A new federally funded report published by the Journal of the American Medical Association (JAMA) finds that use of marijuana by U.S. adults 65 and older has increased considerably in recent years amid broader legal access for medical and recreational use.

Cannabis consumption had already been on the rise over the past couple of decades, the research letter says, with reported past-year consumption rising from 1.0 percent in 2005 to 4.2 percent in 2o18. The new findings, which draw on the National Survey on Drug Use and Health, show that past-month use has now climbed to 4.8 percent in 2021 and to 7.0 percent in 2023.

The growth in prevalence over the past few years was seen among nearly all demographic subsets, but it was especially strong among people who listed their race as “other,” women, white people, people with college or post-college degrees, those with higher-income, married people and those living in states with legal medical marijuana, the report says.

Data also showed that people with multiple chronic diseases also reported a recent increase in prevalence of use.

Some trends reveal what authors called “shifts in cannabis use by older adults.”

“Adults with the highest incomes initially had the lowest prevalence of cannabis use vs other income levels,” they said, for example, “but by 2023, they had the highest prevalence, which may indicate better access to medical cannabis given its costs.”

The rise in cannabis use among adults 65 and older in legal jurisdictions “highlights the importance of structural educational support for patients and clinicians in those states,” the report notes, pointing to potential complications in treating chronic disease.

It also flags that tobacco and excess alcohol use “continues to be high among older adults who use cannabis. However, these results do not suggest that concurrent use is changing.”

The report concludes by advising that clinicians “consider screening and educating older patients about potential risks of cannabis use.”

The new findings, by researchers at University of California, San Diego and New York University medical schools, were published as a research letter on Monday.

Along with the report, JAMA also published an editor’s note asserting that “existing therapeutic evidence for medical cannabis in older adults has been inconsistent across several conditions, with many studies suggesting possible benefits, while others finding limited benefit.”

It also highlights “apparent” potential harms that marijuana might cause older adults, including “increased risks of cardiovascular, respiratory, and gastrointestinal conditions, stroke, sedation, cognitive impairment, falls, motor vehicle injuries, drug-drug interactions, and psychiatric disorders.”

“Older adults require information on methods available for taking cannabis and age-specific dosing guidance,” the editor’s note says. “Health care professionals should recognize that older adults are increasingly using cannabis products and promote open and judgment-free conversations about its use.”

Overall, it says, the new research findings “underscore the need for more high-quality evidence evaluating the benefit to risk ratio of cannabis in older adults as well as the need for clinician support to prevent cannabis-related harm.”

A separate study recently published by the American Medical Association found that while the frequency of marijuana use among adults in Canada increased slightly in the years following nationwide legalization, problematic misuse of cannabis in fact saw modest decreases.

The report, published in JAMA Network Open and funded in part by the federal agency the Canadian Institutes of Health Research, looked at data from 1,428 adults aged 18 to 65, who completed assessments roughly every six months between September 2018 and October 2023.

Frequency of marijuana use overall increased slightly but significantly over the five-year period. Among all participants, the mean proportion of days using cannabis increased by 0.35 percent per year, or 1.75 percent over the five-year study period.

People who used cannabis most frequently before legalization saw the largest declines in use. People who consumed marijuana on a daily basis prior to legalization decreased their use frequency more than those who’d used marijuana on a weekly basis.

Those who used marijuana once a month or less before legalization, meanwhile, reported slight increases in use.

Governments and public health experts have been working to track consumer behavior as laws around marijuana continue to change. In the U.S., a Centers for Disease Control and Prevention (CDC) report recently broke down federal data on cannabis use among thousands of U.S. adults, finding that while smoking marijuana remains the most common way to consume it, methods such as eating, vaping and dabbing are growing in popularity.

Overall in 2022, 15.3 percent of adults reported current marijuana use, while 7.9 percent reported daily use. Among users, most (79.4 percent) reported smoking, followed by eating (41.6 percent), vaping (30.3 percent) and dabbing (14.6 percent).

About half of all adults who used marijuana (46.7 percent) reported multiple methods of use—most typically smoking and eating or smoking and vaping.

Rates of both vaping and dabbing—as well as cannabis use in general—were higher in young adults than the general adult population.

An earlier analysis from CDC found that rates of current and lifetime cannabis use among high school students have continued to drop amid the legalization movement.

A separate poll recently found that that more Americans smoke marijuana on a daily basis than drink alcohol every day—and that alcohol drinkers are more likely to say they would benefit from limiting their use than cannabis consumers are.

