Medical cannabis significantly safer for elderly with chronic pain than Opioids
February 13, 2018
Science Daily/American Associates, Ben-Gurion University of the Negev
A new study found cannabis therapy is safe and efficacious for elderly patients who are seeking to address cancer symptoms, Parkinson's disease, post-traumatic stress disorder, ulcerative colitis, Crohn's disease, multiple sclerosis, and other medical issues. After six months, more than 18 percent of patients surveyed had stopped using opioid analgesics or had reduced their dosage.
Medical cannabis therapy can significantly reduce chronic pain in patients age 65 and older without adverse effects, according to researchers at Ben-Gurion University of the Negev (BGU) and the Cannabis Clinical Research Institute at Soroka University Medical Center.
The new study, published in The European Journal of Internal Medicine, found cannabis therapy is safe and efficacious for elderly patients who are seeking to address cancer symptoms, Parkinson's disease, post-traumatic stress disorder, ulcerative colitis, Crohn's disease, multiple sclerosis, and other medical issues.
"While older patients represent a large and growing population of medical cannabis users, few studies have addressed how it affects this particular group, which also suffers from dementia, frequent falls, mobility problems, and hearing and visual impairments," says Prof. Victor Novack, M.D., a professor of medicine in the BGU Faculty of Health Sciences (FOHS), and head of the Soroka Cannabis Clinical Research Institute. Novack is also the BGU Gussie Krupp Chair in Internal Medicine.
"After monitoring patients 65 and older for six months, we found medical cannabis treatment significantly relieves pain and improves quality of life for seniors with minimal side effects reported."
This older population represents a growing segment of medical cannabis users, ranging from approximately seven percent to more than 33 percent, depending on the country. Recent U.S. polls indicate Americans over 65 represent 14 percent of the total population and use more than 30 percent of all prescription drugs, including highly addictive painkillers.
BGU researchers surveyed 2,736 patients 65 years and older who received medical cannabis through "Tikun Olam," the largest Israeli medical cannabis supplier. More than 60 percent were prescribed medical cannabis due to the pain, particularly pain associated with cancer. After six months of treatment, more than 93 percent of 901 respondents reported their pain dropped from a median of eight to four on a 10-point scale. Close to 60 percent of patients who originally reported "bad" or "very bad" quality of life upgraded to "good" or "very good" after six months. More than 70 percent of patients surveyed reported moderate to significant improvement in their condition.
The most commonly reported adverse effects were dizziness (9.7 percent) and dry mouth (7.1 percent). After six months, more than 18 percent of patients surveyed had stopped using opioid analgesics or had reduced their dosage.
All patients received a prescription after consulting with a doctor who prescribed treatment. More than 33 percent of patients used cannabis-infused oil; approximately 24 percent inhaled therapy by smoking, and approximately six percent used vaporization.
While the researchers state their findings to date indicate cannabis may decrease dependence on prescription medicines, including opioids, more evidence-based data from this special, aging population is imperative.
https://www.sciencedaily.com/releases/2018/02/180213111508.htm
Baby boomers on dope: Recreational marijuana use is on the rise among adults over 50
Study seeks to understand prevalence of use in older adults
December 5, 2016
Science Daily/New York University
The recent legalization of recreational marijuana (cannabis) use in California, Colorado, and Washington reflect the sweeping changes in the attitudes and perceptions towards marijuana use in the United States. Eight states have voted in favor of legal recreational marijuana and 26 states in total allow medicinal marijuana.
There is a common misperception that widespread marijuana use is limited to younger generations. However, the Baby Boomer generation has reported higher rates of substance use than any preceding generation.
"Given the unprecedented aging of the U.S. population, we are facing a never before seen cohort of older adults who use recreational drugs," says Benjamin Han, MD, MPH, a geriatrician and health services researcher at the Center for Drug Use and HIV Research (CDUHR) and in the Division of Geriatric Medicine and Palliative Care at NYU Langone Medical Center (NYULMC).
"With the increased availability of legalized marijuana, there is an urgent need to understand the prevalence of its use and also its effects among older generations," continued Dr. Han. "The paucity of knowledge in this area constrains the care for a changing demographic of older adults with higher rates of substance use."
To address this, Dr. Han and his team led a study, "Demographic Trends among Older Cannabis Users in the United States, 2006-2013." Published in Addiction, the study sought to determine the trends in the prevalence and patterns of cannabis use, attitudes towards cannabis use, and determine correlates of use among adults over the age of 50.
The researchers evaluated responses from 47,140 adults aged 50 and older in the United States through a secondary analysis of the National Survey on Drug Use and Health (NSDUH) from 2006 to 2013. The NSDUH provides national data on the use of tobacco, alcohol, illicit drugs and mental health in the United States.
The authors found a 71% increase in marijuana use among adults aged 50 and older between 2006 and 2013. Adults ages 65 and older had a significantly lower prevalence of marijuana use compared to those ages 50-64, but prevalence of use increased two and a half times over eight years. Overall, prevalence was higher among men than women through all years.
"We found only five percent of these older adults felt using marijuana once or twice a week was a great risk to their health" said Joseph J. Palamar, PhD, MPH, a CDUHR affiliated researcher and an assistant professor of Population Health at NYULMC.
"I thought the perception of low risk was fascinating because, typically, we think of older generations as drug-adverse, and perceiving most drugs to be risky," said Dr. Palamar. "But apparently very few Baby Boomers consider marijuana use risky. But after all, this was the generation who was there, in the late 1960s, when the counterculture revolution exploded marijuana into mainstream popularity."
