Cannabis use, comorbidities, and prescription medication use among older adults in a large healthcare system in Los Angeles, CA 2019–2020

Abstract

Objective To describe the reported prevalence of cannabis use and co‐use with prescription medications among older adult patients attending primary care (PC) clinics in Los Angeles, CA. Methods We used electronic health record (EHR) data from sixty PC clinics part of a university‐based, urban healthcare system. Patients' ≥50 years of age with an annual physical examination between July 2019 and May 2020 were eligible for inclusion (n = 42,555). Cannabis use was assessed by clinic staff at the time of the visit and recorded in the EHR. We also used EHR data on clinical characteristics including current prescriptions and comorbidities. Results The median age was 63 years (range: 50–101) and 56% were female. Recent cannabis use was reported by 7.6%, which was higher than tobacco use (4.0%; p < 0.01). Prevalence of cannabis use was higher among patients prescribed psychotropic medications. For instance, 10.9% of patients prescribed benzodiazepines reported cannabis use as compared with 7.3% among patients without a prescription for benzodiazepines (p < 0.01). Patients with neurologic/musculoskeletal medications such as antiepileptics also had a higher prevalence of cannabis use when compared with those without these prescriptions (13.6% vs. 7.6% respectively; p < 0.01) as did those who were prescribed muscle relaxants (10.3% vs. 7.5% respectively; p < 0.01). After adjusting for age, sex, race/ethnicity, and comorbidities those prescribed medications for psychiatric (adjusted OR = 1.5; 95% CI 1.4–1.7), respiratory (adjusted OR = 1.2; 95% CI 1.1–1.3), or neurologic conditions (adjusted OR = 1.4; 95% CI 1.2–1.5) had increased odds of cannabis use compared with those not prescribed these medications. Discussion The prevalence of cannabis use among older adults attending PC clinics in a university‐based healthcare system was higher among those prescribed medications, which may interact with cannabis. These findings suggest that key groups of older patients who may benefit from routine PC screening for cannabis use and brief advice.

Associations between Oral Health and Cannabis Use among Adolescents and Young Adults: Implications for Orthodontists

“…Raters accounted for misspellings or alternative names for cannabis (e.g., marijuana, weed, hash), and differentiated current use from lifetime use. Previous studies have adopted timeframes ranging from past 1–3 months in defining current cannabis use [ 44 , 45 , 46 ]. However, owing to the open-ended nature of the question in this study, only responses that alluded to ongoing cannabis use as of the date appointment were recoded as current use.…”

Electronic health record data may lead to underestimates of cannabis use—Especially among older populations

“…The authors have no other potential conflicts to declare. Joseph J. Palamar PhD, MPH 1 Austin Le MSc, DDS 1,2…”

“…Javanbakht et al published an important paper in this issue of the Journal of the American Geriatrics Society (JAGS) that estimated the prevalence of current cannabis use among older adults within a large healthcare system in Los Angeles, California 1 …”

“…Javanbakht et al published an important paper in this issue of the Journal of the American Geriatrics Society (JAGS) that estimated the prevalence of current cannabis use among older adults within a large healthcare system in Los Angeles, California. 1 The authors should be commended for appropriately noting many of the limitations of utilizing a data source derived from self-report. We hope to expand this discussion by further considering the potential limitations associated with utilizing data from electronic health records.…”

Marijuana use among community‐dwelling older adults: A population‐based study

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