Cannabis Use Among Caregivers of Older Adults: A Systematic Literature Review
University of California, La Jolla, USA
Herbert Wertheim School of Public Health and Human Longevity Science University of California, La Jolla, USA
San Diego State University, La Jolla, USA
Abstract
As the global population ages, the number of caregivers has risen accordingly. Though caregiving has many rewards, it may also cause psychological stress. To manage this burden, caregivers may adopt various coping strategies, including cannabis use. This systematic review aimed to synthesize existing literature on cannabis use among caregivers for older adults. A database search in PubMed, PsycINFO, and CINAHL identified 357 unique peer-reviewed articles to screen and five were included in the review. Studies were included if they reported empirical data on cannabis use among caregivers for older adults. Of the five included studies, four studies found that caregivers reporting high stress or emotional burden used cannabis to cope, with two finding new or increased use during the COVID-19 pandemic. One study found that using cannabis improved caregivers’ self-reported health and well-being; another found positive caregiver attitudes toward recreational cannabis. Two studies found higher caregiver anxiety was associated with increased cannabis use. Despite limited research, these studies underscore the role of cannabis as a potential coping mechanism for caregivers of older adults experiencing emotional burden. Additional research should seek to characterize longitudinal patterns of cannabis use among caregivers and its potential impact on both caregiver and care recipients.
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Keywords: caregiver, cannabis, coping mechanism, emotional burden, healthcare communication
Article notes
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Received 2025 Oct 19; Revised 2026 Jan 26; Accepted 2026 Jan 30; Collection date 2026 Jan-Dec.
Introduction
The global rise in aging populations, coupled with an increasing prevalence of neurocognitive disorders, is placing unprecedented demands on healthcare systems and long-term care services (Jones, 2021; Noto, 2023; Tsiakiri et al., 2024; Varma et al., 2024). In response, caregiving roles have evolved to meet the growing and complex needs of older adults (Reckrey et al., 2021; Reyes et al., 2021). Caregivers can be paid professionals but are often unpaid family members who assist with daily living activities and provide psychological support (Green et al., 2025; Reckrey et al., 2021). As more older adults choose to age in place, the responsibilities and demands placed on caregivers continue to increase (Fields et al., 2021).
One study estimates that roughly one in five U.S. adults were caregivers for people with chronic conditions or disabilities from 2021 to 2022 (Kilmer, 2024). Being a caregiver can bring psychological fulfillment, such as building emotional bonds with care recipients, experiencing personal growth, and developing resilience and mastery (Hung et al., 2025; Quinn & Toms, 2019). However, the complex and demanding nature of the task can also lead to high physical, psychological, and emotional burden, commonly referred to as caregiver burden. Liu et al.’s (2020) conceptual model of caregiver burden positions the caregiver in the center of the framework. In the model, antecedents, such as insufficient finances and conflict of responsibilities, contribute to caregiver burden. These burdens are enhanced by attributes of the caregiving experience, such as long-term, caregiving or perception of strain. Ultimately, the pressures of caregiving antecedents and attributes can enhance caregiver burden in ways that lead to negative consequences such as decreased quality of life and deterioration of health.
One study describes caregiver burden as something that affects over 50 million unpaid caregivers of older adults in the U.S. in 2020 (Tabata-Kelly et al., 2023). Specifically among caregivers for people living with Alzheimer’s disease, studies show that caregivers perceive their job to be “extremely hard” and report experiencing the negative consequences of caregiver burden including, lack of sleep, increased difficulty providing care, and higher rates of anxiety and depression” (Vu et al., 2022). Additionally, unpaid caregivers may face financial stress and insecurity while caring for older adults (Varma et al., 2024). This burden is often intensified for family caregivers who may find it especially distressing to witness their family member’s decline (Vu et al., 2022).
