Seniors and Cannabis: Use Rises as Stigma Falls

According to Statistics Canada, seniors are the age group showing the most growth in cannabis use. As the chart below shows, more than a quarter of Canadians enjoying weed for the first time in 2019 were age 65-plus . This - er - boom in boomers has increased the average age of cannabis users by nearly a decade, from 29.4 in 2004 to 38.1 in 2019. 

In the US, where cannabis remains federally illegal, senior stoners are also on the rise.  A recent study in the Journal of the American Medical Association says cannabis use among Americans 65 and older has gone up almost two percent from 2015 to 2018.

The findings continue a trend seen over the last decade, the study’s lead author, Benjamin Han, an assistant professor of geriatric medicine and palliative care at the NYU School of Medicine, told Reuters

“Consider that not even 10 years ago, 0.4 percent of adults 65 and older said they had used marijuana in the past year, and now it's 10 times that at 4 percent,” Han said.

Seniors Opting for Medical Cannabis

These new older cannabis users tend to look for the medical benefits of THC and CBD, which can help alleviate a wide range of symptoms, from chronic pain to insomnia.

An April 2020 study, based on the findings of a survey completed by 568 patients at a geriatrics clinic in La Jolla, California, found that 10% of older adults reported cannabis use within the past six months, with most turning to it for medical purposes.

Kevin Yang, first author of the study and medical student at the University of California, San Diego, told Leafly: “The most common reasons for cannabis use were for pain, problems sleeping, and anxiety, which is unsurprising given that these are very common symptoms experienced by older adults. We also found that 43% reported using cannabis for more than one condition.” said Yang. 

Among those who used cannabis to help ease anxiety, 70% found that it was extremely or somewhat helpful in soothing their worries.

Another large scale study published in 2018,  followed almost 3,000 medical patients, and concluded that cannabis can be safe and effective for seniors. Significant benefits include a decrease in the use of pharmaceuticals, including opioids. Ninety-four per cent of senior patients reported improvement in their condition, with their pain level reduced by half.

Potential Risks for Seniors Using Cannabis

Cardiac Health and Cannabis Use

While cannabis is known to increase heart rate and can increase blood pressure, there is no evidence directly linking cannabis use with coronary events, according to a recent review by the Journal of the American College of Cardiology. Still, the authors recommend screening people with coronary disease for cannabis use, but especially younger users.

Medication interactions

“Older people tend to have comorbid health conditions and may be taking multiple medications,“ writes Peter Grinspoon in the Harvard Health blog. “Cannabis has about 600 chemicals in it, and in theory, the two main active ingredients in cannabis, THC and CBD, could either increase or decrease the blood levels of other drugs you are taking, by affecting the enzymes in your liver that help metabolize your medications. CBD, in particular, is at risk for increasing the other drugs in your system by ‘competitively inhibiting’ (or, in plain English, using at the same time) the molecules that you need to break down and clear these medications from your body.”

The blog goes on to note that people should be particularly cautious using cannabis with anti-seizure medications and with blood thinners, as these meds can have serious side effects.

Talk Cannabis With Your Doc

For canna-curious seniors, the best advice is to have a discussion with your doctor to weigh the safety risks, especially if you have cardiac issues, are taking multiple medications, or have cognitive changes due to aging. Most of the adverse effects associated with cannabis are dose-related, so new users should start with the lowest effective dose. 

Mona Sidhu, a geriatrician who works out of Hamilton Health Sciences, told HealthyDebate.ca that she starts seniors on a lower medical cannabis dose than she uses for other people, in the same way as she would modify the dose of a pharmaceutical drug. She also recommends seniors use a vaporizer or oral dose. 

“I learned from some other physicians, and after trying it on some seniors, and seeing how their fentanyl and morphine use started to reduce, I started prescribing it more.” She says it has helped many of her patients manage their pain, sleep better, and reduce anxiety.