By Deborah Jeanne Sergeant
The incidence of pain affecting older adults is considerable: half of this population who live independently and about 80% of those who live in long-term care facilities suffer from chronic pain, according to the National Institutes of Health.
As medical marijuana gains traction across the US, should older adults seek its use?
That depends upon whom one asks.
Physician Az Tahir, who practices holistic integrative medicine at High Point Wellness in Syracuse, said that many of his older patients have “reported beneficial effects of medical marijuana and canabidoil.”
To take medical marijuana, patients must have physician approval to obtain it at a legal dispensary. Cannabidiol , also known as CBD, is a supplement from the hemp plant which contains only minute traces of THC, the compound inherent to marijuana that causes hallucinogenic effects. It’s available over the counter since it’s a supplement and therefore not regulated by the Food & Drug Administration.
“A lot of chronic pain patients had spoken about this,” Tahir said. “It’s very, very beneficial. I don’t see much risk involved with CBD or medical marijuana for chronic pain.”
He added that conferring with a doctor about taking either is a good idea to avoid any negative prescription interactions.
For a generation that took recreational marijuana, taking prescribed marijuana may seem a more natural course than conventional pain medication; however, physician Sharon Brangman, who serves as chief of the Department of Geriatrics at Upstate University Hospital, offered a word of caution.
“It’s an area where we don’t have a lot of science, where we don’t know how it affects older adults,” Brangman said.
She added that many patients ask about medical marijuana or CBD, but with few studies as to their safety and efficacy for older adults, these are not something easily recommended.
If medical marijuana isn’t smoked but taken orally or topically, the experience may be quite different for those who experimented with it recreationally in the past, since its effects take more time to begin and last longer.
Part of that may be because medical marijuana is more of a nutrac eutical containing many different compounds than a lab-derived pain medication. Consistency in the product can be hard to achieve.
“Using CBD oil topically probably has little problem,” Brangman said. “TCH and CBD taken orally can interfere with the metabolism and breakdown of some medications, like some used for acid indigestion, anxiety and depression. It interferes with anti-psychotics, caffeine absorption and blood pressure medicine. People should not think THC and CBD are completely side-effect free. We don’t know the long-term side effects, either.”
The age of the patients involved also can make a difference. In their 20s, their faster moving metabolism handled marijuana differently than now, when a slower metabolism, other medication and age-related disease processes can impact how marijuana affects the body.
Brangman said that further research could help physicians know whether medical marijuana could help older adults; however, like any medication, it’s a tough age group to study because most have several health conditions and other prescriptions. Long-term studies are difficult because their health status can change over the years, which complicates the study.
“As a result, many medications are tested on younger people who are healthy and we have to see if they make sense for older people,” Brangman said. “There are many things we have to build into these studies to accommodate the needs of older people.”
She foresees many years’ research before physicians can have the answers they need to recommend medical marijuana or CBD oil for older adults. In the meantime, anyone interested in these items should discuss contraindications with their doctor.