The researchers note that the majority of self-reported marijuana users indicated they first started using before the age of 18. This means that most of the current users either continued use or have begun using again more recently. Research is needed to determine whether this is related to changes in local, state, and national acceptance.
"Personally, I don't think we need to be very alarmed about most older people who are using marijuana," notes Dr. Palamar, "as our results suggest that only 4% started use after age 35. It is probable that most older users are at least somewhat experienced and are hopefully at reasonably low risk of harming themselves or others after use."
The results, however, give the researchers reason to believe the population may be at a particularly high risk for adverse health outcomes, as the concurrent use of multiple substances (marijuana, prescribed prescription drug, and even self-prescribed illicit drugs) all used in combination may make older adults further vulnerable to poor physical and mental health outcomes and certainly can impact their care.
Dr. Palamar notes that as a public health researcher, "for years we've been worried about the potential effects of marijuana on the developing brains of teens, but now we may need a bit more focus on their grandparents, who are increasingly more likely to be current users."
"Older people may use marijuana for a variety of reasons -- including medical reasons -- however we need to make sure they are not using in a hazardous manner since older adults may be vulnerable to its possible adverse effects. One particular concern for older users is the risk of falls while using marijuana, however this has not yet been studied," Dr. Han added.
This study underscores the need for further research on marijuana use and its effects in this population. More importantly, the research dispels the myth that older adults do not use recreational drugs. It is the researchers' hope that their study encourages cannabis use questions to become a part of older adults' care plan screenings.
https://www.sciencedaily.com/releases/2016/12/161205091216.htm
Marijuana use continues to grow among baby boomers
Middle-aged and older adults more likely to use if used marijuana as teens
September 6, 2018
Science Daily/New York University
Marijuana use is becoming more prevalent among middle-aged and older adults, with 9 percent of adults aged 50-64 and nearly 3 percent of adults 65 and older reporting marijuana use in the past year, according to a study by researchers at NYU School of Medicine and the Center for Drug Use and HIV/HCV Research (CDUHR) at NYU Rory Meyers College of Nursing.
These new figures, which use data from 2015-2016, demonstrate a substantial increase in marijuana use over the past near-decade -- double the percentage of adults aged 50-64 (4.5 percent) and more than seven times the percentage of adults 65 and older (0.4 percent) reporting use in 2006-2007.
The new findings, published online in the journal Drug and Alcohol Dependence, build on an earlier Addiction study by the same researchers to illustrate this growing trend among baby boomers.
Attitudes towards marijuana use are changing in the U.S., with a growing number of states legalizing medical and recreational marijuana. Although marijuana users are more likely to be young adults, the baby boomer generation is unique, having more experience with recreational use of drugs than previous generations.
"The baby boomer generation grew up during a period of significant cultural change, including a surge in popularity of marijuana in the 1960s and 1970s. We're now in a new era of changing attitudes around marijuana, and as stigma declines and access improves, it appears that baby boomers -- many of whom have prior experience smoking marijuana -- are increasingly using it," said lead author Benjamin Han, MD, MPH, an assistant professor in the Department of Medicine's Division of Geriatric Medicine and Palliative Care and Department of Population Health at NYU Langone Health.
In this study, the researchers analyzed responses from 17,608 adults aged 50 and older from the 2015-2016 National Survey on Drug Use and Health. Participants were asked about marijuana use, including when they first used it and whether they used it in the past year. The researchers also looked at respondents' demographics and several health factors, including other substance use and chronic disease.
In the past year, 9 percent of adults aged 50-64 and 2.9 percent of adults 65 and older reported using marijuana. In addition, more than half (54.5 percent) of adults 50-64 have used marijuana at some point in their lives, and over a fifth (22.4 percent) of adults 65 and older have ever used it.
When people first started using marijuana varied by age group. Nearly all adults aged 50-64 (92.9 percent), but only roughly half of adults 65 and older (54.7 percent), first used marijuana when they were 21 years of age or younger.
"Most baby boomers who recently used marijuana first used as teens during the 1960s and 1970s. This doesn't mean these individuals have been smoking marijuana for all these years, but most current users are by no means new initiates," said CDUHR researcher Joseph Palamar, PhD, MPH, the study's senior author and an associate professor in the Department of Population Health at NYU Langone Health.
In addition, some adults who used marijuana in the past year (15 percent of users aged 50-64 and 22.9 percent of those 65 and older) reported that a doctor had recommended it to them, reflecting the substantial use of marijuana for medical purposes.
A concerning finding from the study was the correlation between marijuana use and other unhealthy substance use. Adults who used marijuana were more likely to also report alcohol use disorder, nicotine dependence, cocaine use, and misuse of prescription medications (including opioids and sedatives) than non-users.
"Marijuana has been shown to have benefits in treating certain conditions that affect older adults, including neuropathic pain and nausea. However, certain older adults may be at heightened risk for adverse effects associated with marijuana use, particularly if they have certain underlying chronic diseases or are also engaged in unhealthy substance use," said Han, who is also a CDUHR researcher.
Because using multiple drugs may have additive adverse effects -- for instance, simultaneously using marijuana and alcohol can be detrimental for cognitive and motor functioning -- the researchers suggest that clinicians screen older patients who use marijuana for other substance use to ensure they are educated on the potential risks of using multiple drugs, especially concurrently.
https://www.sciencedaily.com/releases/2018/09/180906100458.htm