Geriatrician Jennifer Watt opened the elderly man’s file. She was doing a follow up appointment with him after he’d come to an emergency room with delirium, a type of confusion that’s common in the elderly, and been admitted to the hospital. The notes said the issue had resolved itself, and it wasn’t clear what set it off. “There are lots of different risk factors for delirium, and he had things that would put him at risk,” she explains. But the trigger was unclear – until they started discussing his drug use.
He’d been looking for pain relief, and sought out some marijuana himself. “He began taking it, and got confused,” she says. “He was very honest with me when I asked. It was just that no one had asked before.”
Gabriella Gobbi, a professor of psychiatry at McGill University and psychiatrist at McGill University Health Centre, says she’s also seen several elderly patients with delirium caused by cannabis use.
We often hear about the potentially negative health effects of marijuana on young people, especially on developing adolescent brains. But some doctors, like Watt and Gobbi, believe we need more research on its effects on the elderly. They are concerned that we don’t know enough about its potential side effects, including confusion and an increased risk of falling.
Many seniors use cannabis for medicinal reasons, including pain and insomnia. Medical marijuana has been legal in Canada since 2001 – some dispensaries even offer seniors’ discounts. And its use is on the rise, with almost 130,000 Canadians registered to purchase it as of 2016, up from 7,900 in 2014. General use may also rise as the federal government moves to legalize marijuana by July 2018.
The elderly are significantly less likely to use marijuana than the regular population. But as cannabis becomes more generally accepted and aging Boomers hit retirement, more seniors may use it in the future. The U.S., which has legalized marijuana in eight states, has seen a rise in cannabis use in people over 50: in 2006/07, three percent of people in that age bracket said they’d used marijuana in the past year; in 2012/13, that number rose to five percent.
“It’s use has become a very important issue,” says Gobbi. “More regulated research must be done in the elderly, to understand how cannabis can be used in this vulnerable population without side effects.”
The health effects of cannabis
There has been quite a bit of research into the health effects of marijuana in general, with more than 60 systematic reviews on the subject. Some studies have found it can help with treating nausea and vomiting from chemotherapy, reducing spasticity from multiple sclerosis, helping with Tourette’s syndrome, and reducing sleep disorders, though the evidence tends to be mid- to low-quality and vulnerable to bias. Cannabis is also often used for pain reduction, but the evidence around that is mixed.
There are some negatives: marijuana may increase the risk of testicular cancer and some mental health problems and it’s not safe during pregnancy. There have also been studies that suggest cannabis might be associated with problems like depression, anxiety, bladder cancer, bone loss or brain changes, among others, but the evidence around all of this is still inconclusive.
Elderly people may have distinct risks: A 2014 review on marijuana and older people pointed out that drowsiness and dizziness were two known side effects of marijuana that could contribute to falling in older people. It also pointed to an increased risk of arrhythmia.
Other studies have shown that marijuana might trigger a stroke in people with coronary artery disease. Marijuana’s cognitive effects could have a larger impact on older people who are already struggling cognitively. And cannabis can cause side effects when mixed with other medications, such as increasing the risk of bleeding, lowering blood pressure, and affecting blood sugar levels.
It’s difficult to research marijuana in the U.S., where it’s classified, federally, as a Schedule 1 narcotic. It’s much easier to do studies on it in Canada, but it still hasn’t gone through the same rigorous process as a regular pharmaceutical drug would have. “Cannabis took this strange pathway,” says Gobbi. “I think that cannabis should go through clinical phases, as all drugs do, which would include testing on the elderly population.”
Effects on the elderly
The vast majority of cannabis research is done for the population in general and either doesn’t include the elderly at all or doesn’t report on them separately. A 2014 editorial in the Journal of the American Geriatrics Society made the argument that we need more research on the elderly and pot, as they’re likely to have adverse effects that are specific to them.
Mona Sidhu, a geriatrician who works out of Hamilton Health Sciences, knows this issue well. She routinely prescribes marijuana for seniors, mostly for pain management in people without cancer. “I fell into this,” she says. “I was asked to see patients that would be potential candidates for cannabis use, and having very little background knowledge, I didn’t know the potential.
“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.
