Medical Cannabis for Older Patients

Minerbi, Amir; Haüser, Winfried; Fitzcharles, Mary‐Ann

doi:10.1007/s40266-018-0616-5

Cited by 77 publications

(57 citation statements)

References 84 publications

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“…THC has intoxicating properties whereas CBD does not. 21 Older adults may be more sensitive to the intoxicating effects of THC, which may explain why in our study older adults were more likely to use and start with products of equal or low THC:high CBD ratios, indicating lower THC concentrations than younger age groups. However, over time, older adults increased their THC dosing at a similar rate as other age groups, suggesting that as older adults become more comfortable with cannabis they may be more willing to use cannabis products with higher THC doses, or develop a tolerance to THC necessitating increased doses over time.…”

Section: Cannabis Use Patterns In Older Adultsmentioning

confidence: 64%

“…For example, sublingual tinctures administered by buccal route may result in a more rapid onset of action than oral capsules; all of which may impact how cannabis influences an older adult's functioning. 21 The two key cannabinoids in medical cannabis are THC and CBD, and both have different risk and benefit profiles for older adults. THC has intoxicating properties whereas CBD does not.…”

Section: Cannabis Use Patterns In Older Adultsmentioning

confidence: 99%

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Patterns of Medical Cannabis Use Among Older Adults from a Cannabis Dispensary in New York State

Kaufmann

Kim

Miyoshi

et al. 2022

Cannabis and Cannabinoid Research

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Background: Cannabis use has increased among older adults. Few epidemiological studies have examined the medical diseases reported for cannabis use, routes of cannabis administration, and methods of consumption among older adults, and how they differ from younger adults. Methods: We analyzed invoice data on purchases of cannabis products from a large medical cannabis dispensary in New York State between January 1, 2016 and December 31, 2017. Data came from n = 11,590 patients stratified by ages 18-49 (n = 4,606), 50-64 (n = 3,993), and ‡ 65 years (n = 2,991). We assessed differences in groups by demographic characteristics of patients, qualifying conditions and symptoms for cannabis use, cannabis product dosing of THC and CBD, THC:CBD ratios, and cannabis delivery methods. Results: Among cannabis patients, 25.8% were aged ‡ 65 years, and 34.5% were ages 50-64. Across all age groups, severe or chronic pain was the predominant symptom for cannabis use, although older patients were more likely to use cannabis for cancer and Parkinson's disease among other conditions. Older adults were more likely to use sublingual tincture versus other consumption methods, to use products with a lower THC:CBD ratio, and to begin cannabis treatment with a lower THC and higher CBD dose compared with younger age groups. However, all age groups demonstrated a similar increase in THC dosing over time. Conclusion: Analysis of medical cannabis invoices from a dispensary in New York State showed that although there are similarities in patterns of cannabis use across all groups, there are key characteristics unique to the older adult medical cannabis user.

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Section: Cannabis Use Patterns In Older Adultsmentioning

confidence: 64%

Section: Cannabis Use Patterns In Older Adultsmentioning

confidence: 99%

Patterns of Medical Cannabis Use Among Older Adults from a Cannabis Dispensary in New York State

Kaufmann

Kim

Miyoshi

et al. 2022

Cannabis and Cannabinoid Research

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show abstract

“…For example, both cannabis (including both THC and cannabidiol [CBD]) and alcohol are contraindicated while taking high blood pressure medications, antibiotics, antihistamines, medications for erectile dysfunction, pain relievers (prescription and over the counter), sleep aids, antidepressants, and some cholesterol medications, and may cause hepatoxicity [39,40]. Using substances while taking medications can delay the biotransformation or digestion of medications, cause excessive sedation, or potentiate blood thinning [40,41]. Anesthetics should be adjusted if an OA drinks heavily or uses marijuana or CBD due to cross tolerance [42,43].…”

Section: Kuerbismentioning

confidence: 99%

“…While there is at least preliminary evidence of medicinal benefits to marijuana use among OA, its therapeutic effects are understudied in this group, and its benefits may be overstated, as in the case of treating neuropathic pain [52]. There are also less-well-known risks related to marijuana use among OA [41]. Marijuana (with chemical compounds THC and CBD) causes impairment in shortterm memory; increases heart and respiratory rates, elevates blood pressure; and contributes a fourfold increased risk for heart attack after the first hour of smoking marijuana.…”

Section: Painmentioning

confidence: 99%

Substance Use among Older Adults: An Update on Prevalence, Etiology, Assessment, and Intervention

Kuerbis

2019

Gerontology

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The global population is aging, and as the population ages, high-risk alcohol and other drug use, particularly cannabis and prescription medications, is growing among older adults (OA). OA, defined here as 50 years of age and older, have a number of unique vulnerabilities to drug and alcohol use due to both biological as well as psychosocial factors compared to younger adults. Understanding the wide spectrum of these vulnerabilities is important to assessment, diagnosis, and intervention. Specific techniques, assessment tools, and interventions known to be effective in OA are reviewed.

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“…However, currently, there is a dearth of evidence about the efficacy of cannabis in older adults for any of these symptoms. This has been emphasized in several reviews [16,17,18] and in large reports such as the report of the National Academies of Sciences in the United States [19] and the Information for Health Care Professionals in Canada [20].…”

Section: Introductionmentioning

confidence: 99%

Medical Cannabis for Older Patients—Treatment Protocol and Initial Results

Abuhasira

Ron²,

Sikorin³

et al. 2019

JCM

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Older adults may benefit from cannabis treatment for various symptoms such as chronic pain, sleep difficulties, and others, that are not adequately controlled with evidence-based therapies. However, currently, there is a dearth of evidence about the efficacy and safety of cannabis treatment for these patients. This article aims to present a pragmatic treatment protocol for medical cannabis in older adults. We followed consecutive patients above 65 years of age prospectively who were treated with medical cannabis from April 2017 to October 2018. The outcomes included treatment adherence, global assessment of efficacy and adverse events after six months of treatment. During the study period, 184 patients began cannabis treatment, 63.6% were female, and the mean age was 81.2 ± 7.5 years (median age-82). After six months of treatment, 58.1% were still using cannabis. Of these patients, 33.6% reported adverse events, the most common of which were dizziness (12.1%) and sleepiness and fatigue (11.2%). Of the respondents, 84.8% reported some degree of improvement in their general condition. Special caution is warranted in older adults due to polypharmacy, pharmacokinetic changes, nervous system impairment, and increased cardiovascular risk. Medical cannabis should still be considered carefully and individually for each patient after a risk-benefit analysis and followed by frequent monitoring for efficacy and adverse events.

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Medical Cannabis for Older Patients

Cited by 77 publications

References 84 publications

Patterns of Medical Cannabis Use Among Older Adults from a Cannabis Dispensary in New York State

Patterns of Medical Cannabis Use Among Older Adults from a Cannabis Dispensary in New York State

Substance Use among Older Adults: An Update on Prevalence, Etiology, Assessment, and Intervention

Medical Cannabis for Older Patients—Treatment Protocol and Initial Results

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