Fat Embolism Syndrome Following Elective Orthopedic Surgery in a Patient With Duchenne Muscular Dystrophy.

Cannabis is the third most commonly consumed addictive substance in the United States (following alcohol and tobacco). In 2013, 4.7% of adults ages 60-64 and 1.4% of those ages 65+ reported past-year cannabis use which increased to 17.5% and 9.5%, respectively, in 2023 () (). Considering older adults’ cannabis use within an age-period-cohort framework (), this acceleration coincided with increased access to cannabis via state-level medical and recreational legalization, stronger-than-ever delta-9 tetrahydrocannabinol (THC) cannabis product potency (), increasing rates of cannabis use disorders (), and lower-than-ever cannabis-related risk perceptions (). The National Academies of Science and Medicine () identify older adults as a vulnerable population that require critical monitoring in the changing cannabis policy landscape to prevent negative health impacts. Cannabis has attracted consumer interest and research given potential therapeutic benefits across conditions (). Most US states allow possession and consumption of cannabis for medical reasons. States vary in medical cannabis regulations (): many require a medical professional’s recommendation to use cannabis that is limited to the presence of one or more “qualifying conditions,” with required medical provider documentation varying across states (e.g., choosing ≥1 diagnosis from a checklist, or selecting a “primary serious condition”). Some conditions, such as Alzheimer’s Disease and associated agitation from behavioral and psychological symptoms (“AD” hereafter), have little or no scientific evidence demonstrating cannabis as an effective treatment. Specifically, a recent Cochrane Review () found no strong evidence for the efficacy of cannabis on behavioral and psychological symptoms of dementia broadly (most participants studied had AD). Given the growing population of US older adults living with AD (), public interest in potential therapeutic benefits, including among older adults (), the increased prevalence of cannabis consumption among older adults, and the changing policy context (), monitoring trends in medical cannabis use as related to AD is important. A 2016 report () found that 9 of 23 states allowing medical cannabis allowed it for AD-related reasons (among others), yet data were limited about how frequently AD was the basis for medical cannabis consumption. Now, 38 states allow medical cannabis and 22 have legalized recreational cannabis. The purpose of this brief report is to provide a snapshot, detailing the states allowing for medical cannabis and the proportions of patients reported as receiving medical cannabis for AD over time, with examination of trends post-recreational legalization. Although this descriptive analysis precludes formal hypothesis testing, we expected to see increases in appearance of AD as a qualifying condition, but we did not have an a priori hypothesis about fluctuations in AD as a qualifying condition based on state-level recreational cannabis policy.