Caregivers use a variety of coping and adjustment strategies to manage prolonged stress and prevent caregiving burnout. The caregiving literature describes these strategies in terms of problem-focused coping, emotion-focused coping, and cognitive coping (Hawken et al., 2018). Problem-focused coping involves actions that change the relationship between the caregiver and their environment to gain a better sense of control. This could include actions such as recruiting another caregiver to help, modifying the home environment in ways that ease caregiving burden, or engaging in activism (Figueiredo et al., 2014; Sabo & Chin, 2021). Emotion-focused coping seeks to alter the meaning of the caregiving experience through behavioral adjustments. These strategies might include engaging in practices that prioritize personal well-being to keep emotions under control or engage in avoidance or distraction for a short time. Physical activity, mindfulness, and taking respite are examples of emotion-focused coping activities (Spigelmyer et al., 2023). Cognitive coping refers to the psychological adjustments or altering thoughts to deal with stressful situations. An example of cognitive coping is reappraising the caregiving situations to arrive at a sense of acceptance (Williams et al., 2014).
Some caregivers may use substances such as prescription medications, alcohol, tobacco, or cannabis (Kaskie et al., 2021), as a form of emotion-focused coping. A recent systematic review found that acute cannabis use increases sleep quality in people living with chronic pain, which may help caregivers feel more refreshed and able to provide care (AminiLari et al., 2022). However, another review warns against long-term cannabis use for sleep due to the risk of dependence and withdrawal symptoms (Babson et al., 2017). Prolonged cannabis use is also associated with mood disorders and cannabis use disorders, which could make caregiving more taxing and lead to further burnout (Karila et al., 2014).
It is unclear how substance use may affect caregivers’ ability to provide care to their recipients, which poses ethical questions. With cannabis laws loosening across the United States, its accessibility is increasing for the general population, and as of June 2025, medical cannabis is legal in 40 states and recreational cannabis is legal in 24 states (McGinty et al., 2016; National Conference of State Legislatures, 2025). Studies estimate that daily or near daily cannabis use in the United States increased by 269% between 2008 and 2022 (Caulkins, 2024). Understanding the underlying motives to use cannabis may provide valuable insight for healthcare providers to best support their patients.
This study aimed to synthesize existing research on cannabis use among caregivers of older adults, focusing on frequency of use, underlying motivations, and potential implications for caregiver health and the caregiving experience. The findings are intended to inform researchers and health care providers, support the development of clearer guidance on cannabis use among caregivers of older adults as well as identify areas for further investigation in this emerging area.
Methods
Systematic Search
The reporting of this systematic review was guided by the standards of the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement (Page et al., 2021). A systematic search of the literature was conducted in January 2025 in PubMed, PsycINFO, and CINAHL. Articles were filtered to include peer-reviewed studies published 1996 or later to reflect when cannabis was first legalized in the United States (Patton, 2020). The search strategy used three keywords (“caregiver,” “cannabis,” and “use”) and their associated terms as shown in Table 1, with the final search text combining each of the three search strings with “AND.” Articles appeared in the search if they contained at least one term from each of the three search strings. The online website Rayyan was used to collect articles, remove duplicates, and organize the study screening (Ouzzani et al., 2016).
| Key term | Search string |
|---|---|
| Caregiver | caregiver OR caretaker OR “care provider” OR eldercare OR care worker OR “caring duties” OR “care aide” OR “care assistant” OR “support worker” OR “nursing aide” OR “informal care” OR “family care” OR “elderly care” OR “home nurse” OR “home nursing” |
| Cannabis | cannabis OR marijuana OR THC OR CBD OR cannabinoid OR cannabidiol OR dronabinol OR nabilone OR weed OR pot OR hashish OR sativa OR indica OR bhang |
| Use | use OR usage OR consumption OR administration OR self-medication OR self-treatment OR utilization |
Eligibility Criteria
Articles were included in the systematic review if they met the following criteria: (1) reported empirical data on cannabis use among caregivers; (2) care recipients were primarily older adults; (3) published in 1996 or later; (4) published in English; and (5) published in peer-reviewed journals. Articles were excluded if they only reported data for parents or caregivers of children, adolescents, or younger adults.
