The Silent Shift: Understanding Cannabis and Alcohol Use Among Older Adults

As cannabis becomes more accessible and socially accepted, a subtle but critical trend is emerging: older adults are increasingly turning to cannabis and alcohol, often without fully understanding the risks. Dr. Dennis Helmuth, a board-certified psychiatrist and addiction specialist who consults with OneEighty, is working to shift the conversation around cannabis, starting with language and education.

“The most important thing people should understand is that potency and dose matter. Cannabis products today are 20 times stronger than they were a few decades ago,” says Dr. Helmuth.

He sees patients weekly and participates in treatment team meetings at the residential centers.

“I give my opinion on diagnoses and recommended treatment,” he explains. “And I’ve developed a strong interest in the effects of cannabis over the years because I kept seeing people – especially young people – treat it like it was harmless. That just isn’t true.”

Redefining the Conversation: Why “Cannabis” Matters

Before diving into usage trends and risks, it’s important to understand why OneEighty and other public health organizations are phasing out the word “marijuana” in favor of “cannabis.”

As our Clinical Director John Fishburn, MSSA, LISW-S, explains, “Cannabis is the entire plant and a scientific term. ‘Marijuana’ historically has racial connotations and was often used to target Mexican immigrants in the early 1900s. It’s still used in legal contexts, but from a prevention and clinical standpoint, ‘cannabis’ is now the preferred and more accurate term.”

The Hidden Risks: Why Today’s Cannabis Is Not Harmless – Especially for Older Adults

One of the most common misconceptions about cannabis is that it’s safe simply because it’s legal in many states. But legalization doesn’t equal harmlessness. In fact, new research is painting a much more serious picture, particularly for older adults, who are biologically more vulnerable to the effects of cannabis.

A 2025 study published in JAMA Neurology found that older adults who presented at hospitals with cannabis-related conditions had 1.5 times the risk of being diagnosed with dementia within five years, and 3.9 times the risk compared to the general population. As cannabis becomes more potent and widely available, emergency departments are seeing a rise in older patients presenting with complications.

“We’re seeing a dramatic rise in emergency room visits among people over 65 due to cannabis,” says Dr. Dennis Helmuth. “And that age group is already biologically more vulnerable to THC’s effects.”

So, what’s fueling this increase in cannabis use among individuals, particularly older adults?

According to Dr. Helmuth, the shift is being driven more by perception than recklessness. Many in this demographic remember using cannabis in their youth and assume today’s products are similar. “People say, ‘I used it in the 1970s, and it was fine.’ But a joint back then had 7 milligrams of THC. Now, a gummy can have 250 milligrams. That’s a completely different drug,” Helmuth explains.

Many are experimenting with edibles or THC vapes, assuming they are mild or even medicinal. In reality, high-potency cannabis today is often unregulated, and users have little idea how much THC they’re actually consuming.

“Cannabis use is definitely increasing among older adults,” Helmuth says. “They think it’s harmless, and they’re uneducated about today’s products.”

Adding to the concern is a recent shift in substance use trends: Daily cannabis use now outpaces daily alcohol use in the U.S., and both come with serious risks.

Dr. Helmuth outlines how cannabis impacts people differently depending on their age:

• Under 30: Higher risk of psychosis, violent behavior, and long-term psychiatric issues
• Middle-aged adults: Increased likelihood of addiction and dependency
• Older adults (60+): Greater risk of dementia, cognitive decline, and even mortality

“Cannabis may seem like the safer option compared to alcohol or tobacco, but that’s largely because the public hasn’t been educated about the real risks,” Helmuth says. “THC is not benign – it’s neurotoxic at high doses, especially for older adults.”

In addition to memory problems and addiction, cannabis can also affect coordination, increase fall risk, and negatively interact with medications that many older adults already take.

As the cultural narrative around cannabis shifts to one of acceptance and normalization, Helmuth emphasizes the need for education and early intervention. “During the time cannabis was illegal we had very little research on its mental health effects, and now we’re catching up,” he says. “Older adults need access to accurate information and treatment options—not just dispensaries.”

