As cannabis becomes more accepted in the medical community, a rising number of older adults are trying it, especially for pain.
Ileane Kent, 80, has spent years vaping nightly. A breast cancer survivor, she got a medical marijuana card in June 2020 so she wouldn’t have to risk going to her supplier’s house. Barbara Blaser, 75, dealt with the pain and anxiety produced by a complicated surgery with five milligrams of edible marijuana, which came in the guise of a chocolate-covered blueberry, every morning and evening. Harry B. Lebowitz, 69, enjoys smoking a joint in his backyard every night while his partner drinks her vodka and soda.
Cannabis Use Among Seniors Rising
A recent analysis culled from the National Survey of Drug Use and Health concluded that the use of marijuana among those over 65 rose 75% from 2015 to 2018, from 2.4% to 4.2%. It jumped again in 2019 to include 5% of seniors. The lead author expects the trend, which is particularly strong among women and the affluent, to continue to increase sharply.
“It’s rare to see that much change in a three-year period,” said William Jesdale, an epidemiologist at the University of Massachusetts.
“It’s easier to get and it’s also less stigmatized,” Dr. Jesdale says.
The $17.5 billion legal cannabis industry has taken note. Dispensary discounts for older adults appear on “Silver Sundays” and “Senior Appreciation Days”. Some savvy retailers provide free delivery for their older customers. Other retailers have sent cannabis advocates to talk to residents in assisted living facilities or picked up seniors at a retirement development to bring them to the dispensary, complete with a catered lunch, product information, and a special discount.
Does Pot Work?
The efficacy of products containing marijuana is still debatable. The effect of pot was “modest” to alleviate nausea and vomiting due to chemotherapy, muscle spasms caused by multiple sclerosis, certain sleep disorders and chronic pain, according to a 2017 report from the National Academy of Science. And the American Bar Association offers cautionary results culled from a plethora of data.
Furthermore, older adults adding pot to other medications and/or alcohol may be at increased risk of negative drug interactions and falls. Cannabis is known to increase heart rate and possibly blood pressure, but a recent review by the Journal of the American College of Cardiology failed to find direct evidence linking cannabis consumption to coronary events.
Of more concern is seniors combining cannabis with anti-seizure medications and/or blood thinners, since there is little room for error, according to Harvard Health Publishing. Make sure to talk to your doctor if you use cannabis and are planning to have surgery. Anesthesia drugs and those used to manage pain post-operatively may require adjusting.
Like many healthcare professionals, researcher Dr.Benjamin H. Han advocates a “start low, go slow” regimen, and he warns older patients who smoked pot in their youth about higher THC concentrations in modern products. Typically, seniors seek marijuana to treat four conditions: pain, insomnia, neuropathy, and anxiety. There is also research supporting the use of cannabis to improve cognitive function.
Many Ways to Take Cannabis
There are four main routes to take cannabis: inhalation, oral, sublingual, and topical. All are a little different, and you may have to try more than one to find what works for you.
- Inhalation delivers active compounds to your lungs, and compounds are delivered to your brain in about 15 minutes. There are two ways to inhale: smoking and vaping. Smoking involves burning cannabis flower and inhaling the smoke. Vaping involves the use of a device to heat the cannabis flower or concentrate to just below the point of combustion, releasing the active compounds into a vapor, which is inhaled.
- Oral ingestion takes place through edibles or tinctures. Edibles include cannabis-infused drinks, baked goods, and gummies, which are absorbed through the digestive tract. It may take anywhere from 20 minutes to three hours to feel the effect. Tinctures are created by steeping cannabis in alcohol. The resulting liquid is taken up with an eye dropper and placed under the tongue, where some is absorbed by the many blood vessels located there and the rest travels to the stomach. The benefit is an immediate effect from the cannabis absorbed into the blood, and a delayed effect from the cannabis that travels to your digestive tract.
- Topical products deliver cannabinoids through the skin via pads or cream to deliver localized relief, usually for muscle soreness or joint pain. No matter what product you use, you won’t get any psychoactive effects from topical application. It may take an hour or two for effects to kick in.
How Much THC
Some states, such as Colorado, mandate that edible marijuana is labeled with the amount of THC that it contains. Users know how much THC is in every cookie, candy or treat. Ask your doctor or other healthcare professional how much to use, and make sure they know what other drugs you’re taking. Start with a very low dose and remember some methods of ingestion are slow to take effect.
“Older adults generally need less, because their metabolism has slowed,” says Eloise Theisen, president of the American Cannabis Nurses Association and a geriatric nurse-practitioner. “They can have a delayed onset, so it’s easier to over-consume, especially with products that taste good.”
Another concern is the accidental consumption of edibles by children. If grandchildren visit your house, it is very important that you treat your edibles like poison and keep them somewhere safe. Kids may eat more than one, and a large dose can cause “changes in blood pressure, heart rate, severe tiredness, trouble breathing, and even coma,” according to the Upstate New York Poison Center.
Driving, Working While Using Cannabis
Driving under the influence of marijuana is illegal in every state. Even if pot is legal in your state, you can still be convicted of a marijuana-related DUI. But states differ according to the letter of the law. Read up on DUIs for driving high and research the law in your particular state.
Using cannabis at work can still get you fired or denied a job in most states. That’s true even if you have a medical marijuana card and you’re taking the cannabis in your free time. Some employers are required by federal law to test for marijuana, while others feel it’s a matter of safety in the workplace. If you need/want to use pot at work, read up on the latest workplace regulations. Currently, there is no relief on this point from the ADA, which does not prohibit employers from having a drug-free workplace policy. Read more about the ADA and cannabis use.
Cannabis may become an important part of your healthcare regimen. Marijuana may help you sleep better, or free you from constant pain. It could reduce anxiety and worry. It’s more available than ever, and there are endless resources to help you decide how you’d like to try it. Just remember to consult with your doctor first, start with a very low dose, and make sure to keep your cannabis products away from children.
Blog posting provided by the Society of Certified Senior Advisors
We hope this information is helpful to you in the important work you do as a family caregiver.
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