The Cannabis and Older Persons Study: Has Science Caught Up With Practice Yet?

Abstract Since 2016, the Cannabis and Older Persons Study has examined the increasing use of cannabis among Americans over 60 years old. Our current work dives into particular groups of cannabis users and explores outcomes related to medical conditions and symptoms. This symposium also features a range of methodological approaches from an analysis of the BRFSS caregiving and cannabis modules, a convenience sample of more than 4,000 older cannabis users enrolled in the Illinois Medical Cannabis Program and qualitative interviews conducted with aging veterans. Kanika Arora examines the association between informal caregiving and marijuana use and whether this association varies by age. Julie Bobitt shares findings from 32 interviews with older Veteran cannabis users. Alton Croker examines cannabis use as a complement or alternative to palliative care. HyoJung Kang clusters negative outcomes experienced by older persons who use cannabis. Brian Kaskie compares cannabis use among persons with Multiple Sclerosis (N=135) and persons diagnosed with arthritis (N=582) or cancer (N=622). While we certainly find reason to remain concerned that cannabis use alone and co-occurring use with prescription opioids may contribute to increased rates of substance misuse and other undesirable outcomes among older adults, we find it increasingly difficult to overlook the benefits many persons derive when taking cannabis as a method to manage pain or address other medical conditions. At this point, public policy officials and program administrator should strive to strike a balance between addressing cannabis harms relative to promoting benefits such as opioid reduction and diversion.

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Cannabis Use among Older Persons with Arthritis, Cancer and Multiple Sclerosis: Are We Comparing Apples and Oranges?

Brain Sciences ◽

10.3390/brainsci11050532 ◽

2021 ◽

Vol 11 (5) ◽

pp. 532

Author(s):

Brian Kaskie ◽

Hyojung Kang ◽

Divya Bhagianadh ◽

Julie Bobitt

Keyword(s):

Multiple Sclerosis ◽

Older Persons ◽

Behavioral Outcomes ◽

Cannabis Use ◽

Medical Cannabis ◽

Opioid Use ◽

Quality Of Sleep ◽

Impact Processes ◽

Lower Baseline

Although researchers have identified medications that relieve symptoms of multiple sclerosis (MS), none are entirely effective and some persons with multiple sclerosis (PwMS) use alternatives. Our study compared cannabis use among PwMS (N = 135) and persons diagnosed with arthritis (N = 582) or cancer (N = 622) who were age 60 and older, enrolled in the State of Illinois Medical Cannabis Program, and invited to complete a survey fielded between June and September, 2019. We used logistic regression to identify significant differences in self-reported effects of cannabis on psychological wellbeing, quality of life, and three behavioral outcomes, and we also considered effects of past year opioid use relative to these outcomes. We found that the majority of individuals from all groups used cannabis to address pain and improve quality of sleep. While PwMS reported lower baseline levels across all five outcomes, we found that the reported effects of cannabis were largely comparable across the groups. We also found that cannabis benefitted persons with sleep and digestive issues regardless of condition, whereas persons who used opioids in addition to cannabis were less likely to experience an improvement in any of the outcomes. This comparative evaluation suggests that cannabis’ effects are not specific to MS, arthritis, or cancer as much as they impact processes common among these distinct conditions. We also found evidence that cannabis may be a viable alternative to opioids for those with these conditions and experiencing pain.

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ASSESSING HEALTH-RELATED OUTCOMES OF MEDICAL CANNABIS USE AMONG OLDER PERSONS IN COLORADO AND ILLINOIS

Innovation in Aging ◽

10.1093/geroni/igz038.738 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S204-S204 ◽

Cited By ~ 1

Author(s):

J Alton Croker ◽

Julie Bobitt ◽

Kanika Arora ◽

Brian Kaskie

Keyword(s):

Older Persons ◽

Sleep Disturbances ◽

Cannabis Use ◽

Medical Cannabis ◽

Treatment Needs ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Specific Patient ◽

Patient Reported ◽

Health Related

Abstract The use of cannabis is increasing among older Americans. A growing body of evidence shows cannabis and cannabinoids effective for treating chronic pain, spasticity, nausea, and sleep disturbances. States seeking to respond to the treatment needs of specific patient populations have legalized the use of cannabis for medical purposes. Few instruments offer standard outcomes for understanding the use of medial cannabis from the patient perspective, particularly focusing on older persons. Using cross-sectional survey data from a sample of older persons in Colorado and Illinois, we validate two scales to consistently measure patient-reported health related outcomes of medical cannabis use. We confirmed the validity of two separate, reliable outcome scales: a three-factor scale for measuring global health outcomes and a single-factor scale for capturing adverse health events. The COPS questionnaire revealed strong construct validity and internal consistency, and a lack of meaningful factor variance.

