Older people who use cannabis to relieve or treat health conditions generally don’t discuss their substance use with doctors, according to a new study.
In this study of over 17 000 people aged 50 and over in the US, some use cannabis daily and others have mental health problems. The findings were published in peer-reviewed The American Journal of Drug and Alcohol Abuse.
The research is the first to identify where older users obtain cannabis, with the majority saying obtaining it was easy. Those who use cannabis for health reasons are more likely than non-medical (recreational) users to buy it at a medical dispensary (20% vs 5%) and less likely to get it for free (25% vs 46%) or from other sources such as parties (49% vs 56%).
According to the authors, the findings have significant clinical and policy implications especially as more US states are legalising cannabis, which is leading to a rapid rise in uptake among older people. This has implications for other countries such as South Africa, which has recently decriminalised it for personal use.
They urge that doctors should be routinely screening older people for cannabis and other substance use, as well as checking cannabis users for mental health problems, and recommending treatment when necessary. They add that education on the risks of obtaining cannabis and cannabis products from unregulated sources is also vital for this group.
“Cannabis is readily available and accessible to older cannabis users for medical or non-medical purposes,” said Namkee G Choi from University of Texas.
“The findings suggest that some medical users may be self-treating without healthcare professional consultation.
“All older people who take cannabis should consult healthcare professionals about their use. As part of routine care, healthcare professionals should screen for cannabis and other substance use, and for mental health problems.
“They should also recommend services or treatment when indicated. Given the increase in THC (tetrahydrocannabinol) potency, healthcare professionals should educate older cannabis users, especially high-frequency users, on potential safety issues and adverse effects.”
THC content has increased significantly over the past decades. Since 1995, the potency of illicit cannabis plant material seized in the US has consistently increased over time, from approximately 4% in 1995 to approximately 12% in 2014. Among older US adults, cannabis has more than doubled between 2008 and 2019. Reasons include pain relief and treating health issues. However, not much is known about where they obtain cannabis and how much they discuss their use with doctors.
Data for the research was drawn responses from the 2018 and 2019 National Survey on Drug Use and Health (NSDUH), with 17 685 men and women aged 50 and older. This annual national survey measures substance use and misuse and mental illness across the US.
The researchers analysed responses including those on frequency of cannabis use, reasons for taking it, where it was obtained, and how much they utilised healthcare services.
The study found that, overall, 9% used cannabis over the past year and of these, 19% used cannabis for a medical purpose to some extent, eg, to treat chronic pain, depression or diseases like arthritis, while the rest (81%) were recreational (non-medical) users.
The authors also found that people who reported cannabis use as being for medical reasons were over four times as likely than non-medical users to discuss their use with a healthcare professional. Nevertheless, only a minority of medical users did so, which implies that some are self-treating without consulting a doctor.
Medical users were also more likely than non-medical users to more frequently take cannabis, with 40% using it between 200 and 365 days a year.
A higher proportion of older cannabis users had mental illness, alcohol use disorder, and nicotine dependence compared with non-users of the same age, although medical users were less likely to have alcohol problems compared to recreational users.
As well as calling on doctors to do more, the study authors say the NSDUH needs updating to “reflect changing cannabis product commercialization”, such as including products available to older people like cannabidiols, topical solutions and edibles.
Limitations of the study included the relatively small number of medical users and the fact some respondents may have under-reported their cannabis and other substance use.
Source: Medical Xpress
Journal information: The American Journal of Drug and Alcohol Abuse, www.tandfonline.com/doi/full/1 … 0952990.2021.1908318