She does start seniors on a lower dose than she uses for other people, she says, in the same way as she would modify the dose of a pharmaceutical drug. She also recommends seniors use a vaporizer or oral dose. She’s swayed by her personal experience, and by the anecdotal research out there supporting it. “Even though the high quality data is not out there, we should not ignore the anecdotal evidence that supports the use of marijuana,” she says.
Brian Kaskie, a researcher at the University of Iowa and the author of a 2016 paper that looked at the trends around marijuana usage in seniors, agrees. His paper pointed out that more older adults are using cannabis, and many of them are using it for medicinal reasons, and in place of prescription medications. While he acknowledges that may lead to some side effects, like falls, he’s excited about the possibility it brings, too. Many of these issues, like pain, “aren’t as relevant to people under 50,” he says. “The potential here is compelling.”
Fiona Clement, director of the Health Technology Assessment Unit at the University of Calgary and co-author of a review of the evidence around cannabis, looks at it differently. “If we held marijuana to the same standards as the other drugs we allow on the market, I don’t think it would meet the bar [for effectiveness as a treatment],” she says.
And everyone agrees that the evidence around all of this is still hazy. As Watt says, “At the end of the day, when it comes to knowing the potential benefits and harms and having that conversation with patients, right now we’re quite hindered by the lack of evidence.”
The comments section is closed.
MARIJUANA KEPT ME WORKING INTILL I WAS 60 years old……HELLO…I am 81 years old NOW. (2021)
I am 70 been using since I was 18 no problems other then being in a state that haven’t legalized it yet.
I’m 67, and have battled back pain for years. I saw a Doctor, and got my state license for medical marijuana.
I love having it. My pain is so bad, and I take my CBD and THC tincture to relax and get a good nights sleep. You do get high, maybe have a laugh, but it is a real resource for those with chronic pain. Good sleep is even more critical, I think, when you are battling pain- with middle of the night wake ups.
I can feel that it is working in my brain – I’ll have some ‘funny’ or weird thoughts.
I’m careful with my cognitive powers and don’t want to mess with it.
I usually have my tincture late afternoon- but I have to stay in/ I know I could fall, or maybe act a little off.
It’s all new to me, but I have to say, I rely on it to help me relax and eventually sleep. It doesn’t knock out my pain like a pain pill would- but it does seem to soften the ‘edges’.
I have used cannabis since I was about 13 years old( i am 57, now , soon to be 58) and no problems. In the past 1.5+ years, wen I use it now i get paranoid and severely anxious to the point where I cannot go out the door, answer or make phone calls, have you heard of this happening and any suggestions
This is very interesting. Such an intriguing discussion. I will share this with my friends and professors in scholl. thanks for posting this.
This article was very informative I’ve been using marijuana for many years I also grow my own I find it helps me to sleep and helps me not to be so anxious in usually by eight or 9 o’clock I have no joint pain I’m 79 years old the only thing I find It does make me short of breath but I also have congestive heart failure I only smoke it the only edible That I eat there’s a half a gummy bear at night when I go to bed I am able to sleep eight hours a night without getting up to go to the bathroom which I feel that’s great that’s it.
I’m 85 years old in good health, I have marijuana once a day just because it makes my day better.
How many people out there feel the same?
This article was very informative I’ve been using marijuana for many years I also grow my own I find it helps me to sleep and helps me not to be so anxious in usually by eight or 9 o’clock I have no joint pain I’m 79 years old the only thing I find It does make me short of breath but I also have congestive heart failure I only smoke it the only edible That I eat there’s a half a gummy bear at night when I go to bed I am able to sleep eight hours a night without getting up to go to the bathroom which I feel that’s great that’s it.
I am 81 years old—medical condition: pinch nerve, low back pain, leg cramps, spasm in the stomach and chest, insomnia—-also cancer, THE marijuana shrunk my tumor, and help me a great deal and no side effects………ZAMORA……..HELLO—SMOKE—-MARIJUANA works wonders for the elderly, LETS STOP THE SUFFERING ON THE ELDERLY…….HELLO
I’m in my mid 60’s and marijuana makes me ill. I get nauseated, light-headed, dizzy and very forgetful. Marijuana sucks.
This is hardly a “healthy debate.” You are basically cherry-picking studies to support your opinion that marijuana is bad and are not even addressing the reality that the lives of many, many seniors (including my elderly mother) have been drastically improved by the regular use of marijuana.