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Assessing Health-Related Outcomes of Medical Cannabis Use among Older Persons: Findings from Colorado and Illinois

Clinical Gerontologist ◽

10.1080/07317115.2020.1797971 ◽

2020 ◽

Vol 44 (1) ◽

pp. 66-79 ◽

Cited By ~ 2

Author(s):

James Alton Croker ◽

Julie L. Bobitt ◽

Kanika Arora ◽

Brian Kaskie

Keyword(s):

Older Persons ◽

Cannabis Use ◽

Medical Cannabis ◽

Health Related

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Medical cannabis use in the Australian community following introduction of legal access: The 2018-2019 Online Cross-Sectional Cannabis as Medicine Survey (CAMS-18)

10.21203/rs.2.24266/v2 ◽

2020 ◽

Author(s):

Nicholas Lintzeris ◽

Llewellyn Mills ◽

Anastasia Suraev ◽

Maria Bravo ◽

Thomas Arkell ◽

...

Keyword(s):

Mental Health ◽

Chronic Pain ◽

Online Survey ◽

Medical Profession ◽

Cannabis Use ◽

Medical Cannabis ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Convenience Sample ◽

Plant Matter

Abstract Background: In 2016 the Australian federal government passed legislation enabling a range of cannabis-based products to be prescribed to patients by registered healthcare professionals. An online survey conducted immediately prior to these legislative changes found that the vast majority of respondents at the time were illicitly sourcing cannabis plant matter, smoking was the preferred route of administration, and mental health, chronic pain, and sleep conditions were the most frequently cited reasons for medical cannabis use. This manuscript reports the results of a follow-up survey conducted in 2018-2019, the Cannabis As Medicine Survey (CAMS-18). The goal of this second questionnaire was to examine patterns of use and consumer perspectives regarding medical cannabis use in Australia, two years after the introduction of legal access pathways. Methods: Anonymous online cross-sectional survey with convenience sample, recruited mainly through online media between September 2018 and March 2019. Participants were adults (18 years or over) residing in Australia who reported using a cannabis product for self-identified therapeutic reasons during the preceding 12 months. The survey measured consumer characteristics; indications and patterns of medical cannabis use; routes and frequency of administration; perceived benefits and harms; experiences and preferred models of access to medical cannabis. Results: Data were available for 1388 respondents. The main categories of condition being treated with medical cannabis were pain (36.4%), mental health (32.8%), sleep (9.2%), neurological (5.2%) and cancer (3.8%). Respondents reported using medical cannabis on 15.8 (11.2) days in the past 28, by inhaled (71.4%) or oral (26.5%) routes and spending AUD$82.27 ($101.27) per week. There were high levels of self-reported effectiveness, but also high rates of side effects. There was uncertainty regarding the composition of illicit cannabinoid products and concerns regarding their possible contamination. Few respondents (2.7%) had accessed legally prescribed medical cannabis, with the main perceived barriers being cost, disinterest from the medical profession, and stigma regarding cannabis use. Conclusions: Chronic pain, mental health and sleep remain the main clinical conditions for which consumers report using medical cannabis. Despite two years of legal availability, most consumers in Australia reported accessing illicit cannabis products, with uncertainty regarding the quality or composition of cannabis products.

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Concomitant Cannabis Misuse and Associations with Depression, Pain and Substance Misuse among Patients Prescribed Opioids

Pharmacy ◽

10.3390/pharmacy9030134 ◽

2021 ◽

Vol 9 (3) ◽

pp. 134

Author(s):

M. Aryana Bryan ◽

Elizabeth Charron ◽

Omolola Adeoye-Olatunde ◽

Jennifer Brown ◽

Udi Ghitza ◽

...

Keyword(s):

Depressive Symptoms ◽

High Risk ◽

Substance Misuse ◽

Monitoring Program ◽

Secondary Data ◽

Cannabis Use ◽

Community Pharmacies ◽

Medical Cannabis ◽

Abuse Treatment ◽

The Relationship

Background: Cannabis use is common among individuals with pain who are prescribed opioids, occurring in approximately 10% of this population. This study aims to explore the relationship between non-medical cannabis use and other health risks among individuals filling opioids at community pharmacies. Methods: This study was an exploratory secondary data analysis of a National Drug Abuse Treatment Clinical Trials Network (CTN)-sponsored study, Validation of a Community Pharmacy-Based Prescription Drug Monitoring Program Risk Screening, examining the relationship between risky cannabis use and depressive symptoms, pain, overdose, and other substance misuse among individuals filling opioid prescriptions in community pharmacies (N = 1440). Results: Participants reporting moderate- to high-risk compared to low-risk cannabis use were more likely to report depressive symptoms (adjusted OR = 1.67, 95% CI = 1.11–2.56), history of overdose (adjusted OR = 2.15, 95% CI = 1.34–3.44), and moderate- to high-risk use of alcohol (adjusted OR = 2.10, 95% CI = 1.28–3.45), opioids (adjusted OR = 2.50, 95% CI = 1.67–3.76), sedatives (adjusted OR = 2.58, 95% CI = 1.72–3.86), stimulants (adjusted OR = 4.79, 95% CI = 2.83–8.01), and tobacco (adjusted OR = 3.60, 95% CI = 2.47–5.24). Conclusions: Community pharmacies may be valuable sites for identifying, studying, and intervening with substance use problems.

