Understanding Medical Marijuana and its Potential Benefits and Harms in Older Adults Living with Pain

Monitoring persons on medical marijuana

Potential harms...

• Accidents
• Interactions with prescription medications
• Coughing/lungs
• Spending lots of $$ but no health benefit
• Severe side effects (vomiting, passing out, dizzy, paranoid)
• Addiction (cannabis use disorder)
• Withdrawal

No strong evidence of causing cancer, severe lung disease, mental illness...

No strong evidence to suggest long-term cognitive effects in adults

Population using medical marijuana (MM)

In Florida, by Feb. 2021

Active MM card holders: 491,370
Physicians who can certify patients: 2,627

• 58.9% of the state’s early MM users (N = 7,548) were older adults.
• Most common condition for MM use include musculoskeletal disorders and spasms (48.4%) and chronic pain (44.4%).
• Many of them are also on other drugs:
  • antidepressants (32.8%)
  • anxiolytics and benzodiazepines (23.5%)
  • opioids and narcotics (23.5%)
  • cardiovascular agents (27.9%)

Brown et al. 2020

On Tuesday, February 23, 2021, Dr. Robert Cook and Dr. Yan Wang presented for the Integrative Pain Management Series for Health Care Providers on medical marijuana and its effects on chronic pain and related health outcomes.

The presentation, Understanding Medical Marijuana and its Potential Benefits and Harms in Older Adults Living with Pain, focused on fostering understanding about various medical marijuana products in the state of Florida and its application for pain management within the older adult patient population.

Dr. Wang also provided an overview of recent medical marijuana research along with findings from a pilot study focused on older adults with chronic pain newly initiating medical marijuana use.

Learning Objectives from the Presentation:

1. Define and distinguish cannabis, hemp, CBD, marijuana, and “medical marijuana”
2. Describe mechanisms by which marijuana could improve outcomes in older people with pain
3. List several different routes of administration of medical marijuana and their potential advantages and disadvantages
4. Identify potential safety issues to monitor in persons who are using medical marijuana
5. Overview of medical marijuana and the user demographics
6. Current research evidence of marijuana’s effect on chronic pain
7. A pilot study on medical marijuana use and its impact on older adults with chronic pain

The Integrative Pain Management Series for Health Care Providers, hosted by the Aging and Integrative Pain Assessment and Management Initiative (AI-PAMI), specifically addresses pain management issues unique to the aging population, such as cognitive impairment, falls, medication side effects and polypharmacy. 

Health care providers learn how to help patients incorporate non-medication therapies into their pain management plan, including aromatherapy, dry needling, meditation, virtual reality and more, with the goal of increasing patient safety and quality of life.

AI-PAMI is a comprehensive project addressing non-opioid pain management in adults ages 50 and older living in Northeast Florida. The overall goal of AI-PAMI is the advancement of innovative pain education and patient care focused on multimodal and integrative pain management. The project encompasses community outreach, education and research.

View the live webinar recording of Understanding Medical Marijuana and its Potential Benefits and Harms in Older Adults Living with Pain.

Resources from the Presentation:

Marijuana and Potential Long-term Effects (MAPLE) study
The Florida Department of Health Office of Medical Marijuana Use (OMMU)
The Health Effects of Cannabis and Cannabinoids

References:

Aging and Integrative Pain Assessment and Management Initiative (AI-PAMI)