Tuesday, July 23, 2024

Cannabis for Seniors: Why Older Adults Are Opting for Medical Marijuana

Seniors are one of the fastest-growing populations of cannabis users in the United States. While some older adults have used pot for decades, studies suggest that others are turning to the drug for the first time to help them sleep better, dampen pain or treat anxiety — especially when prescription drugs, which often come with unwanted side effects, don’t work as intended.

In 2007, only about 0.4 percent of people age 65 and older in the United States had reported using cannabis in the past year, according to the National Survey on Drug Use and Health. That number rose to almost 3 percent by 2016. As of 2022, it was at more than 8 percent.

Nancy Herring, 76, has been using cannabis recreationally for her entire adult life — she describes herself as “one of the hippies from the ’60s.” But it wasn’t until her husband was diagnosed with Parkinson’s disease and dementia two years ago that she began to wonder about pot’s medicinal use.

During the course of his illness, her husband, now 79, had developed insomnia. Soon, neither of them was sleeping.

Doctors prescribed pills to help him rest, but “nothing really worked,” she said. At one point, he reacted so negatively to a medicine he ended up in the hospital.

Then they tried an indica strain from a dispensary near where they live in Clearwater, Fla. Now, after one gummy and a hit on a pipe, her husband “can sleep at night, which is a huge thing,” she said.

Marijuana’s medicinal properties have not been well studied, particularly among older users, making it difficult for doctors to counsel their patients on the benefits and risks. Cannabis companies have rushed to fill the void, offering tips to older adults about doses or formulations and even creating products meant to appeal to them. Meanwhile, as more seniors experiment with cannabis, they are evangelizing to one another about its benefits, and sharing the problems they’ve encountered along the way.

“People are just desperate,” said Dr. Aaron Greenstein, a geriatric psychiatrist in Denver. “They’re willing to try anything.”

When his own grandmother became convinced that she was reliving the Holocaust during the later stages of her dementia, taking a dissolvable strip with a small amount of THC — the psychoactive component in marijuana — put an end to her flashbacks and helped her feel at peace.

“I have had dozens of patients who tell me that it has cured their various ailments,” said Dr. Haley V. Solomon, a geriatric psychiatrist in San Diego who, along with Dr. Greenstein, has written about the promise and risks of seniors using cannabis. “I think that it’s really important to listen to them, to acknowledge that and then to study it further.

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Older adults need to be aware of potential drug interactions, she added, and also consider how cannabis can affect cognition, coordination and balance.

Without a North Star guiding older adults on how to use cannabis, there is a grass-roots effort among some seniors to teach one another.

Carminetta Verner, 88, has become the go-to source for cannabis information at her retirement community, the sprawling Leisure World complex in Montgomery County, Md., which houses about 8,000 older adults.

In 2018, she founded a club devoted to educating residents about medical cannabis. The club’s membership, which has now grown to about 100 people, might be higher if it weren’t for the stigma still associated with the drug, Ms. Verner said.

“There are a lot of people up here that are suffering and in pain, and medicine isn’t working for them,” she said.

Damien Cornwell, the owner of a dispensary in Binghamton, N.Y., that opened in February, said his business has attracted customers who are “seeking relief they can’t find at the doctor’s office.” They have ailments such as rheumatoid arthritis, anxiety and insomnia, he said.

As more states legalize cannabis — it is now permitted for recreational use in more than 20 states and Washington, D.C., and for medical use in 38 states and D.C. — the number of seniors who turn to marijuana will only continue to grow, experts said. An October Gallup poll found that about two-thirds of adults 55 and older think the use of marijuana should be legal.

Steve Hickerson, who lives in Laguna Woods, Calif., wants to sleep better.

He used cannabis sublingual drops but said they didn’t help, so he’s trying gummies, “which seem to work much better.” In the past, he felt using mind-altering drugs was morally wrong — “I’m a Christian,” he explained — but now, he said, “I’m 79, things are different.” He is willing to explore products that have a medical use.

