As more people explore marijuana for medical use, Stanford Medicine experts say older adults should be especially cautious.
While cannabis may help with pain, anxiety, or sleep issues, it also brings serious risks that many don’t realize.
Eloise Theisen, a geriatric nurse at Stanford, started using medical cannabis herself after a bad car accident.
She noticed many of her older cancer patients were also trying it—even though most doctors weren’t giving clear advice.
“They were going to use it no matter what,” she said. “But older people have more risks that need to be looked at before they use it.”
Cannabis use is growing in the U.S., including among people over 65. Many turn to it for pain relief or sleep, but scientists still don’t know enough about how it affects our health—especially in older adults. One big reason is that marijuana remains illegal under U.S. federal law, which makes it harder to study.
Dr. Smita Das, a psychiatrist at Stanford, says older adults face risks such as heart problems, possible cancers, addiction, and worsened memory issues. Cannabis may also interfere with medications. And today’s marijuana is much stronger than in the past, so it’s easier to accidentally take too much.
Back in the 1970s, marijuana had just 1–4% THC (the part that makes people feel “high”). Now, legal cannabis can have 20% or more THC—and some products, like oils or edibles, can reach up to 90%. These strong forms can be dangerous, especially for seniors who may not know how powerful they are.
In fact, a study in Canada showed that emergency room visits for cannabis poisoning nearly tripled among people over 65 after marijuana became legal. This was mostly due to overuse or accidental consumption.
There are other dangers too. Dr. Joseph Wu, a heart expert at Stanford, says cannabis can lead to inflammation in blood vessels. Studies show that regular cannabis users have a 29% higher risk of heart attacks and a 20% higher risk of strokes. The risk gets worse if users also smoke tobacco or drink alcohol.
Even low doses of cannabis may not be totally safe, Wu says. “There’s no completely safe amount of cannabis. Not even occasional use,” he explained. Smoking or vaping cannabis is riskier than using edibles, but all forms carry some level of danger.
Another concern: cannabis may make people dizzy or confused, increasing the chance of falls. It can also interact with common medicines. For example, CBD (a compound in cannabis that doesn’t cause a high) can make blood thinner drugs stay in your system longer, which could be risky during a fall or injury.
Some people believe cannabis isn’t addictive—but that’s a myth. Studies show that about 30% of regular users develop “cannabis use disorder.” That means they may rely on it heavily, need more over time, or struggle to quit.
Das says doctors should ask patients directly about cannabis use. Many older adults won’t bring it up unless asked. If someone wants to stop using cannabis but can’t, treatments like counseling or therapy can help.
Despite these risks, cannabis might help in certain cases. The FDA has approved specific cannabis-based medicines for rare epilepsy types and for nausea in cancer or HIV patients. Some research suggests it may help with muscle spasms from multiple sclerosis or reduce opioid use for chronic pain.
Eloise Theisen works with patients in palliative care—those with serious or terminal illnesses. For these patients, cannabis may ease pain and bring joy in their final months. “Feeling joy is important,” she said. “And in small doses, THC can actually be helpful.”
Still, all experts agree: it’s best to talk with your doctor before trying cannabis. They can help check if it’s safe for your health conditions and medications. Relying on advice from dispensary workers or the internet isn’t always safe.
“Your doctor knows your full medical history,” said Dr. Padula. “Being honest about your cannabis use can help keep you safe.”
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