Functional Impairments Associated With Non-Medical Use of Psychoactive Drugs Among Older Adults

With psychoactive substance use being risky for some adults with functional impairments, this study investigated cannabis use, prescription opioid, and tranquilizer/sedative (mis)use among US adults aged ≥50 years who reported functional impairments.

Misuse of psychoactive drugs was associated with functional impairments among adults aged ≥50 years, according to results of a cross-sectional study published in the American Journal of Preventive Medicine.

Data from the National Survey on Drug Use and Health from 2015 to 2019 were analyzed for this study. Adults (N=43,867) aged ≥50 years were surveyed for their use of cannabis and psychoactive drugs.

Individuals who had impairments were more likely to report medical use of cannabis (2.5% vs 0.9%; adjusted odds ratio [aOR], 2.28; 95% CI, 1.57-3.30), prescription opioids (51.2% vs 30.1%; aOR, 2.23; 95% CI, 2.09-2.38), and prescription tranquilizers or sedatives (32.2% vs 16.9%; aOR, 2.02; 95% CI, 1.88-2.17) as well as nonmedical use of opioids (3.8% vs 2.0%; aOR, 1.62; 95% CI, 1.38-1.91) and tranquilizers or sedatives (2.2% vs 1.2%; aOR, 1.59; 95% CI, 1.20-2.11).

Nonmedical use and possible misuse increased with the number of impairments (P <.001).

Among cannabis users, medical use was associated with thinking (aOR, 1.77; 95% CI, 1.22-2.56) and walking (aOR, 1.74; 95% CI, 1.20-2.51) impairments. Nonmedical use was associated with thinking impairments (aOR, 1.27; 95% CI, 1.06-1.54). Individuals who had difficulty with errands were less likely to report nonmedical use of cannabis (aOR, 0.82; 95% CI, 0.69-0.97).

For opioids, individuals with walking (aOR, 2.14; 95% CI, 1.98-2.31), dressing (aOR, 1.24; 95% CI, 1.10-1.40), thinking (aOR, 1.20; 95% CI, 1.09-1.32), and errands (aOR, 1.11; 95% CI, 1.01-1.21) impairments were associated with medical use and individuals with thinking (aOR, 1.45; 95% CI, 1.15-1.83) and errands (aOR, 1.34; 95% CI, 1.01-1.78) impairments were associated with nonmedical use.

Medical use of tranquilizers or sedatives were associated with thinking (aOR, 1.69; 95% CI, 1.51-1.88), walking (aOR, 1.53; 95% CI, 1.40-1.67), and errands (aOR, 1.28; 95% CI, 1.07-1.52) impairments and for nonmedical use, thinking impairments (aOR, 1.88; 95% CI, 1.27-2.78).

The study had some limitations. It remains unclear to which degree individuals had functional limitations and all use was self-reported.

These data indicated adults with impairments may be at a risk for the misuse of opioids, tranquilizers, and sedatives.


Han BH, Le A, Funk-White M, Palamar JJ. Cannabis and prescription drug use among older adults with functional impairment. Am J Prev Med. Published online May 20, 2021. doi:10.1016/j.amepre.2021.01.042