Latest news with #BenjaminHan
Medscape
10-06-2025
- Health
- Medscape
As Cannabis Users Age, Health Risks Appear To Grow
Benjamin Han, a geriatrician and addiction medicine specialist at the University of California-San Diego, tells his students a cautionary tale about a 76-year-old patient who, like many older people, struggled with insomnia. 'She had problems falling asleep, and she'd wake up in the middle of the night,' he said. 'So her daughter brought her some sleep gummies' — edible cannabis candies. 'She tried a gummy after dinner and waited half an hour,' Han said. Feeling no effects, she took another gummy, then one more — a total of four over several hours. Han advises patients who are trying cannabis to 'start low; go slow,' beginning with products that contain just 1 or 2.5 milligrams of tetrahydrocannabinol, or THC, the psychoactive ingredient that many cannabis products contain. Each of the four gummies this patient took, however, contained 10 milligrams. The woman started experiencing intense anxiety and heart palpitations. A young person might have shrugged off such symptoms, but this patient had high blood pressure and atrial fibrillation, a heart arrhythmia. Frightened, she went to an emergency room. Lab tests and a cardiac work-up determined the woman wasn't having a heart attack, and the staff sent her home. Her only lingering symptom was embarrassment, Han said. But what if she'd grown dizzy or lightheaded and was hurt in a fall? He said he has had patients injured in falls or while driving after using cannabis. What if the cannabis had interacted with the prescription drugs she took? 'As a geriatrician, it gives me pause,' Han said. 'Our brains are more sensitive to psychoactive substances as we age.' Thirty-nine states and the District of Columbia now allow cannabis use for medical reasons, and in 24 of those states, as well as the district, recreational use is also legal. As older adults' use climbs, 'the benefits are still unclear,' Han said. 'But we're seeing more evidence of potential harms.' A wave of recent research points to reasons for concern for older users, with cannabis-related emergency room visits and hospitalizations rising, and a Canadian study finding an association between such acute care and subsequent dementia. Older people are more apt than younger ones to try cannabis for therapeutic reasons: to relieve chronic pain, insomnia, or mental health issues, though evidence of its effectiveness in addressing those conditions remains thin, experts said. In an analysis of national survey data published June 2 in the medical journal JAMA , Han and his colleagues reported that 'current' cannabis use (defined as use within the previous month) had jumped among adults aged 65 or older to 7% of respondents in 2023, from 4.8% in 2021. In 2005, he pointed out, fewer than 1% of older adults reported using cannabis in the previous year. What's driving the increase? Experts cite the steady march of state legalization — use by older people is highest in those states — while surveys show that the perceived risk of cannabis use has declined. One national survey found that a growing proportion of American adults — 44% in 2021 — erroneously thought it safer to smoke cannabis daily than cigarettes. The authors of the study, in JAMA Network Open , noted that 'these views do not reflect the existing science on cannabis and tobacco smoke.' The cannabis industry also markets its products to older adults. The Trulieve chain gives a 10% discount, both in stores and online, to those it calls 'wisdom' customers, 55 or older. Rise Dispensaries ran a yearlong cannabis education and empowerment program for two senior centers in Paterson, New Jersey, including field trips to its dispensary. The industry has many satisfied older customers. Liz Logan, 67, a freelance writer in Bronxville, New York, had grappled with sleep problems and anxiety for years, but the conditions grew particularly debilitating 2 years ago, as her husband was dying of Parkinson's disease. 'I'd frequently be awake until 5 or 6 in the morning,' she said. 'It makes you crazy.' Looking online for edible cannabis products, Logan found that gummies containing cannabidiol, known as CBD, alone didn't help, but those with 10 milligrams of THC did the trick without noticeable side effects. 'I don't worry about sleep anymore,' she said. 'I've solved a lifelong problem.' But studies in the United States and Canada, which legalized nonmedical cannabis use for adults nationally in 2018, show climbing rates of cannabis-related health care use among older people, both in outpatient settings and in hospitals. In California, for instance, cannabis-related emergency room visits by those 65 or older rose, to 395 per 100,000 visits in 2019 from about 21 in 2005. In Ontario, acute care (meaning emergency visits or hospital admissions) resulting from cannabis use increased fivefold in middle-aged adults from 2008 to 2021, and more than 26 times among those 65 and up. 'It's not reflective of everyone who's using cannabis,' cautioned Daniel Myran, an investigator at the Bruyère Health Research Institute in Ottawa and lead author of the Ontario study. 'It's capturing people with more severe patterns.' But since other studies have shown increased cardiac risk among some cannabis users with heart disease or diabetes, 'there's a number of warning signals,' he said. For example, a disturbing proportion of older veterans who currently use cannabis screen positive for cannabis use disorder, a recent JAMA Network Open study found. As with other substance use disorders, such patients 'can tolerate high amounts,' said the lead author, Vira Pravosud, a cannabis researcher at the Northern California Institute for Research and Education. 