Cannabis-impaired driving is a public health concern that is under-investigated in subpopulations, such as middle and older adults. Per the National Survey on Drug Use and Health (NSDUH), ~15.0 % of people aged 50 +  report past-year cannabis use. Illustrating increasing consumption rates for this population (Kepner et al., 2023), past-year cannabis use rose from 9.6 % in 2013 to 20.8 % in 2024 among adults 50–54 years-old and from 1.2 % to 10.5 % among those 65 + (Substance Abuse and Mental Health Services Administration, 2025, Substance Abuse and Mental Health Service Administration, 2014). Estimates vary by data sources; recently Monitoring the Future reported 19.7 % past-year prevalence among 55–65 year-olds (Patrick et al., 2025).

Rising cannabis consumption has occurred concurrent with increased access via medical and recreational cannabis policies, higher potency (i.e., THC levels) products (Cash et al., 2020), investigations into therapeutic applications, and decreasing cannabis-related risk perceptions (Substance Abuse and Mental Health Services Administration, 2024). A current challenge for the field is to address potential cannabis-related public health risks, including driving after consuming cannabis which occurs among ~25 % of adults with past-year consumption (per NSDUH’s measure: driving “under the influence of” cannabis).

Although measuring the impact of cannabis use on driving-related outcomes has challenges (McCartney et al., 2021), recent data indicate that cannabis-impaired driving could increase under policies expanding legal access. For example, Canada’s population prevalence of driving within 2 h of cannabis use (herein: DCU) increased post-recreational legalization (Kucera and Hammond, 2025); 19.9 % of people with past-year cannabis consumption reported DCU. THC positivity rates among Washington State drivers in fatal crashes more than doubled post-recreational legalization (Tefft and Arnold, 2021). Recent work among trauma center patients admitted for motor vehicle crashes (MVC) showed increasing rates of cannabis positivity, across ages, including adults 65 + (Al Ma'ani et al., 2025).

McCartney et al.'s meta-analysis (2021) determined that acute cannabis use detrimentally affects several driving-related cognitive functions (e.g., attention, reaction time, information processing) with negative impacts on driving performance present for some indices (e.g., weaving, lateral control, reaction time), but not others (e.g., speed, speed variability). Simmons et al.'s (2022) meta-analysis showed similar results, along with cannabis-related speed decreases. Notably, tolerance may alter functioning; those with more frequent consumption can evidence less impairment than those using occasionally (McCartney et al., 2021).

Although DCU is more prevalent in younger individuals, 2020 NSDUH data showed that ~21 % of 50–64 year-olds and ~18 % of 65 +year-olds with past-year cannabis use drove under the influence (Myers et al., 2023). Because cannabis can impair critical cognitive executive functions (Broyd et al., 2016, Stefanidis et al., 2025) and because cognitive functions can be declining in middle and older adults (Brayne, 2007, Lemire et al., 2024, Salthouse, 2009), research on DCU in this population is warranted. The LongROAD study found that among 65–79 year-olds with past-year cannabis use (vs. those without), 14.5 % reported a past-year MVC (vs. 11.1 %) and 13.4 % reported traffic stops (vs. 9.1 %); the association was only significant for traffic stops (DiGuiseppi, et al., 2019). Johnson et al. (2021) examined oral fluid from drivers at MVC sites finding that adults ages 64 +  who were THC-positive were at elevated crash risk. A driving simulator study found increased weaving and decreased speed when individuals 65 +  drove 30 min after consumption (Di Ciano et al., 2024).

Research is needed to address potential impacts of cannabis consumption on driving, including elucidating the scope of DCU for population subgroups to inform developmentally-appropriate interventions to address DCU [most “drugged driving” interventions target younger populations (Razaghizad et al., 2021)]. Thus, we report past-year cannabis use prevalence among US adults ages 50 + , DCU, and its correlates, with attention to socio-demographics (including residence in legal recreational states), social functioning [e.g., caregiving, social isolation given association of isolation with cognitive decline (Htun et al., 2025)], and cannabis use motives (to inform cannabis-reduction interventions which may reduce associated DCU).