Meeting the Treatment Needs of Older Adults

For many older adults, recognizing a substance use issue – particularly with cannabis or alcohol – isn’t easy. In fact, one of the biggest obstacles to getting help is realizing that there’s a problem in the first place.

“They often don’t realize they’re addicted until they try to stop and can’t sleep, get irritable, or feel anxious,” says Dr. Dennis Helmuth, consulting psychiatrist at OneEighty. “That’s when it becomes clear that withdrawal is happening and that dependency has already taken hold.”

Another major barrier is stigma. Many older adults with stable professional lives may not view themselves as the “type” of person who needs treatment. For this demographic, addiction is often internalized as a personal failure, rather than a diagnosable and treatable condition.

Even when financial resources and insurance coverage are available, shame or denial can prevent people from seeking care, leaving them to suffer in silence as symptoms worsen.

A New Path Forward: OneEighty’s Fourth Intensive Outpatient Program

To address growing community needs, OneEighty is launching a new Intensive Outpatient Program (IOP) – our fourth – to expand access to treatment for individuals seeking support on their recovery journey. For older adults specifically, OneEighty offers a Sober After 60 group dedicated to fostering connection and provides tailored support for those navigating sobriety later in life.

This IOP is designed to remove common barriers to treatment by offering:

• Educational programming specific to cannabis and alcohol use in aging populations
• Flexible scheduling options that accommodate working professionals and retirees
• A preventative focus, helping participants intervene early before substance use escalates into crisis

When to Seek Help: Warning Signs for Families and Individuals

Often, family members are the first to notice that something isn’t right. Subtle changes in behavior, mood, or health can be early warning signs of problematic substance use. Dr. Helmuth encourages people to trust their instincts and take proactive steps.

Here are some red flags to watch for:

• Daily or near-daily use of alcohol or cannabis
• Withdrawal symptoms like insomnia, irritability, anxiety, or difficulty concentrating
• Cognitive or behavioral changes, such as memory problems, emotional volatility, or social withdrawal
• Secrecy, denial, or defensiveness when substance use is mentioned

“If a loved one seems off, they probably are,” says Helmuth. “It doesn’t mean they need inpatient rehab. But it could mean they need support – something our outpatient programs can absolutely provide.”

What Treatment Looks Like – and Why It Works

All of OneEighty’s programs are built around evidence-based practices, including the Cognitive Behavioral Therapy (CBT), which remains the gold standard for treating both alcohol and cannabis use disorders. CBT helps individuals understand the thoughts and behaviors that contribute to their substance use and teaches coping strategies that support long-term recovery.

In addition to therapy, medications can help ease withdrawal symptoms and improve overall outcomes. Dr. Helmuth sometimes recommends medications like:

• Gabapentin – may help with withdrawal anxiety and agitation
• Hydroxyzine – a non-addictive antihistamine used for anxiety and sleep
• Clonidine – helps regulate blood pressure and reduces withdrawal discomfort

“People need to know there are real, effective tools out there,” Helmuth says. “This isn’t just about willpower. It’s about science, structure, and support.”

The Most Powerful Tool: Education

At the heart of OneEighty’s expanded treatment offerings is our commitment to education as a preventive measure. Dr. Helmuth has made it his mission to speak directly to communities – from city councils and women’s groups to mental health conferences – about what THC actually does to the aging brain.

“Once people learn the facts about the strength of today’s cannabis, about its links to dementia, psychosis, and addiction, they think twice,” he says. “But they have to hear it first. People just aren’t being told the truth about today’s cannabis.”

By combining clinical care, targeted education, and compassionate outreach, OneEighty is creating a safer path forward for older adults – a population that’s too often overlooked, but increasingly at risk.

This isn’t just about addressing addiction – it’s about breaking down the stigma, removing barriers, and making sure that everyone, regardless of age or background, knows that help is available and recovery is possible. OneEighty is meeting this crisis where it’s growing – one patient, one family, and one conversation at a time.

“Addiction doesn’t discriminate by income or background,” Helmuth concludes. “It can affect anyone.”