Cannabis has been used for centuries in pain relief and as a sleep aid, among its many other purposes. Until recently, there has been little evidence in its safety and effectiveness, largely in part due to relatively recent restrictions on its use, which have hampered research efforts and resulted in doctors having little to no understanding of its use.
Aging influences the biochemical and physiological effect of drugs on the body. For example, a slow metabolism, a normal part of aging, can increase the likelihood of experiencing side-effects, such as nausea, vomiting, constipation and falls in seniors who take prescription medicines such as opioids for pain management.
There has, however, been an explosion in the number of studies published since 2012. One such study, published in March 2018, sheds some more light on the subject of medical cannabis and its efficacy and safety in elderly patients. According to researchers at Ben-Gurion University of the Negev (BGU) and the Cannabis Clinical Research Institute at Soroka University Medical Center, “medical cannabis therapy can significantly reduce chronic pain in patients aged 65 and older, without adverse effects”.
The new study, published in The European Journal of Internal Medicine, found that 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 effects this particular group, which also suffers from dementia, frequent falls, mobility problems, and hearing and visual impairment”, says Prof. Victor Novack, professor of medicine in the BGU Faculty of Health Sciences (FOHS), and head of the Soroka Cannabis Clinical Research Institute. Prof. 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 that Americans over 65 represent 14 percent of the total population and use more than 30 percent of all prescription drugs, and 30 percent of over-the-counter drugs, including highly addictive painkillers.
BGU researchers surveyed 2,736 patients 65 years and older, who received medical cannabis through “Tikun Olam”, the largest medical cannabis supplier in Israel. More than 60 percent were prescribed medical cannabis due to pain, particularly pain associated with cancer. After six months of treatment, more than 90 percent of 901 respondents reported their pain had 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 6 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%) and dry mouth (7.1%). 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 6 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. The research shows that medical cannabis is safe and effective with minimal to no side-effects for elderly patients.
The study had its limitations though: Researchers acknowledge that the observational nature of the study only allowed them to determine a link between cannabinoids and pain relief. In addition, most of the patients were using a mixture of preparations and cannabis strains, which means that researchers couldn’t determine the exact dose of active cannabinoids that each patient was consuming. They admit that additional study is needed, including double-blind, randomized controlled trials.
- The most common indications for cannabis in the elderly were pain and cancer;
- At six months of cannabis treatment, 93,7% reported improvement in their condition;
- At six months of treatment, the number of reported falls was significantly reduced;
- Medical cannabis decreased the use of prescription medicines, including opioids.
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