Older adults and Cannibus use in Canada

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.