Experts Offer Tips on Integrating Medical Marijuana Into Geriatric Practice

"The needs of older adults are complex and it is important for clinicians to know what their patients are using," said Dr Walter Prozialeck
"The needs of older adults are complex and it is important for clinicians to know what their patients are using," said Dr Walter Prozialeck

Cannabis is "one of the most widely used and controversial substances worldwide."1 Although it is federally prohibited in the United States, 30 states and the District of Columbia have legalized some form of medical marijuana, and 8 states and DC have also legalized recreational marijuana for adults.2 According to the National Institute on Drug Abuse (NIDA), cannabis use in the United States has increased dramatically in the last decade from 14.5 million people (5.8% of people > 12 years of age) to 19.8 million (about 7.5%) in 2013.3

Marijuana use by older adults is also rising. A study by the National Survey of Drug Use and Health (NSDUH) found that from 2002-2014 the proportion of adults aged 50 to 64 who reported cannabis use in the past year more than tripled from 2.9% to 9.0%.4 Among adults age 65 or older, there was more than a ten-fold increase (from 0.2% to 2.1%).5  Data from a Substance Abuse and Mental Health Services Administration (SAMSHA) report reveal that as many as 132,000 older US adults use marijuana on a given day.6 Another study suggested that cannabis use among adults age 50 and above increased by 250% from 2006 to 2013.7

Compared with nonmedical use only, medical use has been found to be directly associated with older age, older marijuana initiation age, disability, Medicaid status, stroke diagnosis, poor self-rated health, anxiety disorder, daily or near daily marijuana use, residing in a medical marijuana legalization state, and perceived state legalization of medical marijuana.8 Interestingly, it was inversely associated with heavy alcohol use and nonmedical use of prescription stimulants and analgesics.8

"There are many reasons for the current increase in cannabis use among older adults," said Walter Prozialeck, PhD, Professor of Pharmacology, Department of Pharmacology, Chicago College of Osteopathic Medicine, Midwestern University, Glendale, Illinois. “The needs of older adults are complex and it is important for clinicians to know what their patients are using,” he told MPR.