Hi I’m 61 years young. I’ve been taking viagra and having a joint before sex. It is mind blowing. My partner and I having great sex life after 60
I am 80 yrs old and just started to use the M Gummies. Low dose and it helps me to relax and sleep. I get them from a friend that supplies her. I don’t know who the supplier is. I asked her and she told me that he does not want his name revealed.
I am a 75 yr old male. For the past 10 months I have smoking cannibis on a nightly basis (3 or 4 three “Jointlets” the size of regular roll-up cigarettes.) I did smoke weed, when I was much younger, but as I became older suppliers refused to deal -they took me for The Old Bill!
I find it dulls the awful recalls othe tragedy of a heart-breaking family motor accident. ( And it makes me feel really good.
My worst enemy apart from the former problem is lonliness. However I do get relaxation with a joint from that, and other issues.
Another problem. This there is another inconvienience. or should I say point that I would like clarified. Because I smoke regularly. At my age (76 soon) who , without exception say that it causes all kinds of damage to the body, the brain, one’s sex life, and can even make you impotent. So what is the truth? Do think that my new and thoroughly enjoyable little habit will do me any harm and if so, how would manifest any physical implications?
I hope you will respond to this note, as I can’t seek from any other scource.
Smoke on… If you feel good with it. Smoke on, but only in the evening.
Hi All
Recently you asked me about will topical CBD test positive.
I found a little about it on web site:
Since CBD products like topical creams, ointments, and massage oils do not get people high and typically contain low- to no levels of THC, there are low chances for a positive drug test. THC edibles are also surefire way to test positive on a drug test since they can stay in your system for up to a month.
Have had several strains that impact my ability to walk very unstable on my feet…(sour disel ,9lb hammer,granddaddy purple)……..wear as hybrid like Girl Scout cookie is wonderful and no neurological impact on my legs or ability to walk
I and my husband have smoked marijuana, 43 years for me and more than 50 years for him, daily. Ever since it became legal the strength and quality in Colorado, anyway, has depleted. I grew for myself the ten years prior to legalization and had control of quality. This seems to be the base of the problem with marijuana in general.
I started smoking when I was16 because of severe menstrual cramps. Purely medicinal. I later found other issues were helped by pot i.e. depression, severe neck pain after a car accident, life long insomnia were helped tremendously.
We both smoke the strongest we can find now; it does very little.
Our bodies are different now. We both have SEVERE memory loss that started after about 40 years of smoking for each of us (you know when it became legal and turned to garbage). Our brains all of a sudden are a mess when the government started controlling pot.
It could easily be just our age, but I know my body very well and our problems are not just normal or routine for older people. Without studies, we’ll never know. I would love to be in one.
Dear Bettye,
I read your comments with interest.
At 75 I have again started having a daily joint (or three or more!)
I am very sorry that you feel that your daily smoke is affecting your memory, really I am. I don’t mean to sounding patronising in my response to you, but I’m sure you know that we do lose our recall capacity as we get older. I speak with some authority, as I too smoke too; two – to four normal cigarette size joints daily. I smoke alone, because I light my first spliff at about 11:30 pm., and I don’t know anyone who I can share the joy of being off their head at that time at night!
Dope is illegal in England, so I have to rely on dealers. Luckily, mine is a decent guy, and I get a good deal for my money. Where do you buy yours? And how much do you pay for it?
Do you smoke durig the day as well as nights? I am trying to avoid this!!)
All the best……….
Clive, (from Norfolk, England)
My advice is smoke on… but only in the evening
Thank you for sharing and spreading awareness! Cannabis is really indeed magical. As studies progress, it unfolds a lot of possible uses and applications in science and medicine. I hope this could be the future treatment of a lot of diseases. I hope that this magical plant would not be abused and misused. Everything, if used properly and moderately proves to be beneficial.
There are pros and cons in taking medicines. But if using medical marijuana can help ease the pain of the elderly then it’s okay. as long as they follow the right dosage.
I am 72. I have been smoking weed for 50yrs. I take no meds! I go to the gym 3 times a week. My workouts are 35 to 45 minutes. I also ride a bike 4 days a week for 1hr. I also studied martial arts in the past. I started at the age of 40. I studied for 10yrs.
For those many people who’ve tried cannabis can say cannabis is one the best medicine for the to consider. Many seniors use cannabis for medicinal reasons to sometimes relieve their pains.