Data Extraction
One author initially screened 357 articles for titles and abstracts to remove articles that did not directly address caregiver cannabis use. Of the 39 remaining articles, 3 authors first reviewed a set of identical articles using a data extraction template and compared results to ensure consistency across raters. The data extraction template included: title, journal, year of publication, country, objective, participant characteristics, methods, relevant outcomes, inclusion status, and reason for exclusion (if applicable). After the authors collectively screened nine articles and confirmed consistency, the remainder were divided among the three authors to independently perform full-text screening using the same data extraction template. Five authors later met and reviewed the results of the full-text screening to collectively agree on which articles to include or exclude. Results were synthesized based on themes in their findings as they related to the objectives of the review. This approach allowed for the results to be presented as a cohesive narrative.
Results
Study Screening and Characteristics
Figure 1 describes the study screening process. Of the 537 articles initially identified, 5 were included in the final review. Many studies in the full-text screening were excluded because the care recipients were primarily children.
Frequency of Caregiver Cannabis Use
Study characteristics are summarized in Table 2. Multiple studies provided insight into the frequency of cannabis use among caregivers. In a study by Kaskie et al. (2021), 23% of caregivers used cannabis in the past year. Varma et al. (2024) compared non-caregivers with two caregiver groups: those caring for adults (including older adults) and parent-caregivers, who were simultaneously parenting a child and caring for an adult. The study found that 40.7% of caregivers of adults and 24.4% of parent-caregivers reported “age related decline” as the reason for caregiving. Additionally, 11.5% of caregivers of adults and 20.4% of parent-caregivers reported using cannabis in the past 30 days to cope with stress from the COVID-19 pandemic. Caregivers had seven times higher odds of initiating or increasing substance use compared to non-caregivers, with parent-caregivers having the highest adjusted odds ratio of all (aOR: 7.19 [5.87–8.83], p < .001). Arora et al. (2020) found that 42% of participants reported cannabis use in the past year, although the specific proportion of caregivers (13% of the total sample of 192 older adults) who used cannabis was not provided.
| Author, year | Title | Study type, country | Objective | Methods | Participants | Relevant outcomes |
|---|---|---|---|---|---|---|
| Varma et al. (2024) | Substance use and help seeking as coping behaviors among parents and unpaid caregivers of adults in the United States during the COVID-19 pandemic. | Cross-sectional survey, U.S. (Utah, Washington) | Examine patterns of substance use as a means of coping with stress and a willingness to seek help among parents, unpaid caregivers of adults, and parent-caregivers. | Quantitative data Internet-based surveys targeted toward demographically representative sample Survey assessed caregiver experiences, coping behaviors, and substance use | 10,444 adult respondents. Mean age of 49.8 years. Of the 42.6% who were parents or caregivers of adults: − 11.2% were caregivers of adults − 23% were parent-caregivers (both a parent to a child under the age of 18 and a caregiver for an adult over the age of 64) Demographic variables collected: age, sex, race, education, employment status, financial status, anxiety and depression symptoms | (1) 11.5% of caregivers of adults and 20.4% of parent-caregivers reported using cannabis in the past 30 days to cope with stress. (2) 18.9% of caregivers of adults and 65.4% of parent-caregivers reported new or increased substance use in the last 30 days to cope with stress. (3) Parent-caregivers had the highest anxiety/depression symptoms at 70%. (4) Caregivers of adults had the highest insomnia symptoms at 26.1%. |
