Study explores medical marijuana as opioid alternative for older adults

Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic editor on aging. Her work has appeared in NextAvenue.com, Journal of Active Aging, Cancer Today, Kaiser Health News, the Connecticut Health I-Team and other outlets. She is a senior fellow at the Center for Health Policy and Media Engagement at George Washington University and co-produces the HealthCetera podcast.

Photo: Chuck Coker via Flickr

U.S. Attorney General Jeff Sessions wants to crack down on medical marijuana. He was soundly rebuked by Congress last year, which provided no funding for his plan. That’s good news for older adults, who are among the fastest growing cohort of users.

They increasingly are turning to medical marijuana to manage a range of conditions, from cancer and Parkinson’s disease to chronic pain. A recent study published in The European Journal of Internal Medicine found that cannabis therapy is safe and effective for elderly patients who are seeking to address these and other medical issues.

Researchers surveyed 2,736 patients, 65 years and older, who received medical cannabis from January 2015 to October 2017 in a specialized medical cannabis clinic.  More than 60 percent were prescribed medical cannabis because of pain, particularly that 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 the patients who originally reported “bad” or “very bad” quality of life had upgraded to “good” or “very good” after six months. More than 70 percent of patients surveyed reported moderate to significant improvement in their condition. After six months, 18.1 percent stopped using opioid analgesics or reduced their dose.

All patients first consulted with a doctor before receiving a prescription. More than 33 percent of patients used a cannabis-infused oil; approximately 24 percent inhaled their therapy by smoking, and about 6 percent used vaporization. While the researchers state their findings to date indicate cannabis may decrease dependence on prescription medicines, including opioids, they said more evidence-based data from the aging population is imperative.

In the United States, marijuana remains a Schedule I narcotic, the same classification as heroin and LSD. However, 28 states have legalized its use for medical purposes, from managing cancer-related nausea to PTSD. But many physicians are still wary about its use, according to The Washington Post. Others readily recommend it to older patients, and see it as a potential solution to the overuse of prescription pain medications, as the San Diego Union-Tribune reported.

However, as this Pain News Network article notes, a RAND Corporation extended analysis of opioid death rates found that after 2013, the association between medical marijuana and lower opioid death rates “completely disappeared.” Researchers surmised “as states have become more stringent in their regulation of dispensaries, the protective value generally has fallen.”

Of course, smoking, ingesting or otherwise using cannabis can lead to side effects like rapid heartbeat, changes in blood pressure, increased risk for anxiety disorders, depression or problems with memory formation, according to a new report from the National Academies of Sciences, Engineering and Medicine (NASEM). That can be problematic for older adults who suffer from chronic conditions affected by such side effects.

That same report, however, also found that marijuana may help protect the brain from stroke, relieve pain, and for adults with multiple sclerosis-related muscle spasms, found “substantial evidence” that short-term use of certain manufactured cannabinoid-based medications known as “oral cannabinoids” improved their reported symptoms. Researchers also found conclusive evidence that for adults with chemotherapy-induced nausea and vomiting, oral cannabinoids were effective in preventing and treating those ailments. NASEM recommends more investigation to close the gaps in knowledge and address the current barriers to advancing medical marijuana research.

The Marijuana Policy Project offers an updated list of legalization and medical marijuana legislation.

Here are some questions to answer in your reporting:

  • Is medical cannabis legal in your state?
  • How many physicians are registered to prescribe it?
  • Do they see an uptick in older users?
  • Has there been a decrease in prescription painkillers among this population?
  • How do pain physicians and other specialists feel about the issue?

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