Thc has a very unique effect on the mind, special if consume orally, it helps you see the way you think, as if you are observing the mind, a young mind will most likely love this (high) (trip) because you can see many sides of your own personality and you see where you can change, i can see why older people would get delirium from this, a older mind is already more grounded on his/her beliefs on what is life and how to act about it, psychological habbits, thc in a way opens your mind to more information by allowing you perceive more then what you usually perceive, older people may get confused when they are face with the detachment of thoughts and observation.
I am 35 with stage 4 metastatic cervical cancer they say. I just recently started fyntanal patch. Can I still smoke weed
The percentage of U.S. seniors who use marijuana is small, but it’s growing quickly. Here’s why marijuana’s use among older adults is becoming more widespread.
According to data gathered from the latest survey done by the National Survey on Drug Use and Health, the number of people age 65 and up who said they use marijuana grew 250 percent between 2006 and 2013.
I am very interested in the effects of marijuana on the elderly. I would appreciate any mailings that you have on this subject.
My wife and I have used cannabis for over 40 yr. in Sept after 1 hit she had a major seizure for 3 min. I mean a full blown seizure. The test all showed nothing. So 3 months later she tried some more. These days we do a tiny amount for sleeping or maybe to destress. Well last week she did one small hit and had a major seizure at the market. They wanted to call an ambulance but we dthey lined seeing it has happened before. It was a total different strain than the last time. Albeit it was pretty potent weed but this was only after 1 hit. We are done with cannabis. It never did much when Inwas going through chemo. At least not for me. She was totally embarrassed now we have to go back to the Dr and start the process again.
My pain level is off the charts. I use canabis every other day the pain does not go away, But for a few moments i can rest. Is canabis adding to my pain long term? At least for a few minutes i can watch tv and laugh. At my age thats a lot.
As long as seniors take the right dose, there’s should be no problem at all.
Seniors can benefit from cannabis. My grandfather was treated with cannabis for his arthritis.
Is there any risk to elderly using topicals cbd:thc 1:1 for pain? I also have a pain patch that’s the smae ratio and another that is cbd only. Any advantage or adverse reaction from either? My dad is 88 with severe undiagnosed head and ear pain. Is there a negative cognitive side effect? What about tinctures? Taste bad but work for me.
We have been users for 50 yr and my wife at 68 after doing our mini bong hit( just 1) had a seizure. I nean a full blown seizure for 3 min in my arms. All the tests show nothing. Please dont make light of “ its probabbly killer weed” etc. its not our first rodeo and I grt it from the same oerson for yr. It was goid weed but not particularly potent. I am dying of cancer and have tried using it for nausea and pain but does nothing for me. Face it I just like being high.I am not sure if it is the weed but to me it isnt worth the risk of another seizure. Dr says it probably isnt the weed but honestly they at times arent up on the latest even in their own field. So we stopped. Good for all that say it works for them I would never quit if it werent for this. At this point its not worth the risk for her. Just something to think about.
I have just recently started vaping marijuana for chronic migraines. I have suffered with these for 50 years! I have never used illegal drugs nor do I smoke or use alcohol. After vaping 3 to 5 puffs a day for the past 3 weeks, my daily, extremely bad headaches, have been reduced by 50 to 60%. I still have some headaches, but the intensity of these are greatly reduced. I am somewhat concerned about potential health problems from using medical marijuana, but read ANY prescription drug’s adverse reaction list and you will see dozens of possible side effects on ALL of them! At this point in my life (68) I am ready to try almost anything to reduce decades of pain!
I am a 76 yrs old man. I retired to mexico and live in a wonderful town along with many other expats. I enjoy getting high alone and with friends and we have great thoughtful conversations and much laughter. That is what pot is for…enjoyment and improving health. Just enjoy and ease your pains and take the same care as you would drinking wine or beer.
-has there been any evidence of marijuana use in seniors for TMJ? Would be interesting to know.
More fearmongering and baseless playing down cannabis’ powers.
I take it for ulcerative colitis and there is no doubt that
it has the same levels of antiinflamatory powers upon
my body as prednisone at 40mg or higher. Fools
who claim there is no evidence are brainwashed
or guided by nefarious agendas in similar ways
as happens in other fields with billion dollar interests
at stake of being lost.
