Gerontology is the study of the social, cultural, psychological, cognitive, and biological aspects of aging. Between 2006 and 2013, cannabis use increased by 58 percent for adults aged 50 to 64 and by 250 percent for those over 65, according to the research team at New York University, using data from the National Survey on Drug Use and Health.  Cannabis medicines are increasingly being used to address many medical challenges facing older people.
The use of medicinal cannabis by older people was addressed in a 2017 policy study by University of Iowa researchers for the Gerontological Society of America, which concluded that cannabis could support the well-being and health of a significant amount of aging people. Cannabis could very well be an effective substitute for prescription opioids and other misused medications; and cannabis has emerged as an alternative for the undertreatment of pain at the end of life.  For more information, see our articles on Pain, and Opioid Addiction.
Throughout this older population group, the use of cannabis continues to be a controversial issue, notably due to the divergent experiences with the drug. The largest issue facing seniors who want to use medical cannabis, is safe and reliable access to the medicine in countries that lack formal systems of access to medical cannabis. This challenge has somewhat been relieved by the institution in many US jurisdictions, of more liberal medical cannabis policies, with such reform often widely supported by older voters. This trend continues to spread across the world to this day, as more states in the US, and countries bring about reform and new laws.
A lot of the conditions for where cannabis medicines can be of value, from chronic arthritis pain to insomnia to appetite stimulation, are common among this senior group. Baby boomers who used weed recreationally in the 1960s are now returning to it as a medicine, many of them after decades of abstinence. For more, find our related articles on Insomnia and Sleep, and Appetite Stimulation.
One of the main challenges for using cannabis effectively with older patients is education. For many older adults that used cannabis in the 1970s or earlier, the increased potency of today’s herbal cannabis can, especially street forms of marijuana, can show up as an unpleasant surprise.
Appropriate expectations must be outlined for an achievable outcome, along with a frank assessment of potential side effects and how they could very well be avoided. Although there isn’t any reason to overly dramatize the likelihood or severity of side effects from psychoactive cannabis medicines, the older patient should be prepared for some level of side effects.
Using cannabis or hemp for medicinal purposes to treat conditions, pain, and diseases of the elderly goes back as far as the 19th century, when the well known physician John Reynolds used Cannabis indica extract to treat an older patient with dementia.  Dr Reynolds was well ahead of his time, as recent evidence does show that cannabis can slow or prevent some aspects of Alzheimer’s disease and other forms of senile dementia. Reynolds also treated Queen Victoria’s PMS and menstrual cramps with cannabis. For more info, see our article on Alzheimer’s, and Women’s Health; PMS, Cramping and Mood.
The cannabis plant contains a multitude of compounds that are pharmacologically active and able in treating many symptoms that are associated with aging, especially because many of these compounds are analgesic (pain relieving), regulate appetite, anti-inflammatory, and elevate mood.
The information in this article is for informational purposes only and does not constitute medical advice. Prior to making changes to your lifestyle or treatment plan, always consult with your doctor. It is recommended to work with a doctor who has experience recommending medical marijuana either derived from indica or sativa marijuana strains that can offer chronic pain relief, relieve anxiety, and helps those in their older years feel better in their body.
Getting the dosing right with older people can be a challenge and needs to be carefully and conservatively approached. Many of the psychoactive effects of cannabis medicines can be rather alarming to older people. Special care needs to be taken when using psychoactive cannabinoids, since the side effects can be difficult to frame for these people. What a regular medical cannabis user might consider “euphoria” is often described by older, cannabis-naive people as “dizziness” or “vertigo.” Another important mention is that it’s vital to avoid drug interactions with other medications that an older person may be taking. Reduction in any opiate medication may be recommended, because cannabinoids often increase the effectiveness of opiates.
Cannabis products that are orally ingested could prove to be the safest method of delivery, however, getting the minimum effective dose right is important in avoiding adverse effects of psychoactive cannabinoids. With THC-based medicines, start with doses of 1 to 2.5 mg, which begins below the threshold of psychoactivity. For the first few days, dose twice per day, at lunch and after dinner. Increase the dose by a few milligrams every third day until a balance between medicinal effect and tolerable levels of psychoactivity is reached. Because there is a wide variation in response to oral cannabis, establishing proper dosage often requires trial and error. And it is always preferable to underdose than overmedicate. You can always take more, but you can’t take less. Users should start low and slow, and titrate their way up.
Many older people prefer the quick onset and ease of dose titration that comes with vaporized and smoked products. A grasp of how the compounds are vaporized sequentially, according to the compounds boiling point by the heat of the vaporizer, will help achieve a complete and predictable dose.
Topical products can be of value for skin conditions and arthritis. Both THC and CBD, work on their own and in combination as a balm, cream, or salve. Keep in mind, topical products must contain adequate levels of cannabinoids in order to be effective. A jar that contains 25 grams of cream, but only 200 mg of cannabinoids, will not be effective. For more information, read our articles on Osteoarthritis, and here, and Rheumatoid Arthritis for treating these types of conditions.
CBD and THC combination cannabis strains are recommended. Generally, the relaxing terpene strains high in limonene and myrcene are more suitable strains to choose from and better tolerated than the more stimulating beta-caryophyllene and terpinolene strains. Functional wide-leafleted strains with moderate THC levels, such as Bubba Kush, are easier to titrate for older patients when vaporized or smoked. Read our Ultimate Guide to Terpenes.
After someone becomes acclimated to THC, high-terpinolene, narrow-leafleted hybrids, such as Jack Herer or Pincher Creek, can be valuable for daytime pain, appetite stimulation, and mood elevation. A high-CBD strain such as ACDC and Deadlights can be utilized anytime, but are best used during the day, as CBD can be wake-promoting.
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