U.S. adults who drink alcohol are nearly three times as likely to say they’d be better off reducing their intake of the drug compared to marijuana consumers who said they’d benefit from using their preferred substance less often, the survey found. Further, it found that while lifetime and monthly alcohol drinking among adults was far more common than cannabis use, daily marijuana consumption was slightly more popular than daily drinking.

An earlier report published in the Journal of Studies on Alcohol and Drugs that found that secondhand harm caused by marijuana use is far less prevalent than that of alcohol, with respondents reporting secondhand harm from drinking at nearly six times the rate they did for cannabis.

Yet another 2022 study from Michigan State University researchers, published in the journal PLOS One, found that “cannabis retail sales might be followed by the increased occurrence of cannabis onsets for older adults” in legal states, “but not for underage persons who cannot buy cannabis products in a retail outlet.”

The trends were observed despite adult use of marijuana and certain psychedelics reaching “historic highs” in 2022, according to separate data.

As for older consumers specifically, a study earlier this year on the use of medical marijuana by patients age 50 and above concluded that “cannabis seemed to be a safe and effective treatment” for pain and other conditions.

“Most patients experienced clinically significant improvements in pain, sleep, and quality of life and reductions in co-medication,” it found.

Nearly all patients used products consumed orally, such as edibles and extracts, as opposed to smoked or vaporized cannabis, and most preferred products high in CBD and relatively low in THC.

The study involved use of medical marijuana by patients under the care of a health care provider, with the treating physician reporting data around the use of cannabis and other medications as well as impacts on pain, sleep, quality of life and any adverse effects.

“Over the six-month study period, significant improvements were noted in pain, sleep, and quality of life measures,” the report says, “with 45% experiencing a clinically meaningful improvement in pain interference and in sleep quality scores.”

Last year, separate studies found that both older medical marijuana patients as well as people with fibromyalgia reported that cannabis improved their sleep.

A different study last year from the retirement group AARP found that marijuana use by older people in the U.S. has nearly doubled in the last three years, with better sleep as among the most frequently cited reasons.

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Activists seeking to put another marijuana legalization on the ballot in Florida have collected enough signatures to initiate the next steps in the process, triggering a fiscal and judicial review by state officials.

About five months after filing the measure and launching a signature drive, the campaign Smart & Safe Florida has collected 377,832 valid signatures—about 150,000 more than required to kick off the review process, according to the state Division of Elections.

This is the campaign’s second attempt to pass adult-use legalization at the ballot after its first initiative fell short of a steep 60 percent threshold to be enacted last year, while still getting a majority of the vote.

In order to make the ballot, activists will need to gather 880,062 valid signatures from registered voters, with a minimum of 8 percent of voters in at least half of the state’s congressional districts.

At its current signature count, the campaign has succeeded in reaching an initial milestone. The state is now statutorily obligated to conduct a judicial and financial review of the measure that will determine its legal eligibility and inform the electorate about its potential economic impact.

The latest initiative was filed with the secretary of state’s office just months after an initial version failed during the November 2024 election despite an endorsement from President Donald Trump.

Smart & Safe Florida is hoping the revised version will succeed in 2026. The campaign—which in the last election cycle received tens of millions of dollars from cannabis industry stakeholders, principally the multi-state operator Trulieve—incorporated certain changes into the new version that seem responsive to criticism opponents raised during the 2024 push.

For example, it now specifically states that the “smoking and vaping of marijuana in any public place is prohibited.”Another section asserts that the legislature would need to approve rules dealing with the “regulation of the time, place, and manner of the public consumption of marijuana.”

Gov. Ron DeSantis (R) had repeatedly condemned the 2024 initiative over that issue, claiming there were not parameters to prevent public smoking, while expressing his distaste for the smell of cannabis.

The governor said in February that the newest measure is in “big time trouble” with the state Supreme Court, predicting it will be blocked from going before voters next year.

“There’s a lot of different perspectives on on marijuana,” DeSantis said. “It should not be in our Constitution. If you feel strongly about it, you have elections for the legislature. Go back candidates that you believe will be able to deliver what your vision is on that.”

“But when you put these things in the Constitution—and I think, I mean, the way they wrote, there’s all kinds of things going on in here. I think it’s going to have big time trouble getting through the Florida Supreme Court,” he said.

Last year, the governor accurately predicted that the 2024 cannabis measure from the campaign would survive a legal challenge from the state attorney general. It’s not entirely clear why he feels this version would face a different outcome.

