Characteristics of Older Adults Who Were Early Adopters of Medical Cannabis in the Florida Medical Marijuana Use Registry

Abstract

Use of medical marijuana is increasing in the United States and older adults are the fastest growing user group. There is little information about the characteristics and outcomes related to medical marijuana use. This study is a descriptive analysis of older adults (aged ≥50 years old) who were early adopters of a medical marijuana program in the U.S. state of Florida. Per state legislation, initial and follow-up treatment plans were submitted to the University of Florida College of Pharmacy. Data collection included demographics, clinical history, medical conditions, substance use history, prescription history, and health status. Follow-up treatment plans noted changes in the chief complaint and actions taken since the initial visit. Of the state’s 7548 registered users between August 2016 and July 2017, N = 4447 (58.9%) were older adults. Patients utilized cannabidiol (CBD)-only preparations (45%), preparations that had both tetrahydrocannabinol (THC) and CBD (33.3%) or were recorded to use both CBD-only and THC + CBD products (21.7%). The chief complaints indicating medical cannabis treatment were musculoskeletal disorders and spasms (48.4%) and chronic pain (45.4%). Among other prescription medications, patients utilized antidepressants (23.8%), anxiolytics and benzodiazepines (23.5%), opioids (28.6%), and cardiovascular agents (27.9%). Among all drug classes with potential sedating effects, 44.8% of the cohort were exposed to at least one. Patients with follow-up visits (27.5%) exhibited marked improvement as assessed by the authorizing physicians. However, the patient registry lacked detailed records and linkable information to other data resources to achieve complete follow up in order to assess safety or efficacy. Future improvements to registries are needed to more adequately capture patient information to fill knowledge gaps related to the safety and effectiveness of medical marijuana, particularly in the older adult population.

Natural and Synthetic Cannabinoids: Pharmacology, Uses, Adverse Drug Events, and Drug Interactions

“…The effects of THC on cognition, including euphoria, sedation, and dissociative effects, are typically thought to be responsible for pain relief, which is a primary reason for medical cannabis and cannabinoid use 62,75,83 . THC use, however, is also associated with long‐term memory deficits 84,85 .…”

Demographics, Perceptions, and Use of Medical Marijuana among Patients in Florida

“…Reblin and colleagues [12] investigated MMJ use practices among Florida MMJ glioma patients. Brown et al [3] analyzed the data of adults aged 50 and older who were early adopters of MMJ in Florida and found many were using MMJ to treat musculoskeletal disorders and spasms (48.4%), chronic pain (45.4%), cancer (15.5%), and psychological disorders (including PTSD) (23.2%). Almost 73% reported at least some improvement of their condition since initiating treatment.…”

“…The National Academies of Sciences, Engineering, and Medicine report [2] analyzed over 10,000 studies and concluded that cannabis and/or cannabinoids are effective for treating a variety of symptoms including chronic pain, nausea and vomiting, and stimulating hunger. Today, individuals use medical marijuana (MMJ) to treat a wide range of health conditions, including chronic pain, muscle spasms, anxiety, depression, PTSD, insomnia, headache, nausea, appetite issues, cancer, and the adverse effects of cancer chemotherapy [1,[3][4][5][6].…”

Comparing older nonmedical and medical cannabis users: health-related characteristics, cannabis use patterns, and cannabis sources

“…In eight states with medical cannabis laws (MCL) in 2014-2015, one third to more than one-half of medical cannabis registrants were aged 50+ (11). Of Florida's 7,548 registered medical users between August 2016 and July 2017, 58.9% were aged 50+; their chief medical complaints were musculoskeletal disorders and spasms, chronic pain, and PTSD or other psychological disorders (12). Our analysis of 2019 NSDUH data showed that 18.8% of past-year cannabis users aged 50+, compared to 11.3% of cannabis users aged 18-49, reported medical use.…”