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POLICY SERIES: REEFER MADNESS, SADNESS, OR GLADNESS? THE CANNABIS AND OLDER PERSONS STUDY

Innovation in Aging ◽

10.1093/geroni/igz038.735 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S203-S203

Author(s):

Brian P Kaskie ◽

Julie Bobitt

Keyword(s):

Older Adults ◽

Program Implementation ◽

Policy Development ◽

Older Persons ◽

Symptom Relief ◽

Cannabis Use ◽

Medical Cannabis ◽

Dementia Caregivers ◽

Provider Perspectives ◽

Cannabis Policy

Abstract In 2016, we began our examination of the intersection between cannabis and older persons by convening focus groups with 163 older adults from senior centers and dispensaries in nine states with varying levels of cannabis legalization. Since then, we have secured competitive research grants and contracts to examine cannabis use among older persons in California, Colorado, Illinois and Iowa. Our work is guided by the primary hypothesis that cannabis use among older persons is shaped by an individual’s calculations concerning risk (e.g., developing a cannabis use disorder, lawbreaking) and reward (e.g., relaxation, symptom relief), and individuals living in a state with a legal cannabis program may perceive less risk and also may be receiving more information about the benefits of cannabis. We also hypothesize that older adults’ access to and use of cannabis is shaped by where they live, particularly defined by local cannabis program implementation efforts and relevant contextual conditions. In this symposium, we will examine our latest work concerning (a) life-span attitudes toward cannabis, (b) clinical perspectives on counseling and certifying older persons for medical cannabis, (c) provider perspectives on state cannabis policy and program implementation, (d) cannabis use among a sample of dementia caregivers and (e) outcomes experienced by older persons who use cannabis for medical or recreational purposes. Our discussion focuses on implication for policy development and program implementation.

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Medical cannabis use in the Australian community following introduction of legal access: The 2018-2019 Online Cross-Sectional Cannabis as Medicine Survey (CAMS-18)

10.21203/rs.2.24266/v1 ◽

2020 ◽

Author(s):

Nicholas Lintzeris ◽

Llewellyn Mills ◽

Anastasia Suraev ◽

Maria Bravo ◽

Thomas Arkell ◽

...

Keyword(s):

Mental Health ◽

Chronic Pain ◽

Online Survey ◽

Medical Profession ◽

Cannabis Use ◽

Medical Cannabis ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Convenience Sample ◽

Plant Matter

Abstract Background : In 2016 the Australian federal government passed legislation enabling a range of cannabis-based products to be prescribed to patients by registered healthcare professionals. An online survey conducted immediately prior to these legislative changes found that the vast majority of respondents at the time were illicitly sourcing cannabis plant matter, smoking was the preferred route of administration, and mental health, chronic pain, and sleep conditions were the most frequently cited reasons for medical cannabis use. This manuscript reports the results of a follow-up survey conducted in 2018-2019, the Cannabis As Medicine Survey (CAMS-18). The goal of this second questionnaire was to examine patterns of use and consumer perspectives regarding medical cannabis use in Australia, two years after the introduction of legal access pathways. Methods : Anonymous online cross-sectional survey with convenience sample, recruited mainly through online media between September 2018 and March 2019. Participants were adults (18 years or over) residing in Australia who reported using a cannabis product for self-identified therapeutic reasons during the preceding 12 months. The survey measured consumer characteristics; indications and patterns of medical cannabis use; routes and frequency of administration; perceived benefits and harms; experiences and preferred models of access to medical cannabis. Results : Data were available for 1388 respondents. The main categories of condition being treated with medical cannabis were pain (36.4%), mental health (32.8%), sleep (9.2%), neurological (5.2%) and cancer (3.8%). Respondents reported using medical cannabis on 15.8 (11.2) days in the past 28, by inhaled (71.4%) or oral (26.5%) routes and spending AUD$82.27 ($101.27) per week. There were high levels of self-reported effectiveness, but also high rates of side effects. There was uncertainty regarding the composition of illicit cannabinoid products and concerns regarding their possible contamination. Few respondents (2.7%) had accessed legally prescribed medical cannabis, with the main perceived barriers being cost, dis-interest from the medical profession, and stigma regarding cannabis use. Conclusions : Chronic pain, mental health and sleep remain the main clinical conditions for which consumers report using medical cannabis. Despite two years of legal availability, most consumers in Australia reported accessing illicit cannabis products, with uncertainty regarding the quality or composition of cannabis products.

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