'They continue using even if it interferes with their social or work or family obligations' and may experience withdrawal if they stop. Among 4,500 older veterans (with an average age of 73) seeking care at Department of Veterans Affairs health facilities, researchers found that more than 10% had reported cannabis use within the previous 30 days. Of those, 36% fit the criteria for mild, moderate, or severe cannabis use disorder, as established in the Diagnostic and Statistical Manual of Mental Disorders. VA patients differ from the general population, Pravosud noted. They are much more likely to report substance misuse and have 'higher rates of chronic diseases and disabilities, and mental health conditions like PTSD' that could lead to self-medication, she said. Current VA policies don't require clinicians to ask patients about cannabis use. Pravosud thinks that they should. Moreover, 'there's increasing evidence of a potential effect on memory and cognition,' said Myran, citing his team's study of Ontario patients with cannabis-related conditions going to emergency departments or being admitted to hospitals. Compared with others of the same age and sex who were seeking care for other reasons, research shows these patients (ages 45 to 105) had 1.5 times the risk of a dementia diagnosis within 5 years, and 3.9 times the risk of that for the general population. Even after adjusting for chronic health conditions and sociodemographic factors, those seeking acute care resulting from cannabis use had a 23% higher dementia risk than patients with noncannabis-related ailments, and a 72% higher risk than the general population. None of these studies were randomized clinical trials, the researchers pointed out; they were observational and could not ascertain causality. Some cannabis research doesn't specify whether users are smoking, vaping, ingesting or rubbing topical cannabis on aching joints; other studies lack relevant demographic information. 'It's very frustrating that we're not able to provide more individual guidance on safer modes of consumption, and on amounts of use that seem lower-risk,' Myran said. 'It just highlights that the rapid expansion of regular cannabis use in North America is outpacing our knowledge.' Still, given the health vulnerabilities of older people, and the far greater potency of current cannabis products compared with the weed of their youth, he and other researchers urge caution. 'If you view cannabis as a medicine, you should be open to the idea that there are groups who probably shouldn't use it and that there are potential adverse effects from it,' he said. 'Because that is true of all medicines.'
Medscape
04-06-2025
- Health
- Medscape
Older Adults Are Using More Cannabis
Cannabis use in older adults is up, according to researchers who used a national survey database to study emergent patterns in older adult use of the substance. Their results were published online in JAMA Internal Medicine . After noting an upward trend in seniors using cannabis — from 1.0% in 2005 to 4.2% in 2018— a group of investigators led by Benjamin H. Han, MD, from the University of California San Diego School of Medicine, conducted a cross-sectional analysis of the 2021-2023 cohorts from the National Survey on Drug Use and Health. Their sample included 15,689 adults aged 65 years or older. More than half of the sample (54%) were women. Han and colleagues found that when compared with prior years, past-month cannabis use increased significantly across the cohorts, from 4.8% (95% CI, 3.9%-5.9%) in 2021 to 7.0% (95% CI, 6.2%-8.0%) in 2023. In a subanalysis, the investigators found that increased prevalence in past month cannabis use was associated with multiple demographic factors. Both women and men showed increased trends, with an odds ratio (OR) of 1.32 (1.10-1.59) in women and an OR of 1.18 (0.97-1.43) in men. Increased past month cannabis use was also observed in older adults with a minimum $75,000 annual income, those with college or postgraduate degrees, those who were married, and those living in a state with legalized medical cannabis. Further subanalysis of the survey respondents by race showed that persons who identified as 'other' sustained the highest OR of increased use, OR = 2.26 (1.12-4.59). Older adults with the highest incomes previously were found to have the lowest prevalence of cannabis use compared with other income levels, but by 2023, they had the highest usage increase. The study authors suggested this could be due to their ability to afford medical cannabis. Although an increase in past-month cannabis use was associated with a number of medical conditions, the researchers wrote that they were unable to cleanly sort recreational from medical use. People with chronic diseases, especially those with multiple conditions, saw a spike in cannabis use. The most common medical condition recorded was chronic obstructive pulmonary disease with heart conditions, diabetes, hypertension, cancer, and two or more chronic conditions also noted to have increased prevalence (6.4%-13.5%). 'The substantial increased prevalence in states with legalized medical cannabis highlights the importance of structural educational support for patients and clinicians in those states,' Han and colleagues wrote. 'The use of cannabis products, especially with psychoactive properties, may complicate chronic disease management among older adults.' A cannabis researcher not involved in Han and colleagues' study agreed. 'One of the most important findings was that those in residence in a state where medical cannabis is legal at the time of interview also showed greater increases in cannabis use,' said Elise Weerts, PhD, a professor in the Department of Psychiatry and Behavioral Sciences at Johns Hopkins Medical School, in Baltimore, in an interview with Medscape Medical News . Weerts is also a researcher at the Cannabis Science Laboratory at Johns Hopkins. Meanwhile, in an accompanying editorial, experts pointed to how, despite a lack of consistent data on cannabis use in older age, its use is growing as it is increasingly legalized. 