Navigating Cannabis Use in Older Adults: Potential Risks and Recommendations

As the acceptance and legalization of cannabis continue to grow, its usage among senior and older adult patients is increasingly being reported.

Understanding Cannabis Use Among Older Adults The world of cannabis has come a long way with reduced stigma, lifted restrictions, and a proliferation of articles and advertisements promoting its supposed benefits. These factors have significantly driven the trend of older individuals using cannabis, especially in the form of prescribed medical marijuana and cannabidiol (CBD)​.

The Cannabis Conundrum: Potential Benefits vs. Side Effects While cannabis has been proposed as a remedy to modulate symptoms of stress, insomnia, pain, inflammation, and cognitive impairment, particularly in older individuals, it's important to understand that it's not a free lunch. Like all medications, cannabis comes with its share of side effects and downsides to consider​.

Cardiac Health Considerations Cannabis is known to increase heart rate and can elevate blood pressure. For older patients with underlying coronary disease, particularly those who might consume high doses of cannabis, there could be a risk of triggering a coronary syndrome or an arrhythmia. Regular screening for cannabis use is recommended for people with coronary disease​.

Potential Medication Interactions Older adults often have co-existing health conditions and might be on multiple medications. The active ingredients in cannabis, THC and CBD, could potentially alter the blood levels of other drugs by affecting the enzymes in the liver that help metabolize these medications. This is particularly crucial for those using anti-seizure medications and blood thinners, as these medications have serious side effects and a smaller margin for error​.

Cognition: A Double-Edged Sword While cannabis can potentially cause confusion and other psychoactive experiences, especially in those at risk for dementia, there is also some research indicating that cognitive functioning could improve with the use of medical cannabis. This is attributed to better sleep and pain control, leading to lower doses of medications that could affect cognition. However, these findings need further study to be confirmed and clarified​.

Recommendations for Safe Cannabis Use Given the potential risks, it's crucial for older adults considering cannabis use to have an informed discussion with their doctor. It's especially important if they have cardiac issues, are taking multiple medications, or are experiencing cognitive changes due to aging. The adage of "start low and go slow" is key: Begin with the lowest effective dose and gradually increase it until you find a dose that alleviates symptoms with minimal side effects​.

As we continue to explore the realm of cannabis use in older adults, it's essential to remain informed and cautious, ensuring that the potential benefits outweigh the possible risks.