Benjamin Han, a specialist in geriatric and addiction medicine at the University of California-San Diego, tells his students a warning story about a 76-year-old patient who, like many older people, struggled with insomnia.
“She had problems asleep and she woke up in the middle of the night,” he said. “So her daughter brought her some sleep gummies” – edible cannabis sweets.
“She tried a gummy after dinner and waited half an hour,” said Han.
She felt no effects and took another Gomacht, then another – a total of four for several hours.
Han advises patients who try to start cannabis’ low; Going slowly ‘, starting with products that only contain 1 or 2.5 milligrams of tetrahydrocannabinol, or THC, the psychoactive ingredient that contain many cannabis products. However, each of the four gummies that this patient took contained 10 milligrams.
The woman began to experience intense fear and heart palpitations. A young person may have picked up such symptoms, but this patient had high blood pressure and atrial fibrillation, a heart arithmic. She went to a first aid.
Lab tests and a cardiac shutdown determined that the woman had no heart attack and the staff sent her home. Her only persistent symptom was shame, Han said. But what if she had become dizzy or light in the head and was injured in a fall? He said he was injured in waterfalls or while driving after using cannabis. What if the cannabis had interacted with the prescribed medicines she took?
“As a geriatician it gives me a break,” said Han. “Our brains are more sensitive to psychoactive substances as we get older.”
Thirty -nine states and the district of Columbia now allow cannabis use for medical reasons, and in 24 of those states, as well as the district, recreational use is also legal. While the climbs of older adults are the use of the benefits, “the benefits are still unclear,” said Han. “But we see more proof of possible damage.”
A wave of recent research points to reasons for concern for older users, with cannabis -related emergency rooms and hospital admissions and a Canadian study find a connection between such acute care and subsequent dementia. Older people are more appropriate than younger to try cannabis for therapeutic reasons: to alleviate chronic pain, insomnia or mental health problems, although the proof of their effectiveness remains thin in tackling those disorders, experts said.
In an analysis of national survey data published on 2 June in the medical magazine Jama, Han and his colleagues reported that “current” cannabis use (defined as use in the previous month) had risen in adults aged 65 or older to 7% of the respondents in 2023 in the Chance in 2021. In the Chance in 2021. Cannabis in the cannabis in the previous year.
What drives the increase? Experts call the steady mars of state legalization – use by the elderly is highest in those states – while surveys show that the observed risk of cannabis use has decreased. A national survey showed that a growing proportion of American adults – 44% in 2021 – wrongly thought it was safer to smoke cannabis daily than cigarettes. The authors of the study, open in Jama Network, noted that “these views do not reflect the existing science about cannabis and tobacco smoke.”
The cannabis industry also brings its products to the market for older adults. The Trulieve chain gives a 10%discount, both in stores and online, to those who calls the “Wisdom” customers, 55 years or older. Rise Dispensaries organized cannabis education and empowerment program for two senior centers in Paterson, New Jersey, including excursions to his pharmacy for a year.
The industry has many satisfied older customers. Liz Logan, 67, a freelance writer in Bronxville, New York, had drawn for years with sleeping problems and fear, but the circumstances grew very debilitating two years ago, while her husband died of Parkinson’s disease. “I would often be awake until 5 or 6 in the morning,” she said. “It drives you crazy.”
Logan, looking online for edible cannabis products and discovered that gummies containing cannabidiol, known as CBD, just did not help, but with 10 milligrams of THC it had the trick without noticeable side effects. “I’m not worried about sleep,” she said. “I have solved a lifelong problem.”
But studies in the United States and Canada, who legalized non-medical cannabis use for adults in 2018, show climbing people of cannabis-related use of health care in the elderly, both in outpatient environments and in hospitals.
In Californië bijvoorbeeld, cannabis-gerelateerde spoedeisende hulpbezoeken door die 65 of oudere roos, tot 395 per 100.000 bezoeken in 2019 van ongeveer 21 in 2005. In Ontario, acute zorg (wat betekent dat noodbezoeken of ziekenhuisopnames zijn als gevolg van cannabisgebruik toen hij vijfvoudig in de middenjarige volwassenen van 2008 tot 2021 is gestegen, en meer dan 26 keer tussen de 65 en meer dan 65 en meer dan 65 en upwards.
“It does not reflect everyone who uses Cannabis,” warned Daniel Myran, a researcher at the Bruyère Health Research Institute in Ottawa and main author of the Ontario Study. “It catches people with more serious patterns.”
But because other studies have demonstrated an increased heart risk among some cannabis users with heart disease or diabetes, “there are a number of warning signals,” he said.
A disturbing part of the older veterans who currently use cannabis screen positively for cannabis use disorder, according to a recent study by Jama Network.
As with other disorders for substance use, such patients can “tolerate large quantities,” said the main author, VIRA Pravosud, a cannabis researcher at the Northern California Institute for Research and Education. “They continue to use, even if it disrupts their social or work or family obligations” and can experience withdrawal if they stop.
Among the 4,500 older veterans (with an average age of 73) who seek care in the health facilities of the Department of Veterans Affairs, researchers discovered that more than 10% had reported cannabis use in the last 30 days. 36% of this fits in with the criteria for mild, moderate or serious cannabis use disorder, as established in the diagnostic and statistical manual for psychological disorders.
VA patients differ from the general population, Pravosud noted. They are much more likely to report abuse of resources and have “higher percentages of chronic diseases and disabilities, and mental disorders such as PTSD” that can lead to self -medication, she said.
The current VA policy does not require clinics to ask patients about cannabis use. Pravosud thinks they should.
Moreover, “there is more and more evidence of a potential effect on memory and cognition,” said Myran, referring to the study of his team of Ontario patients with cannabis-related disorders that go into emergency departments or are admitted to hospitals.
In comparison with others of the same age and gender who looked for care for other reasons, research shows that these patients (45 to 105 years) had 1.5 times the risk of a dementia diagnosis within five years, and 3.9 times the risk for the general population.
Even after correction for chronic health problems and sociodemographic factors, those looking for acute care as a result of cannabis use had a risk of 23% higher dementia than patients with non-Cannabis-related disorders and a 72% higher risk than the general population.
None of these studies were randomized clinical investigations, the researchers noted; They were observational and could not find causality. Some cannabis examination does not indicate whether users smoke, vapen, take or rub topical cannabis on painful joints; Other studies miss relevant demographic information.
“It is very frustrating that we are unable to offer more individual guidelines on safer consumer modes and about quantities of use that seem lower risk,” Myran said. “It only emphasizes that the rapid expansion of the normal use of cannabis in North America exceeds our knowledge.”
Yet, in view of the vulnerabilities of the health of the elderly, and the much greater potential of current cannabis products compared to the weed of their youth, he and other researchers insist on caution.
“If you consider cannabis as a medicine, you must be open to the idea that there are groups that probably should not use it and that there are potential adverse effects of it,” he said. “Because that applies to all medicines.”
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