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Companies are capitalizing on the newfound interest. Earlier this year, Mr. Hickerson was bused to an event organized by Glass House, one of the biggest cannabis brands in the country, along with about 50 other people from his retirement community who were offered cannabis products at a substantial discount.

The company Trulieve is also connecting with seniors. It has the largest retail footprint for cannabis products in the United States and a 750,000-square-foot cannabis cultivation facility in north Florida. Much like Glass House, Trulieve organizes “silver tours” that bring seniors to local dispensaries, among other opportunities for in-person education.

Kim Rivers, the co-founder and chief executive of Trulieve, said their “wisdom” customers — those 55 and older — are growing year over year. In Florida, she added, these adults represent 20 percent of their customer base.

Bristol Extracts, which manufactures cannabis in New York, has created a brand called Senior Moments — a collection of tinctures, gummies and mints that debuted in March.

“IT’S TIME TO SPICE THINGS UP A LITTLE!” proclaims the company’s website. “Growing older doesn’t have to be mundane.”

The brand’s edibles also have ingredients like ginkgo biloba that are advertised as supporting “memory and mood.” Soon the line will include body balms and gummies that function as both a sleep aid and an aphrodisiac, said Eric Blazak, the company’s founder and chief executive.

Because cannabis is not federally legal, doctors don’t have enough research to guide them on what conditions it is helpful for, who might be at higher risk for potential harms, how to dose it properly or which strains to recommend, said Dr. Benjamin Han, an addiction medicine specialist at the University of California, San Diego, and one of the few geriatricians in the United States who studies older adults and substance use.

“What makes it even more complicated is cannabis is a very complex plant,” he added, and there are more than 100 cannabinoids — the biologically active components in the cannabis plant — as well as products with different ratios of THC to cannabidiol, or CBD.

Start low and slow. If a patient wants to try cannabis products containing THC, Dr. Han recommends starting at a low dose (generally 1 milligram to 2.5 milligrams) and then “give it one week” before making the decision to increase it.

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Taking too many edibles can cause dizziness, confusion, changes in heart rate and blood pressure, panic attacks, anxiety, nausea, vomiting, and can even land some people in the emergency room.

There’s also the potential for cannabinoid hyperemesis syndrome, a condition that causes recurrent vomiting in heavy marijuana users.

One study, led by Dr. Han, found that emergency department visits associated with cannabis use among older adults rose more than 1,800 percent in California — from 366 in 2005 to 12,167 in 2019.

Older users may lean on their prior experience with the drug, but “the cannabis today is very different,” he said. “It is stronger. And then on top of that, there are all these physiological changes with aging that make you more sensitive than you would have been 40 years ago.”

Discuss the risks and benefits with your doctor. “It’s important to talk with a clinician or health provider, especially if you’re using it for medical reasons to treat chronic disease or chronic symptoms,” Dr. Han said.

Cannabis can interact with certain medications, like warfarin, a drug used to treat blood clots. And seniors who take sedative-hypnotics like Ambien or benzodiazepines like Xanax — or who drink alcohol — should consider avoiding cannabis, Dr. Solomon said, because when paired with those drugs, it can cause dizziness and confusion and make seniors more susceptible to falls and injuries.

And smoking cannabis can trigger respiratory symptoms in those with chronic lung disease, Dr. Han added.

Educate yourself. Ms. Verner recommended going to licensed dispensaries that sell products that have been tested by a third party. Familiarize yourself with state regulations, too, she said.

“You just need to educate yourself, not be afraid of things — learn for yourself,” Ms. Verner said. “You need to know what may work for you — and you go from there.”

Through trial and error, she discovered that cannabinol, or CBN, which is not psychoactive, was most helpful for her insomnia.

Now she takes fewer pills: just one for her thyroid levels and another to reduce her blood pressure.

Many older adults “end up with all these bottles of medicine,” she said. “And I don’t think that’s necessary.”

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