While there’s uncertainty around how the state’s highest court will navigate the measure, a poll released in February showed overwhelming bipartisan voter support for the reform—with 67 percent of Florida voters backing legalization, including 82 percent of Democrats, 66 percent of independents and 55 percent of Republicans.

However, the results conflict with another recent poll from the Florida Chamber of Commerce, a proactive opponent of legalization, that found majority support for the reform among likely voter (53 percent) but not enough to be enacted under the 60 percent requirement.

In the background of the campaign’s signature development, DeSantis signed a GOP-led bill last month to impose significant restrictions on the ability to put initiatives on the ballot—a plan that could impair efforts to let voters decide on marijuana legalization next year.

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Separately, a Florida GOP senator claimed recently that the legalization campaign “tricked” Trump into supporting the 2024 measure by misleading him and the general public about key provisions.

Ahead of the election, Trump said in September that he felt Amendment 3 was “going to be very good” for the state.

Before making the comments, Trump met with the CEO of Trulieve, Kim Rivers, as well as with a GOP state senator who is in favor of the reform.

While Trump endorsed the Florida cannabis initiative—as well as federal rescheduling and industry banking access—he has since been silent on cannabis issues. And his cabinet choices have mixed records on marijuana policy.

Nevada Governor Signs Bill To Stop Disqualifying People From Being Foster Parents Over Past Marijuana Convictions

Photo courtesy of Chris Wallis // Side Pocket Images.

“While European nations have taken a diverse approaches to cannabis policy and reforms, a majority of these models have yet to challenge the foothold of illicit sellers.”

By Niklas Kouparanis, Bloomwell Group

In the last several decades, Europe has made significant strides in its approach to legalized cannabis use, moving from strict criminalization and prohibition to decriminalization and legalized medical and adult-use models. In addition to expanding healthcare and adult-use access to cannabis use, it’s also important to discuss what impact these varying policies have in counteracting the foothold of illicit cannabis markets throughout the European Union.

Under E.U. law, many countries encounter hurdles in legalizing adult-use commercial cannabis, as they likely would be subject to penalties under the European Court of Justice. For this reason, several countries—including the Netherlands, Malta, Luxembourg, Switzerland and Germany—have taken unique approaches to cannabis policy.

Germany, however, stands out in terms of producing a measurable impact to push back against the illicit cannabis market.

The Netherlands: A Tolerance Model Without Market Control

Long seen as a pioneer, the Netherlands’ approach to cannabis is based on tolerance rather than legalization. Adults can purchase small quantities of cannabis from Dutch “coffee shops,” which are tolerated but not fully legalized. These shops are forced to source products from an illegal supply chain due to a lack of legal production.

In terms of impact, the tolerated model might seem like a considerable way to go, as every adult in the Netherlands can access coffee shops. However, in terms of control, product safety and regulation, the Dutch cannabis system is vulnerable, as the whole value chain is not regulated and the products are produced illegally for the coffee shops.

Due to the drawbacks of the tolerance model, the Netherlands has just initiated its Weed Experiment. The experiment will allow coffee shops in 10 municipalities to sell legally produced and supplied cannabis. A report on the results of the closed-loop experiment is expected for 2028.

Malta: Liberal on Paper, Constrained in Practice

Malta decriminalized cannabis use in 2015 and, in 2021, became the first European Union country to allow the cultivation and private personal use of cannabis. However, the market remains heavily restricted.

The government permits adult cultivation of cannabis (up to four plants) and personal possession of seven grams when away from home and 50 grams at home. The country also legalized nonprofit cannabis associations that can distribute cannabis to their members. These clubs are limited to 500 people, and membership is only available to residents. However, the public consumption, transportation and sale of cannabis are still banned and can result in fines.

With club membership strictly limited, public consumption outlawed and no other options for adults to legally purchase cannabis outside of the nonprofit associations, the market remains very limited. As of May 2025, no public information is available detailing the exact amount of cannabis provided by these associations to their members.

Luxembourg: Legalization Without Access

In 2021, Luxembourg legalized cannabis cultivation for adult use. However, it wasn’t until two years later, in 2023, that the country defined its legal cultivation and possession rules for personal use. Under the law, adults can grow up to four plants and possess three grams. However, consumption, transportation, and sale in public spaces are still banned and can result in fines.