Anyone who takes FECO oil (currently illegal because it is pure
and the feds don’t want you getting pure strength or it would
upset the pharma competitors) or thc in other ways
knows that it does make you drowsy, so simply
take it at night before bed like I do, I would not
take this stuff just before driving or in the morning, anyone who
uses it doesn’t do that unless you don’t have any work
to do or place to go.
The claims in this
article that it makes some elderly people delirious is like DUH,
it makes anyone feel that way, that is why
you take it at night, like a sleeping pill, what
fool do you know would take a sleeping
pill in the morning or at noon? This article is jaded by ignorance
and low intelligence level.
People, only at bedtime for seniors. Eliminates accidental falling Period nite nite ssshhhhh
What are the risks of marijuana when pregnant please.
We didn’t look into that specifically, but the March of Dimes has a primer on it http://www.marchofdimes.org/pregnancy/marijuana.aspx and the New York Times did a good story on it recently: https://www.nytimes.com/2017/02/02/health/marijuana-and-pregnancy.html.
1.It would probably be helpful to put cannabis in the context of other medications that are prescribed to seniors. Antipsychotic medications including Seroquel (quetiapine) has a meager evidence base, with significant toxicities, including increased falls and yet is massively overprescribed to seniors in nursing homes. https://www.thestar.com/news/canada/2016/05/16/nursing-homes-urged-to-rethink-drugging-people-with-dementia.html Many seniors are using cannabis as a substitution for opiates and benzodiazepines, medications with significantly higher toxicity. https://www.ncbi.nlm.nih.gov/pubmed/28189912 https://www.linkedin.com/pulse/cannabis-vs-seroquel-insomnia-which-better-choice-ian-mitchell
2. You mentions that cannabis can be associated with problems with bladder cancer. The largest and most recent study showed a 45% decrease in the rate of bladder cancer https://www.ncbi.nlm.nih.gov/pubmed/25623697
3. You mention bone loss, but you completely fail to make any mention of CBD (cannabidiol) in your discussion. Cannabidiol does not cause a high, but has anti-seizure, anti-anxiety and anti-inflammatory properties. Many seniors are very interested in this aspect of cannabis, which remains illegal, despite having no euphoric properties. This drug may also promote bone healing and has positive effects on bone density, something seniors also tend to be interested in.
4. It is also unfortunate that you did not include the most recent, exciting research suggesting that cannabis can increase cognitive function in the elderly https://www.scientificamerican.com/article/marijuana-may-boost-rather-than-dull-the-elderly-brain/
Hi Ian,
Thanks for this. I would mention that the study you refer to in point 4 is on mice, and that we did discuss cannabis’s use as a substitute for opioids in the piece.
Appreciate the comment,
Vanessa
Thank you for these comments. Just started my 87 year old mother on CBD oil
yes, thank you for your input! how many times a day do you take cbd–and how much?–I have been taking an eye dropper and a half–most days–and I see no benefit!! Please, your comments.
thank you. bob
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I have used the CBD (not mind altering) for pain and it works very well. I am 80 years old and can not take most pain medications. My reaction to them are vomiting, hallucinations, seeing double and nausea and vomiting. After total knee replacement the Stanford Pain team said there was nothing they could give me. I had to take a pill to reduce nausea then a codeine. I could not think, I was woozy, still vomiting and my mind was hazy.
When I got home and switched to CBD I did not have pain. the different types of marijuana should definitely be studied for medical purposes in elderly.
.
hi any side affects with the oil.
We have had the same experience Cheryl. Twenty one days after my knee replacement surgery, I resumed my CBD and THC. The THC allowed me to have a good nights sleep every night, and the CBD oil helped with pain relief and inflammation. I can see us using both for the rest of our lives. The CBD has also helped with arthritis and prostate problems. We are both seniors, and have been encouraged by several positive articles in the Canadian seniors magazine, Zoomer.
Is there systematic-review evidence of marijuana use by the elderly and delirium? Hope this has been part of the development of the policy and legislation regarding legalizing marijuana.
We didn’t do a full literature review, but I couldn’t find anything about delirium and marijuana, and none of my sources had heard of anything published about it either.
My 87 year old mom just had this today smoked 2 tokes of a marijuana cigarette and she got super high and became unresponsive she is hospitalized right now so yes it does happen.