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

Choi, Namkee G.; DiNitto, Diana M.

doi:10.1080/00952990.2021.1908318

Cited by 9 publications

(5 citation statements)

References 33 publications

(39 reference statements)

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“…Similar to our study, among users ( n = 7548) registered in a medical cannabis program, 23.6% were ≥ 65 years old [ 27 ]. These results support reports that older adults are more likely to seek clinical sources for medical cannabis use than young and middle-aged groups [ 25 ]. Similar to other studies [ 19 , 20 , 26 , 34 – 36 ], older adults in this study, particularly women, sought medical cannabis most often for pain relief.…”

Section: Discussionsupporting

confidence: 90%

“…However, poor sleep and anxiety were less common than in community (38% and 24%) and clinic-based (29% and 24%) studies [ 35 , 36 ]. These differences may be due to a higher proportion of older adults seeking cannabis for medical purposes [ 25 ], biases in convenience sampling, though increasing social acceptance, easy accessibility, and high rates of self-medication for mood and anxiety symptoms [ 37 ] may also be potential factors. In our results and those of others, older women were frequent medical cannabis users [ 35 , 36 , 38 ].…”

Section: Discussionmentioning

confidence: 99%

“…Older adults use cannabis for medical conditions more often than young and middle-aged adults [ 24 , 25 ], with more than half (52.0%) reporting medical use exclusively, and an additional 23.6% reporting cannabis use for medical and non-medical purposes [ 13 ]. These conditions include chronic pain due to musculoskeletal disorders and cancer, chemotherapy-associated nausea, vomiting and loss of appetite, and various neurological and inflammatory conditions [ 26 , 27 ].…”

Section: Introductionmentioning

confidence: 99%

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Medical Cannabis Use Among Older Adults in Canada: Self-Reported Data on Types and Amount Used, and Perceived Effects

et al. 2021

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Background Medical cannabis use is growing among older adults. In this retrospective study, we aimed to assess the characteristics of older medical cannabis users including the indications, type and amount of cannabis used, perceived changes in symptoms after cannabis use, change in dose of concurrent medications, and adverse effects. Methods Data were collected between October 2014 and October 2020 from patients who were consulting the Canada-wide network of clinics of a medical cannabis provider and who were willing to answer questionnaires based on their medical status. The current study included older adults (≥ 65 years) who completed questionnaires at intake and first follow-up visits. Data were summarized with descriptive statistics, which were compared between men and women with t tests or chi-squared tests. Tests of proportions assessed categorical responses for perceived effects after cannabis use. Logistic regression was used to assess trends in cannabis usage. Results Data included that from 9766 older adult users at intake (mean ± SD age = 73.2 ± 6.8 years, females = 60.0%), among whom 4673 (females = 61.4%) returned for follow-up after 90.6 ± 58 days. The most common primary indication for which medical cannabis was sought was pain (67.7%), which was more common in women, whereas oncological and neurological conditions were more common in men. At follow-up, cannabis oil was used by 81.0% of older adults, among whom compositions containing only or mostly cannabidiol (CBD) had been used by 83.6%. Adverse effects reported by older adults at the follow-up visit included dry mouth (12.8%), drowsiness (8.6%), and dizziness (4.0%). The majority of older adults reported improvements in pain (72.7%, z = 1482.6, p < 0.0001, compared to worsening or no change), sleep (64.5%, z = 549.4, p < 0.0001), and mood (52.8%, z = 16.4, p < 0.0001), with 35.6% reporting use of a reduced dose of opioids and 19.9% a reduced dose of benzodiazepines. Interpretation Among older adults, medical cannabis is used more often by women, with CBD-containing cannabis oils being the most commonly used. Users reported improved pain, sleep, and mood symptoms at follow-up after cannabis use. This study describes the patterns of use of medical cannabis by older adults and highlights the need for research to determine appropriate indications, precise doses of active ingredients, and short- and long-term outcomes among older adults. Supplementary Information The online version contains supplementary material available at 10.1007/s40266-021-00913-y.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Medical Cannabis Use Among Older Adults in Canada: Self-Reported Data on Types and Amount Used, and Perceived Effects

et al. 2021

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“…MC licenced patient numbers have however grown substantially with over 300,000 MC patients in Canada in 2020 and nearly 3 million in the US, with the majority receiving authorization for chronic pain (Boehnke et al, 2019a;Boehnke et al, 2022;Canada, 2022). Using the 2018 and 2019 National Survey on Drug Use and Health data for US subjects at least 50 years of age, past year cannabis use was at 9% for that age group, with almost one-fifth reporting medical use (Choi and DiNitto, 2021). In this study, cannabis was mostly obtained from private/informal sources and medical users were often self treating and without healthcare consultation.…”

Section: Evolving Patient Acceptance Of Medical Cannabismentioning

confidence: 77%

The evolving culture of medical cannabis in Canada for the management of chronic pain

Clarke

Fitzcharles

2023

Front. Pharmacol.

