Medical marijuana laws linked to health and labor supply benefits in older adults

Findings show that pain declines, assessments of health improve and Americans remain in the workforce

March 19, 2019

Science Daily/Johns Hopkins University Bloomberg School of Public Health

A study that examined older Americans' well-being before and after medical marijuana laws were passed in their state found reductions in reported pain and increased hours worked. The study suggests medical marijuana laws could be improving older Americans' health.

The paper analyzed more than 100,000 responses from survey participants age 51 and older from 1992 to 2012. Researchers found a 4.8 percent decrease in reported pain and a 6.6 percent increase in reported very good or excellent health among respondents with a health condition that would qualify for medical marijuana after their states passed medical marijuana laws relative to similar respondents whose states did not pass a law.

The study appears in the Spring 2019 issue of the Journal of Policy Analysis and Management.

"Our study is important because of the limited availability of clinical trial data on the effects of medical marijuana," says Lauren Hersch Nicholas, PhD, assistant professor in the Bloomberg School's Department of Health Policy and Management. "While several studies point to improved pain control with medical marijuana, research has largely ignored older adults even though they experience the highest rates of medical issues that could be treated with medical marijuana."

Medical marijuana remains controversial as national support for it surges. Opponents continue to argue that legalizing medical marijuana would promote illegal use of the drug and increase misuse of related substances. Supporters highlight the potential health benefits of medical marijuana for pain management and other conditions. By the end of 2018, 33 states and Washington, D.C. had passed laws legalizing medical use of marijuana.

For their study, researchers used data from the 1992-2012 Health and Retirement Study (HRS), the largest nationally representative survey to have track health and labor market outcomes among older Americans. The researchers examined survey responses about symptoms that have a plausible link to one's ability to work: frequency of pain, whether health limits work, overall health assessment and depressive symptoms. At the time of the analysis, 20 states had medical marijuana laws in place.

The analysis matched medical marijuana law effective dates to the HRS interview responses, based on month and year, to track the possible effects of these policy changes. The analysis used 100,921 participant responses that represented individuals with one or more of four health conditions that would qualify for medical marijuana treatment under most state laws (arthritis, cancer, glaucoma and pain). The paper found that 55 percent of the study sample were suffering from one or more of these diagnoses.

The study found that medical marijuana laws lead to increases in full-time work in both samples.

In the sample that would qualify for medical marijuana treatment, the researchers found a greater increase in full-time work after medical marijuana laws were passed. In the full sample, researchers found a 5 percent increase in full-time work versus a 7.3 percent in the sample that qualified for medical marijuana. These results suggest that any decline in productivity resulting from medical marijuana usage -- such as not being able to work at capacity while under treatment -- is outweighed by increased capacity to work.

The study found no evidence that medical marijuana laws were associated with changes in daily activities such as getting dressed, going to the bathroom or walking.

"These findings underscore the close relationship between health policy and labor supply within older adults," says Nicholas. "When we're doing policy evaluations, we have to think not only about whether the policy is changing health outcomes, but also whether it does it in a way that supports labor force participation."

The results can help inform policy decisions about medical marijuana policy and broaden clinical support for additional research on marijuana as an effective medical treatment. This is important, the authors say, because marijuana is still illegal and classified as a schedule 1 drug at the federal level, and there remains limited clinical evidence available to inform medical marijuana policies and treatment options for many patients, especially older adults.

The study was supported by the National Institute on Aging.

https://www.sciencedaily.com/releases/2019/03/190319121750.htm

Could medical marijuana help older people with their ailments?

New study shows it may be safe and effective for symptoms of chronic disease

February 28, 2019

Science Daily/American Academy of Neurology

Medical marijuana may bring relief to older people who have symptoms like pain, sleep disorders or anxiety due to chronic conditions including amyotrophic lateral sclerosis, Parkinson's disease, neuropathy, spinal cord damage and multiple sclerosis, according to a preliminary study released today that will be presented at the American Academy of Neurology's 71st Annual Meeting in Philadelphia, May 4 to 10, 2019. The study not only found medical marijuana may be safe and effective, it also found that one-third of participants reduced their use of opioids. However, the study was retrospective and relied on participants reporting whether they experienced symptom relief, so it is possible that the placebo effect may have played a role. Additional randomized, placebo-controlled studies are needed.

According to the Centers for Disease Control and Prevention, approximately 80 percent of older adults have at least one chronic health condition.

"With legalization in many states, medical marijuana has become a popular treatment option among people with chronic diseases and disorders, yet there is limited research, especially in older people," said study author Laszlo Mechtler, MD, of Dent Neurologic Institute in Buffalo, N.Y., and a Fellow of the American Academy of Neurology. "Our findings are promising and can help fuel further research into medical marijuana as an additional option for this group of people who often have chronic conditions."

The study involved 204 people with an average age of 81 who were enrolled in New York State's Medical Marijuana Program. Participants took various ratios of tetrahydrocannabinol (THC) to cannabidiol (CBD), the main active chemicals in medical marijuana, for an average of four months and had regular checkups. The medical marijuana was taken by mouth as a liquid extract tincture, capsule or in an electronic vaporizer.

Initially, 34 percent of participants had side effects from the medical marijuana. After an adjustment in dosage, only 21 percent reported side effects. The most common side effects were sleepiness in 13 percent of patients, balance problems in 7 percent and gastrointestinal disturbances in 7 percent. Three percent of the participants stopped taking the medical marijuana due to the side effects. Researchers said a ratio of one-to-one THC to CBD was the most common ratio among people who reported no side effects.

Researchers found that 69 percent of participants experienced some symptom relief. Of those, the most common conditions that improved were pain with 49 percent experiencing relief, sleep symptoms with 18 percent experiencing relief, neuropathy improving in 15 percent and anxiety improving in 10 percent.

Opioid pain medication was reduced in 32 percent of participants.

"Our findings show that medical marijuana is well-tolerated in people age 75 and older and may improve symptoms like chronic pain and anxiety," said Mechtler. "Future research should focus on symptoms like sleepiness and balance problems, as well as efficacy and optimal dosing."

The study was supported by the Dent Family Foundation.

https://www.sciencedaily.com/releases/2019/02/190228164023.htm