meet patients where they are, we need to stop asking whether cannabis belongs in medicine. And start asking, how do we study it, standardize it, and use it safely, especially for our most vulnerable population? Because seniors aren’t waiting.
Editor’s Note: This content is not meant to supplement, replace, or advise on advice, diagnoses, and treatment from a healthcare provider. Always consult a medical professional when using cannabis for medicinal purposes, and do not disregard the advice of your healthcare provider because of anything you may read in this article.
This article was submitted by an unpaid guest contributor. The opinions or statements within do not necessarily reflect those of GreenState or HNP. The author is solely responsible for the content.