| Maxwell et al. (2023) | Coping behaviors and health status during the COVID-19 pandemic among caregivers of assisted living residents in Western Canada. | Longitudinal survey, Canada (Alberta, British Columbia) | Examine coping behaviors among caregivers of assisted living residents during the first two waves of the COVID-19 pandemic. | Quantitative data Internet-based surveys for caregivers in regional assisted-living facilities Survey assessed caregiver experiences, coping behaviors, substance use, and help-seeking behaviors | 673 primary caregivers of assisted living residents aged 65+ years and resided in the assisted living home for at least 3 months prior to March 1, 2020. Demographic variables collected: age, sex, marital status, race, education, employment status, financial status, relationship to care recipient, other substances used | (1) 8.0% of caregivers reported starting or increasing smoking or cannabis use during the first wave of the COVID-19 pandemic. (2) This was most common for caregivers who were younger, not white, more highly educated, had existing anxiety disorders, or had the greatest concern over income reduction during the pandemic. |
| Vu et al. (2022) | Impact of Alzheimer’s disease on caregivers in the United States. | Cross-sectional survey, U.S. | Examine the factors motivating caregivers to take care of people with Alzheimer’s disease and its impact on their lifestyle. | Quantitative data Internet-based surveys for randomly-selected caregivers, allowing for diverse sample Survey assessed caregiver experiences, coping behaviors, substance use, and motivations | 200 caregivers of people with Alzheimer’s disease. Median age of 37 years with interquartile range of 32 to 47 years. Demographic variables collected: age, sex, marital status, race, education, employment status, financial status, relationship to care recipient, stress levels, motivation for caregiving | (1) 35.5% of caregivers reported an increase in drug use (including alcohol and cannabis) to cope with the stress of caregiving. (2) Drug use, particularly alcohol and cannabis, was more prevalent among caregivers who were younger or experiencing higher financial strain. (3) 58% of caregivers reported extreme stress and 47% reported sleep deprivation due to caregiving stress. |
| Arora et al. (2020) | Measuring attitudes toward medical and recreational cannabis among older adults in Colorado. | Cross-sectional survey, U.S. (Colorado) | Examine how age, physical health, and caregiving status shape attitudes toward cannabis use by designing and evaluating scales assessing both medical and recreational cannabis use and attitudes. | Quantitative data Surveys distributed in clinics, senior centers, and cannabis dispensaries in Colorado Survey assessed attitudes toward medical and recreational cannabis | 192 older-adult respondents: 13% were caregivers for older adults (60+ years old) Demographic variables collected (for the entire sample, not restricted to caregivers): age, sex, marital status, race, education, employment status, other substances used | (1) Caregivers were more likely than non-caregiver to have positive attitudes toward recreational cannabis, but not toward medical cannabis. (2) 42% of the total sample reported cannabis use in the last year, but the proportion of caregivers is unknown. |
| Kaskie et al. (2021) | Cannabis use among persons with dementia and their caregivers: Lighting up an emerging issue for clinical gerontologists. | Qualitative focus group, U.S. (California) | Examine implications of cannabis use among people with dementia and their caregivers. | Qualitative data Focus groups for caregivers in an Alzheimer’s disease center Discussion topics were caregiver perceptions and behaviors relating to cannabis use | 26 informal caregivers of people with dementia. Mean age of 57 years with a range of 30 to 89 years. Demographic variables collected: age, sex, race, education, financial status, self-reported health | (1) 23% of caregivers used cannabis in the last year and found it either “very helpful” or “somewhat helpful” in managing their well-being. (2) 90% of caregivers not using cannabis reported they would be open to learning more or discussing it with their clinician. (3) 34.6% of caregivers reported sleep as a primary caregiving challenge. |
Other studies combined cannabis use with other types of substances, such as alcohol and smoking, into a single variable. Maxwell et al. (2023) reported an increase in substance use among caregivers during the first wave of the COVID-19 pandemic, with 8% of caregivers initiating or increasing smoking and/or cannabis use. Vu et al. (2022) found that 35.5% of caregivers reported an increase in drug use, including alcohol and cannabis, as a method to cope with the stress of caregiving.
