A Narrative Review of Age-specific Issues Submitted
to Active Aging Canada Prepared by: Liza Stathokostas, Ph.D., Research
Consultant, April 2020
When I was in high school Cannabis use was, to my knowledge only among the drugies and low lives of the school I never tried it, when I went to University I had friends who tried drugs and they were, in my mind, out of control and could not keep up with their schooling. I did not use or try it at University. When I was working I tried Cannabis but I did not care
for the effects it had on me, so I stopped using it. However, according to this
report”
The use of cannabis by older adults is increasing faster
than in any other age group. In Canada, 7% of older adults report using cannabis,
up from 1% in 2012.
This increase is similar to observations of older
populations in other countries. This trend has been attributed to the Baby
Boomer generation entering into older age, changes in cannabis legislation, and
the growing promotion of cannabis for its therapeutic potential.
While a majority of older adults are new users, there are
older adults who have been life-long users and those who were early users and have
again begun to use. Older adults use cannabis for both therapeutic and
recreational reasons, although newer users tend to be used for medicinal
purposes. Surveys of the modality of use of cannabis among older adults
demonstrate use of a wide range of cannabis products.
While research is limited, surveys of older adult users
(largely for medicinal purposes) show a fair degree of satisfaction in
targeting specific symptoms and overall quality of life. This represents a
curious contrast to existing research which suggests that there currently is
limited high-quality evidence for the efficacy of cannabis on many of the
chronic conditions for which users may be seeking treatment. However, as the
health care community will likely see continued growth in the interest and
use of cannabis by their older patients, a pragmatic approach is to be able to
have an open and balanced discussion; and this applies to both medicinal and
recreational use.
With regards to the safe use of cannabis by older adults,
there is limited research that has focused on this new emerging user group.
However, as physiological changes with ageing have the potential to impact the
effects of cannabis (both recreational and medicinal), data on efficacy and
safety from younger users cannot be extrapolated without consideration. For
example, cannabis impacts parts of the brain that are known to change with age.
Also, age-related changes in liver and kidney function and body fat can impact
the way cannabis is metabolized in older adults.
Another potential issue for older adults is the
interaction of cannabis with existing chronic conditions and medication being
used for those conditions. Drug interactions include cannabinoid levels being
increased by other medications and can have additive effects on and affect
levels of other drugs.
In order to provide direction for older adults on the safe
use of cannabis, both older adults and health care providers should also be
aware that the issue of cannabis use disorder is not limited to younger
populations. Substance abuse, in general, by older adults, is rising and so it
cannot be assumed that this is not an issue in this age group. Education on
harms reduction, including behaviours such as driving under the influence of
cannabis, is just as prudent in older populations.
Substantial empirically driven, representative research
related to both physiological, attitudinal, and behavioural issues is still
needed to advance the discourse on cannabis and ageing. As is equipping older
adults and their health care providers with education resources.