As reported by the Luxembourg Times, 46.3 percent of the country’s residents have tried cannabis at least once in their lives, including 14.2 percent who have used the plant within the last year and 7.8 percent in the past month, according to an ILRES poll. Just under seven out of ten people who grow cannabis at home said they started cultivation after the government legalized home grow, amounting to just 11.5 percent of recent users.

Despite homegrow gaining moderate interest from residents after legalization, there has not been a significant growth in users, and this has not resulted in an explosion in the market. For now, the market remains stagnant and limited in counteracting illicit sellers due to the country’s lack of legalized sales marketplaces as well as restrictions on public consumption.

Switzerland: Research-Oriented but Limited in Scope

Switzerland has taken a scientific approach through pilot programs across seven major cities to determine the viability of cannabis legalization and controlled distribution within the country over 10 years.

While the pilot programs are set up to allow recreational cannabis commerce at a local level, in terms of true societal impact, this initial rollout does not serve as a solution to counteract the illicit cannabis market. This is mainly due to the limited availability of the majority of Swiss residents. Only Swiss residents who have previously established histories of using cannabis can purchase through the pilot program entities. These pilot programs are also limited to a maximum of a few hundred or a few thousand participants.

Germany: A Functional, Scalable Legal Medical Market

Germany’s cannabis market is widely hailed as one of Europe’s most progressive. On April 1, 2024, the country passed The Cannabis Act (CanG), reclassifying cannabis as a non-narcotic. Through this, administrative burdens were eased for medical cannabis patients and prescribing doctors. CanG also allows possession of up to 25 grams of cannabis and cultivation of up to 3 plants, and it permits the rollout of not-for-profit cannabis clubs.

In January 2025, my medical cannabis company, Bloomwell Group, released its “Cannabis 2024 in Germany: A new era for patients in Germany” report. According to the report, in December 2024, the number of prescriptions issued increased by a little less than 1,000 percent compared to March 2024, following the reclassification of cannabis. The rise of patients who are now able to access cannabis for various medical conditions signals a shift in the perception of cannabis being used for its wellness properties in the medical space.

Telemedical technology in the sector has also positively impacted growth and counteracted the illicit market. Telemedical platforms offer convenience for patients and the physicians who prescribe their treatment. This is extremely helpful to patients who are located in rural or isolated areas of Germany and have geographic limitations in accessing healthcare professionals for their medical needs.

The Bloomwell report also revealed that medical cannabis prices dropped to an all-time low by the end of 2024. During October and November 2024, select strains were available for just €3.99 per gram, a stark contrast to previous pricing models. These decreases are due to a steady supply and increased demand for medical cannabis as the number of self-paying patients continues to soar.

Such demand continues to open doors for international imports of medical cannabis to supply the growing market. Just in the first quarter of 2025, more than 37 tonnes of cannabis for medical or scientific purposes have been imported to Germany, according to the Federal Institute for Drugs and Medical Devices (BfArM).

Unlike other legalized markets, like California in the U.S., which fell victim to being dwarfed by a behemoth illicit market, the passage of CanG served as a catalyst to boom the German medical market, and with more patients able to access cannabis, prices of the plant actually decreased. This allowed the legalized medical market to stay competitive with the illicit market.

Conclusion

While these European nations have diverse approaches to cannabis policy and reforms, a majority of these models have yet to challenge the foothold of illicit sellers. Pilot programs that have emerged in several countries, like the Netherlands, have left many questioning what happens after the inevitable timetable of the programs is up.

Germany’s regulated medical cannabis market is the exception, offering access, affordability and federal legal oversight critical to challenge the illicit market without a determined end date beforehand. As nations globally consider their own approaches to cannabis reforms, Germany’s medical cannabis market can serve as a replicable framework.

Niklas Kouparanis is CEO and co-founder of Bloomwell Group and has served as a serial entrepreneur, medical cannabis pioneer, founder and growth activator of companies since 2017, all while shaping the future of the European cannabis industry. In 2020, Kouparanis co-founded Bloomwell Group, Europe’s largest telemedical cannabis companies. Bloomwell Group serves as a central hub for a new cannabis ecosystem that covers the entire value chain (except cultivation). Through innovation and the digitization of the entire treatment process, Bloomwell Group ensures an effective and reliable supply of medical cannabis to patients and contributes to the destigmatization of cannabis in medicine through data-based research. Today, the Bloomwell Group offers tens of thousands of cannabis patients, pharmacies, doctors and wholesalers a digital home each month.

What Europe Can Learn From Cannabis Legalization In North America (Op-Ed)

Photo courtesy of Chris Wallis // Side Pocket Images.