'Existing therapeutic evidence for medical cannabis in older adults has been inconsistent across several conditions, with many studies suggesting possible benefits, while others finding limited benefit,' the authors of the editorial wrote. 'The potential harms of cannabis use in older adults are apparent, with increased risks of cardiovascular, respiratory, and gastrointestinal conditions, stroke, sedation, cognitive impairment, falls, motor vehicle injuries, drug-drug interactions, and psychiatric disorders,' they wrote. The editorial authors stated concerns about scant evidence and a lack of standards around administering cannabis in this patient population. 'Existing therapeutic evidence for medical cannabis in older adults has been inconsistent across several conditions, with many studies suggesting possible benefits, while others finding limited benefit,' they wrote. 'Much of the evidence for benefit derives from a single or a small number of studies with nonrandomized designs, and very few studies evaluated harms, making the benefit to risk ratio unclear.' The editorialists also pointed to the frustration older adult users of cannabis feel around 'the lack of awareness and education about age-related issues' at cannabis dispensaries and even in healthcare workers. The study's findings did not surprise Weerts, who said she has been tracking similar data elsewhere. She said she agreed with the editorial writers that the gap between cannabis use and the understanding of its potential adverse effects or contraindications is widening. 'I am concerned that older adults using cannabis may not be aware of the risks, and that data supporting its efficacy for medical purposes are still not available,' Weerts said. 'We need randomized placebo-controlled trials to demonstrate any potential benefits and also track any adverse effects and potential harms.'
Daily Record
03-06-2025
- General
- Daily Record
Over 65s are using cannabis more than ever as records reach new high
Are seniors getting stoned? Cannabis use in older adults is higher than ever before. Adults over the age of 65 are using marijuana more than ever before, a new study has revealed. In fact, a staggering seven per cent of over 65s surveyed admitted to using cannabis in the past month. The US based study was led by researchers at the Center for Drug Use and HIV/HCV Research (CDUHR) at the NYU School of Global Public Health, and was published in JAMA Internal Medicine. Interestingly, the findings saw significant increases in use by older adults who are college-educated, married, female, and have higher incomes. 'Our study shows that cannabis use among older adults continues to increase, although there have been major shifts in use according to demographic and socioeconomic factors,' said Joseph Palamar, PhD, MPH, the study's senior author. Marijuana has been legalised for medical use in 39 US states and in 24 states for recreational use. Researchers in the new study examined data from the National Survey on Drug Use and Health from 2021 through 2023 to discover trends in cannabis use in older adults. If the over-65s reported that they'd used cannabis in the past month, this was defined as 'current' use. 'This is the first time we were able to examine 'current' use of cannabis in this age group. Before, we were only able to look at past-year use because the numbers for current use were too small,' said Benjamin Han, MD, MPH, the study's first author. The researchers found that current cannabis use among older adults had increased by nearly 46 per cent in two years. Current use for seniors rose to seven per cent in 2023, up from 4.8 per cent in 2021 and 5.2 per cent in 2022. This is a staggering increase from back in 2006 and 2007, when less than one per cent of older adults had used cannabis in the past year. Those who are married, white, have a college degree, and have an income of at least $75,000 saw a sharp increase in cannabis use over the study period. Older women also saw a significant increase in use, although older men are still more likely than women to use the drug. Expectedly, cannabis use grew more among those living in states where medical marijuana is legal compared to states where it remains outlawed. The researchers also found significant increases in cannabis use by older adults with chronic diseases, and those with multiple chronic conditions, including heart issues, diabetes, hypertension, cancer, and chronic pulmonary obstructive disease. But the scientists urge users to take caution when taking cannabis for chronic illnesses. Han said: 'As a geriatrician, I see more and more people interested in using cannabis for treating chronic health symptoms. "But cannabis can complicate the management of chronic diseases and be potentially harmful if patients are not educated on its use and potential risks." Join the Daily Record WhatsApp community! Get the latest news sent straight to your messages by joining our WhatsApp community today. You'll receive daily updates on breaking news as well as the top headlines across Scotland. No one will be able to see who is signed up and no one can send messages except the Daily Record team. All you have to do is click here if you're on mobile, select 'Join Community' and you're in! If you're on a desktop, simply scan the QR code above with your phone and click 'Join Community'. We also treat our community members to special offers, promotions, and adverts from us and our partners. If you don't like our community, you can check out any time you like. To leave our community click on the name at the top of your screen and choose 'exit group'. If you're curious, you can read our Privacy Notice.
