Growing interest in cannabis has sparked new discussion about the substance’s use by seniors. In fact, the future of cannabis may be silver: older adults represent the fastest growing group of people using the substance.
A surge in popularity
Consider some of the statistics: from 2006 to 2013, the past-year prevalence of cannibis use among people aged 50 years and up in the US increased by a staggering 71.4 percent.
In Ontario, people over age 50 who used cannabis in the past year nearly tripled over the last 10 years and rose five-fold since 1977.
There are several reasons to help explain the surge. Cannabis today doesn’t have the same stigma it did in decades past; there’s more science and less fear behind cannabis.
However, the spike raises many burning questions about how seniors are coping with various health issues and what they need to consider when it comes to this particular substance.
On one hand, seniors may turn to cannabis to avoid adverse effects of harsher pharmaceutical medications. Long-term use of ibuprofen, which is commonly used for pain and inflammation, for example, can cause life-threatening gastrointestinal bleeding and ulceration, while sleep aids can lead to memory problems, headache, and dizziness.
On the other, while medical cannabis may be—or may be perceived as being—potentially less harmful because it’s plant-derived, more research is needed to determine with certainty that it’s safe for certain medical applications, according to Fiona Clement, lead author of Alberta Health’s Cannabis Evidence Series, a comprehensive synthesis of existing scientific research, and assistant professor at the University of Calgary’s Cumming School of Medicine.
What the science says
“When we talk about a substance being ‘safe’—if we’re taking that to mean without risk and without side effects—it’s obvious cannabis is not like this,” Clement says. “There are side effects and risks with using cannabis, even though it’s natural.”
Speaking about cannabis generally and not among seniors in particular, Clement says strong evidence supports its use and effectiveness in two key areas: the management of chronic pain and the treatment of nausea associated with chemotherapy.
Medicinal cannabis has also been shown to have beneficial effects in treating chronic nerve pain specifically. According to a 2018 report published in the Cochrane Database of Systematic Review, which included 16 studies and more than 1,700 participants, cannabis-based remedies appeared to increase the number of people who reported a 50 percent or more reduction in pain relief.
Other research shows promising results. A study by McMaster University found that there may be a role for cannabis in supporting the quality of life of people with head or neck cancers. Cannabis users had significantly lower scores than non-users for anxiety/depression, pain/discomfort, nausea, tiredness, lack of appetite, and drowsiness, as well as higher scores for general well-being.
Early research suggests cannabis could play a role in helping people overcome dependency on prescription medications, including opioids. A European study found that nearly 94 percent of seniors who took medicinal cannabis for pain reported an improvement after six months of use, with 18 percent stopping opioid analgesics or reducing their dose.
Proceeding with caution
Other research is mixed. Take studies related to anxiety, for example. Some people find medicinal cannabis eases symptoms, with early animal studies suggesting the substance stimulates serotonin receptors in the brain in the same way certain anti-anxiety medications do, with much less risk of addiction. However, about 20 to 30 percent of people experience anxiety after ingesting cannabis.
Clement urges seniors to talk to their health care practitioner for an individualized treatment plan if they’re considering cannabis for medical purposes. What works for one person may not suit another.
“People do need to be a little bit cautious and ask: ‘What are the risks for me and the possible benefits for me?’ People have to remember there is a spectrum, and it’s an individual decision that should be based on whether you think it’s working for you, achieving what you want it to achieve, and that you aren’t experiencing any negative side effects,” Clement says. “It’s touted as a cure-all, but people do need to be thoughtful about it.”
Just as there’s concern among health experts about the use of medicinal (or recreational) cannabis in youth and the developing brain, similar trepidation exists when it comes to the aging brain. Coupled with cognitive decline, the effects simply aren’t known, Clement says.
Another reason for caution is that seniors often have multiple health problems and may be taking any number of medications as a result. Little research exists into interactions between pharmaceutical drugs and cannabis. Furthermore, the use of cannabis with tobacco, alcohol, and other illicit substances may exacerbate the negative effects of cannabis use in aging bodies.
Then there are questions surrounding appropriate dosage—standardized dosages are lacking—and potency. Many of today’s strains are stronger than those of the past.
“Some seniors might have tried it when they were younger, but the product, especially in terms of THC [tetrahydrocannabinol, the psychoactive ingredient that makes you feel ‘high’] and CBD [cannabidiol, which has medicinal qualities, but no ‘high’] are quite different than what we were seeing in the ’60s,” Clement says. “If you haven’t smoked in 60 years, start low and go slow. This is not the product you grew up with.”
Who shouldn’t use cannabis
Medical cannabis isn’t for everyone, and it’s important to speak to your health care practitioner to ensure it’s right for you. The following people, for example, should avoid it.
- those with severe cardiopulmonary disease with occasional hypotension (low blood pressure), possible hypertension (high blood pressure), syncope (loss of consciousness), or tachycardia (rapid heart rate)
- those with respiratory diseases such as asthma or chronic obstructive pulmonary disease (COPD)
- people with severe liver or renal disease, including chronic hepatitis C
- psychiatric disorders or a family history of schizophrenia
- anyone with a history of substance misuse
Gail Johnson is a Vancouver-based writer, mom, and fitness instructor.