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Medical Cannabis And It’s Use For Older Adults

Medical Cannabis And It’s Use For Older Adults

By Susan Williams

Medical cannabis, medical marijuana, CBD, THC – this topic is both interesting, confusing and potentially risky.

So I was delighted to have Dr. Rhonda Collins, Chief Medical Officer at Revera join me for another Learning Bites episode to discuss medical cannabis and it’s appropriate use by older adults.

Please note, there are different laws concerning the use of cannabis products and medications dependent on where you live. As well, this information is being provided for informational purposes only. You should always consult your own physician or healthcare practitioner for specific information and recommendations regarding your personal situation.

Here is what Dr. Collins had to share;

These are some of the highlights of our discussion;

Prior to our discussion, Dr. Collins wanted to ensure that everyone is aware that she has received financial stipend from Spectrum Therapeutics (a subsidary of Canopy Growth) because she is involved in a study for the Ontario Long Term Care Association on the effects of cannabis on older adults. She is on the cannabis advisory committee as well the expert panel and this is why she has received compensation. She also shared that she is not a proponent or opponent of cannabis. She is extremely interested in seeing results of studies as there currently is nothing substantive – either yes or no – to suggest we should be prescribing cannabis for older adults.

Medical Cannabis Overview

  • In Canada, medical cannabis has been legal since 2001 and recreational cannabis was legalized in 2018. Note: US Laws for cannabis use vary by State
  • The cannabis plant has over 500 compounds in it. Over 100 (the number changes all the time) are chemical compounds called  cannabinoids. The two that we hear the most about are THC (tetrahydrocannabinol) and CBD (cannabidiol).
  • The difference is that THC is what gives people the “high” when they smoke cannabis whereas CBD doesn’t have the euphoric effect.
  • Why this is important is that in our bodies we have endocannabinoid system – these chemical molecules called endocannabinoids are produced in certain situations, almost like neuro transmitters – and they attach to receptors in our body. They were originally found in the brain and nervous system and now they have been located in other parts of our bodies too – the heart, the lungs, the reproductive system and the muscles as well.
  • This is important because the endocannabinoid system is believed to be involved in processes like pain management, sleep and reproduction. There is a lot of research going into what can external cannabioids (such as THC and CBD) actually do to these processes in our bodies and why these endocannbinoids we produce act like cannabis molecules
  • There is also great interest in understanding how cannabis could help with symptoms like chronic pain, insomnia, anxiety and depression

Types of Cannabis Medications

  • In Canada, Nabilone is being prescribed and Dronabinol in the US. Both are synthetic cannabis products. There is also a nasal spray that is equal components of CBD and THC that is being used for muscular sclorosis (not available in Canada).
  • There are also a number of medical cannabis manufacturers that make a variety of cannabis products (for example soft gel capsules and oils) that contain varying levels of CBD and THC. These levels are really important to know because we want to avoid the psycho active effects from a medical cannabis perspective and get the medical benefits from the CBD but there are certain things that are shown to respond to THC. So sometimes having a little THC with the CBD may be beneficial for the specific symptom being targeted

Symptoms Being Targeted

  • There are many symptoms currently being targeted. Pain management and neuropathic pain is a large area of focus. Also, nausea and vomiting from chemotherapy, palliative care, depression and anxiety and drug resitent types of epiloepsy – are also other areas currently using these medications
  •  What is missing however is good research utilizing these medications over the age of 65. There are always risks and benefits to any type of treatment and these are unknown at the moment

Risks Of Medical Cannabis

  • When using cannabis products there could be risks – such as drowsiness or dizziness which for example could impair someone’s ability to drive. Cannabis could also have an impact on our muscles which could put people at an increase risk for falls
  • Health Canada also advises that certain people should not be taking cannabis. For example those with heart and lung disease, have had a heart attack or a stroke they advise against it, if you are on certain medications (like anti pshycotics, anti depressants, sedatives) cannabis should be avoided
  • Not everything works the same way for everybody. Everyone has a unique genetic makeup for pharmacology that determines how we respond to certain medications so how one person responds may not be the same as someone else

When Should You Consider Using Medical Cannabis

  • Interestingly, the largest growing demographic of cannabis users is people over the age of 65
  • Many of the people using cannabis are experiencing chronic symptoms that are either not responding to the use of their current medications they are taking or are experiencing side effects from these medications
  • Always talking with your healthcare practitioner is the most important thing to do – because you have a relationship with them. Many physicians may not be comfortable prescribing at this stage given the lack of evidence however there are cannabis clinics where physicians are skilled and trained in prescibing and knowing what to monitor for
  • People have to remember that cannabis is a drug. If you consider how much rigor a medication goes through before it’s approved by the FDA or Health Canada whereas the studies currently being used were based on recreational cannabis which primarily consists of THC (the psycho active component)
  • Even if a product is legal, it doesn’t necessarily mean it’s safe or right for everybody. If someone was to google “medical cannabis”, you will see 1000’s of pages that talk about being the cure all for everything. This is absolutely not the case and we need to exercise caution when we think about using cannabis.

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Susan Williams is the Founder of Booming Encore. Being a Boomer herself, Susan loves to discover and share ways to live life to the fullest. She shares her experiences, observations and opinions on living life after 50 and tries to embrace Booming Encore's philosophy of making sure every day matters.