Motivations for Caregiver Cannabis Use
Across the included studies, the primary motivations for cannabis use among caregivers included coping with stress, mental health issues, and sleep issues.
Stress
In the study by Varma et al. (2024), caregivers who reported higher levels of stress, felt underprepared for caregiver situations, felt that the caring situation was unpredictable, resented caregiver role, and had family disagreements about insufficient support had higher odds (aORs range from 1.5 to 2.0) of cannabis use compared to caregivers who didn’t report these concerns. This study also assessed perceptions of caregiving intensity, comparing parent-caregivers and caregivers of adults. While both groups reported high levels of stress and caregiving demands, parent-caregivers and caregivers of adults, respectively, reported feeling that the caring situation was unpredictable (58% vs. 38%), feeling underprepared (54% vs. 26%), being forced to decrease living expenses to cover costs (58% vs. 32%), experiencing family disagreements about lack of help (55% vs. 30%), lacking desired personal freedom (54% vs. 33%), and resenting the caregiving role (53% vs. 18%).
Although the study by Vu et al. (2022) did not specifically examine the relationship between cannabis use and stress, it provides descriptive data about stress for caregivers of people with Alzheimer’s disease. The study found that the majority of caregivers reported extreme stress (58%) and caregiving to be “hard” or “extremely hard” (65%), while only 3% reported that they did not experience any caregiving-related stress. Caregivers reported primary stressors to be worries about their care recipient (50%), financial concerns (12.5%), their lack of medical experience (10.5%), and their own health and well-being (10.5%). Similarly, 61.5% of participants in Kaskie et al. (2021) reported emotional strain as a challenge to being a caregiver.
Sleep
Varma et al. (2024) reported that 26.1% of caregivers of adults and 25% of parent-caregivers experienced insomnia. The study also found that a significantly higher proportion of both parent-caregivers and unpaid caregivers of adults who had insomnia symptoms reported new or increased substance use in the past 30 days (p < .001), including cannabis, compared to those without insomnia.
Vu et al. (2022) found that 47% of caregivers of people with Alzheimer’s disease became sleep deprived after becoming caregivers. Similarly, in the study by Kaskie et al. (2021) 34.6% of caregivers report sleep problems as a primary caregiving challenge. However, neither study explored whether these problems were associated with cannabis use.
Mental Health
Varma et al. (2024) reported that parent-caregivers had the highest percentage of anxiety and/or depression symptoms (70.6%), followed by caregivers of adults (39%). In comparison to individuals without depression and/or anxiety symptoms, those with depression and/or anxiety symptoms were significantly more likely to report substance use, including cannabis, to cope with stress or emotions during the COVID-19 pandemic (p < .001). Similarly, Maxwell et al. (2023) found that caregivers with baseline anxiety (15.4%) and depressive symptoms (13.5%) were more likely to report new or increased smoking and/or cannabis use during both waves of the pandemic, as revealed by adjusted risk ratios (anxiety aRR: 2.21 [1.26–3.88], depressive aRR: 2.04 [1.17–3.55]).
Relationships Between Cannabis Use and Caregiver Characteristics
Significant associations were found between several caregiver demographic variables including parental status, age, income, education, and race, and cannabis use. Varma et al. (2024) found that, among all caregiver groups, parent-caregivers had the highest rate and highest adjusted odds ratio of new or increased cannabis use (20.4%) in the past 30 days. Maxwell et al. (2023) found that caregivers aged 18 to 44 years had the highest risk of increasing smoking and/or cannabis use during the initial wave of the COVID-19 pandemic (aRR: 4.43 [1.92–10.19], compared to caregivers aged 45 to 54 years (aRR: 2.38 [0.93–6.09]) and caregivers aged 55 to 64 years (aRR: 1.90 [0.96–3.79]).
