Study shows ‘sharp’ drop in perceived risks of cannabis use in older adults
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The perceived risks associated with regular cannabis use declined among older adults in the United States during a recent 5-year period, a trend analysis showed.
Past-year cannabis use in older adults in the United States appears to be increasing: previously published data in JAMA Internal Medicine indicate the percentage jumped from 0.7% in 2009 to 4.2% in 2018.
In the new study, Benjamin Han, MD, MPH, a geriatrician and addiction medicine physician in the department of medicine at the University of California, San Diego, and colleagues analyzed data from a repeated cross-sectional sample of 18,794 adults aged 65 years and older who completed the 2015 to 2019 National Survey on Drug Use and Health.
The researchers reported in the Journal of the American Geriatrics Society that in 2015, an estimated 52.6% of the survey sample perceived “great risk” from using cannabis weekly. By 2019, this estimate had lowered to 47.2% (relative decrease = 18.8%; P < .001). The largest drops occurred among those respondents who never married (43.9% to 29.6%; relative decrease = 32.6%, P = .02); men (46.2% to 36%; relative decrease = 22.1%, P < .001); and residents of states where medical cannabis was legal at the time the survey was completed (49.2% to 39.8%; relative decrease = 19.1%, P < .001).
Han and colleagues also reported significant reductions in perceived risk from 2015 to 2019 among survey respondents with a heart condition, type 2 diabetes and hypertension. “Notable” drops were also observed in patients with kidney disease (58.6% to 39.8%; relative decrease = 32.1%, P = .001), COPD (50.3% to 39.5%; relative decrease = 21.5%, P = .02), and two or more chronic conditions (51.6% to 41.2%; relative decrease = 20.2%, P < .001), according to the researchers. In addition, they noted “sharp” reductions in perceived risk among those who in the past month either used tobacco (36.6% to 26.8%; relative decrease = 26.8%, P = .001) or binge drank (33.2% to 22.8%; relative decrease = 31.3%, P = .004).
“It is hard to say this is a good or bad thing given the absence of large, randomized‐controlled clinical trials that we expect from other therapeutics for practicing evidence‐based medicine,” Han told Healio Primary Care.
He said research into the risks of cannabis use in older individuals is “very limited,” but those risks may include postural hypotension, dizziness and confusion. A patient’s exact risks “depend largely on the individual person, their underlying chronic diseases and what other medications they use,” Han said.
“It can also depend on what type of cannabis products they are using,” he added.
These variations aside, health care professionals should “emphasize that any medication, but especially those with psychoactive properties, has potential for harms, especially among people with existing chronic diseases,” Han said.
“Clinicians should convey the possible risks for cannabis use in light of unclear benefits, especially for older adults at high risk for harms, including people who engage in unhealthy alcohol use, tobacco use or have certain chronic conditions,” he said.
References:
Han BH, et al. J Am Geriatr Soc. 2021;doi: 10.1111/jgs.17213.
Han BH, et al. JAMA Intern Med. 2020;doi:10.1001/jamainternmed.2019.7517.