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Although used therapeutically for millennia, cannabis has been a prohibited substance worldwide for most of the 20th Century. With revision of prohibitive regulations in many jurisdictions during the past 2 decades, cannabis is increasingly available to patients as a potential treatment option for various symptoms. Pain relief, sleep promotion and alleviation of distress, depression and anxiety are the most common reasons for cannabis use. Canada has been at the forefront of medical cannabis (MC) legislation revisions to enable and facilitate access for therapeutic use. Although initially viewed with caution and stigma, attitudes to cannabis in general have changed. Medical cannabis is identified as the herbal plant product sourced from a grower/producer and is not at present a regulated pharmaceutical product. Medical cannabis use is currently prevalent in Canada but has bypassed the rigorous study required for usual drug approval. Although uptake has been enthusiastic by patients, the medical community has voiced cautions and concerns. Access to medical cannabis is fairly easy once an approval document is obtained from a healthcare professional, but without obligation for medical or pharmacy oversight. The greatest concern is a dearth of sound clinical evidence for effects and harms. Emerging concerns include prevalent patient self-management with information based on personal research, an abundance of on-line information which may not always be accurate, the emergence of designated “cannabis clinics,” potential risks to society due to accidents, and high cost of the legal medical product leading to access via the recreational market. With cannabis now entrenched in Canadian healthcare, physicians must be sufficiently knowledgeable to provide guidance that is evidence-based and will ensure personal and societal harm reduction. Examination of the changing culture of medical cannabis in Canada will provide insight for countries that may be anticipating similar revisions of cannabis regulations to allow cannabis access for their patient population and learn from the issues created by recreational legalization.

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“…But of those who reported medical use, only a minority said they had discussed this with a healthcare professional. (See Choi and DiNitto, 2021. )…”

mentioning

confidence: 99%

Who Should Be Screened for Marijuana Use? All Adults? All Seniors? Or Nobody?

2021

The Back Letter

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T he United States is undergoing a dramatic change in the organization of medical services. Before the last decade most US physicians worked in practices they or other doctors owned.However, the number of independent US medical practices is plummeting. A 2018 survey found that about a third of US physicians are now employed directly or indirectly by hospitals or hospital-owned practices. That same survey found that only 31% of physicians had an independent medical practice-down from 48.5% in 2012. (See Young et al., 2021; Physicians Foundation, 2018.) So what impact does hospital ownership have on medical practices? Hospitals boast that the integration of services improves the quality of medical care. But the jury is still out on this issue.Critics suggest that the consolidation of medical practices is often a prelude to raising prices. They are also concerned that the integration of medical practices will lead to medical overuse and waste through the increasing referral of patients for profitable hospital services.A new study suggests that the change in the pattern of US healthcare services is a concern. Gary J. Young of Northeastern University and colleagues found that hospital ownership of medical practices led to an increased rate of expensive, inappropriate medical imaging.These researchers used claims data to study patients with three conditions: (1) uncomplicated low back pain; (2) nontraumatic knee pain without effusion (swelling), and (3) shoulder pain without effusion. They wanted to know whether physicians employed directly by hospitals ordered more MRI scans than doctors in independent practices.They gathered data on physician employment from Medicare claims data and the records of healthcare organizations. The study included 583 primary care

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

Cited by 9 publications

References 33 publications

Medical Cannabis Use Among Older Adults in Canada: Self-Reported Data on Types and Amount Used, and Perceived Effects

Medical Cannabis Use Among Older Adults in Canada: Self-Reported Data on Types and Amount Used, and Perceived Effects

The evolving culture of medical cannabis in Canada for the management of chronic pain

Who Should Be Screened for Marijuana Use? All Adults? All Seniors? Or Nobody?

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