Maxwell et al. (2023) also found that caregivers who were most concerned about income reduction during the pandemic had the highest risk of increased smoking and/or cannabis use (aRR: 1.42 [0.69-2.92]), compared to those with lower levels of concern (aRR: 0.78 [0.35–1.73]). Additionally, caregivers with education beyond high school were more likely to increase their use (aRR: 2.10 [1.03–4.28]) than those with a high school education or less (aRR: 1.57 [0.66–3.72]). The study also found that non-White caregivers had a higher risk of increased smoking and/or cannabis use (aRR: 2.12 [1.07–4.19]) compared to White caregivers.
Perspectives and Impacts of Cannabis Use Among Caregivers
Two studies reported positive perspectives and growing interest in cannabis use among caregivers. Arora et al. (2020) examined attitudes toward recreational and medical cannabis use among adults aged 60 years and older, 13% of whom identified as caregivers. The study found that being a caregiver was associated with positive attitudes toward recreational cannabis (p < .01).
A qualitative focus group study by Kaskie et al. (2021) found that 6 out of 26 caregivers used cannabis in the past year and described it being either “very helpful” or “somewhat helpful” for managing their own well-being. Three caregivers reported that cannabis aids with sleep while one caregiver reported that cannabis aids with pain management. Participants were interested in and wanted to learn about and discuss cannabis options, primarily from their healthcare providers. Nearly all (90%) of caregivers in the sample who were not using cannabis said they would consider it if they perceived a need or there was a recommendation by their health care provider. However, none of the caregivers reported that their healthcare providers had discussed cannabis use.
Discussion
With rising accessibility and use of cannabis in the United States (Mahabir et al., 2020), current literature suggests that some caregivers use cannabis to cope with the various stressors and challenges associated with caregiving (Kaskie et al., 2021; Maxwell et al., 2023; Varma et al., 2024; Vu et al., 2022). Four studies in our review detailed the state or province from which data were collected, revealing that both medical and recreational cannabis (with the exception of recreational cannabis in Utah) are legal in these four studies (National Conference of State Legislatures, 2025). While not the focus of our review, two studies suggested that the COVID-19 pandemic may also have led some caregivers to turn to cannabis (Maxwell et al., 2023; Varma et al., 2024). Other motivating factors for cannabis use among caregivers included using cannabis as a way to address issues related to sleep (Kaskie et al., 2021; Varma et al., 2024; Vu et al., 2022) and mental health (Maxwell et al., 2023; Varma et al., 2024). Notably, poor sleep quality (Leggett et al., 2020) and mental health burden (Varma et al., 2024) are commonly reported concerns for caregivers of older adults. In addition to causing adverse health outcomes in caregivers, poor sleep quality is also likely to impact caregiving by increasing risk for caregiver inattention and medication administration errors, which can have serious consequences for older care recipients (Durak & Catikkas, 2024; Ghezeljeh et al., 2025).
There is much evidence that caregivers experience high stress. Stress in caregivers is linked to sleep problems, anxiety, and emotional burden (Beach et al., 2021; Bussè et al., 2022; Milberger et al., 2021). Additionally, each of these factors is generally associated with cannabis use across a broad range of populations (Beletsky et al., 2024; Diep et al., 2022; Gonzales et al., 2022; N. Nguyen et al., 2023; Weidberg et al., 2023). Caregivers often experience higher stress when they have little social or instrumental support (Kent et al., 2020; Xiang et al., 2024), or the care recipient has behavioral or cognitive symptoms that are difficult to manage (Devi et al., 2020; Iravani et al., 2022; Lou et al., 2025). Programs such as adult day care centers, respite care, in-home care, and others exist to alleviate caregiver stress (H. Nguyen et al., 2024; Zebrak & Campione, 2021). Still, caregivers face barriers to utilizing these services, including high costs, difficult access, and cultural preferences for care and help seeking (Boyle et al., 2022; Litzelman & Harnish, 2022; Messina et al., 2024; Tran et al., 2023; Widyastuti et al., 2023). As a result, cannabis use may emerge as a more private, affordable, and accessible way to relieve stress (Vu et al., 2022).
