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

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.

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

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.

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

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S204-S204 ◽  
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.

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

2020 ◽  
Vol 44 (1) ◽  
pp. 66-79 ◽  
Author(s):  
James Alton Croker ◽  
Julie L. Bobitt ◽  
Kanika Arora ◽  
Brian Kaskie
Keyword(s):  
Older Persons ◽  
Cannabis Use ◽  
Medical Cannabis ◽  
Health Related

scholarly journals Risk and Protective Factors Associated with Cannabis Use in Massachusetts Youth

2021 ◽  
Author(s):  
Julie Johnson ◽  
Samantha Doonan
Keyword(s):  
Protective Factors ◽  
Risk Behavior ◽  
Sexual Behaviors ◽  
Risky Behaviors ◽  
Risk And Protective Factors ◽  
Cannabis Use ◽  
Sensitivity Analyses ◽  
Evidence Based ◽  
Medical Cannabis ◽  
Cannabis Policy

Cannabis policies are continuously evolving, over half of U.S. youth now live in a state with a form of legalized cannabis. Monitoring risk and protective factors is critical to ensure evidence-based youth prevention in this post cannabis-prohibition era. Massachusetts has enacted and implemented three forms of legalization: (1) Decriminalization (2008), (2) medical cannabis (2012), and (3) adult-use cannabis (2016). This study used state Youth Risk Behavior Survey (YRBS) data of participants in grades 9-12 from 2007-2017 (N=17,691). Logistical regression models were run to assess effects of varying cannabis policy and risk or protective behaviors on cannabis use outcomes: (1) Lifetime use; (2) Past 30-day; and (3) Past 30-day heavy use. The enactment of cannabis policies was not associated with greater odds of youth reporting Lifetime and Past 30-day cannabis use behaviors. Any adult-support [heavy use OR=0.43 (95% CI=0.37,0.50), p<.001], better grades [heavy use OR=0.25 (95% CI=0.21,0.29), p<.001], and being heterosexual [heavy use OR=0.42 (95% CI=0.34,0.51), p<.001] were associated with lower odds of all cannabis use outcomes. Multiple risk factors broadly categorized under: risky sexual behaviors, non-heterosexual orientation, weapon carrying/exposure, hopelessness and suicidality behaviors, driving behaviors, and disability were associated with greater odds of cannabis use. Sensitivity analyses showed only one risk behavior was moderate by cannabis policy enactment. Results suggest that cannabis prevention efforts should not occur in a silo, rather evidence-based models for reducing risky behaviors generally may have the largest impact. Building and supporting relationships with trusted adults for youth at higher risk should be emphasized.

scholarly journals The costs and benefits of cannabis control policies

2020 ◽  
Vol 22 (3) ◽  
pp. 281-287
Keyword(s):  
Developed Countries ◽  
Cannabis Use ◽  
Costs And Benefits ◽  
Medical Cannabis ◽  
Considerable Uncertainty ◽  
Trade Offs ