In many countries, especially the US, the number of elderly people has increased rapidly in recent years and this is expected to continue. Many elderly people suffer from chronic pain but it is regularly under-treated, partly because managing these patients is often complex. Managing pain in these patients is often complex, because of declining organ function, increased vulnerability to adverse side effects of multiple medications. Pain presentation that is outside of accepted patterns and cognitive impairment may further complicate the picture. Today, pain, especially for this group is frequently under-treated. However, the demand for satisfactory pain management is increasing dramatically and will continue to do so.
Due to the substantial growth in the use of medical cannabis in recent years and with the aging of our population, medical cannabis is increasingly used by the elderly. A recent survey was conducted with over 900 elderly Israeli patients participating, who used medicinal cannabis for at least six months. Their aim was to get a better idea of who was using cannabis by finding common characteristics to better evaluate the safety and efficacy of the treatment that incorporate the God-given herb. For outcomes, or the parameters they were investigating, they focused on pain intensity, quality of life and adverse events at six months.
This study is actually pretty powerful because of the participants, 75% of the patients had no prior history with cannabis consumption, Due to this, this can be a powerful assessment of the onboarding experience in the elderly. Most patients began using cannabis for pain-related conditions including cancer pain, but a smaller number of patients were using it to treat chemo-related nausea, Parkinson’s disease, post-traumatic stress disorder, and Crohn’s disease. While THC-forward strains were the most consumed, CBD-rich strains were especially common in patients suffering from pain, chemotherapy side effects, Parkinson’s disease, and inflammatory diseases. No matter what the individual strain preference was, a whopping 93.7% of patients reported that cannabis improved their symptoms after six months of use. It should be noted that it was particularly helpful in reducing pain, on average reducing pain from an 8 (on a scale to 10) to a 4. This reduction in pain led 15% to entirely stop their opioid pain medications, which to me is a slam dunk considering the HUGE opioid crisis we have on our hands.
There were two adverse affects reported, which were dizziness and dry mouth, which are usual side effects to cannabis use. However, these effects are extremely mild when considering the long list of adverse affects more conventional pharmaceutical options have. The most common side-effects, dizziness and dry mouth, were reported in only 10% and 7% of patients, respectively. Two percent or less reported confusion, disorientation, or weakness. Overall, cannabis use improved quality-of-life from “bad” to “good” with few adverse side effects. Together, these findings strongly support the safety and efficacy of medicinal cannabis in an elderly population for treatment of pain-related conditions.
Our elders have chronic pain, but studies have consistently shown high levels of untreated or under-treated pain in this population which adversely affects their quality of life. In terms of recommendations moving forward, a few different approaches could prove beneficial. However, this study shows that there is a promising future for pain management in regards to cannabis. Increasing awareness among our communities, both patient and medical is extremely important to be well on our way to understanding how pain management can be improved.
Until next time tribe,