The two studies in our review reporting the perspectives and effects of cannabis among caregivers found that caregivers felt positive effects from cannabis use and had positive attitudes toward recreational cannabis (Arora et al., 2020; Kaskie et al., 2021). As the need for caregivers increases due to an aging global population (Choi et al., 2024) and barriers remain to access support, caregivers will consider cannabis to cope with stress especially given perceived benefits of use. Such findings highlight the need to investigate how caregivers obtain information about cannabis safety, appropriate usage, and risks, as there is still much to be learned about cannabis, many formulations available in the marketplace, and many methods of administration (Golombek et al., 2020; Wolf et al., 2020). This is especially relevant as studies estimate that 50% to 87% of cannabis products may contain inaccuracies about their composition (i.e., CBD and THC concentrations) due to a lack of regulation that can adversely impact users’ physical and mental health (Berger et al., 2021; Dowd et al., 2025; Johnson et al., 2022; Spindle et al., 2022). As such, making informed choices can decrease adverse health outcomes of cannabis, especially since many cannabis users report low knowledge about the composition of the products they use (Fischer et al., 2017; Goulette et al., 2024).
Importantly, the study by Kaskie et al. found that none of the caregivers using cannabis engaged in discussions about it with healthcare professionals (Kaskie et al., 2021). This is consistent with existing literature demonstrating a general lack of communication between patients and providers on the topic of cannabis use (Abu Baker et al., 2024; Baral et al., 2025; Elbready et al., 2024; Turner et al., 2024). Because a wide variety of cannabis products and formations are available but there is a high rate of false information about these products, communication between providers and caregivers is essential so that caregivers are educated on how to safely use cannabis while ensuring healthy physical and mental functioning and prioritizing quality of care. However, in clinical practice, a general lack of evidence regarding safety and efficacy of cannabis use leads to hesitancy among providers to initiate discussions (Baral et al., 2025). It is important to acknowledge that communication about cannabis in healthcare settings can be affected by legalization status and stigma. Still, these findings are valuable to inform caregivers, public health researchers, healthcare providers, and policymakers.
Limitations and Future Directions
Our review’s primary limitation includes the small number of studies meeting our inclusion criteria, thereby restricting our ability to reach broad conclusions, or perform a meta-analysis. Additionally, the included studies lacked a standardized or consistent measure of cannabis use, with two studies combining cannabis with other substances (alcohol and cigarettes; Maxwell et al., 2023; Vu et al., 2022) and therefore lacking data for cannabis alone. One study (Varma et al., 2024) did not stratify data for only caregivers of older adults, although the reasons for caregiving revealed that the care recipients were largely older adults. Because of these differences in data reporting, we are unable to make direct comparisons between the included studies. Finally, limitations also may arise from the nature of the review process as it focused on peer-reviewed papers and did not include gray literature.
Many gaps exist in the literature on cannabis use among caregivers of older adults. We recommend that future studies stratify their analyses to disentangle cannabis from other drugs and caregivers of older adults from other caregivers. No studies have explored the impact of cannabis use on relationships between caregivers and care recipients, nor have any studies included care recipients’ perspectives. None of the included studies examine whether caregivers used cannabis prior to taking on the caregiving role, whether caregivers use cannabis while actively providing care, and the forms of cannabis caregivers use. Only one study provided longitudinal data; more longitudinal studies are needed to explore the long-term impact of cannabis use among caregivers and their relationship with care recipients. It may be possible that the COVID-19 pandemic marked the beginning of a shift toward increased cannabis use among caregivers.
Conclusion
This study suggests that caregivers of older adults use cannabis and are influenced by caregiving stress and emotional burden. As cannabis continues to become more widely available in the United States, these findings highlight an emerging area for education on its use among caregivers. Healthcare providers, service providers, and policymakers should be aware of these trends for a more holistic understanding to support caregivers.
Footnotes
Footnote Group
References
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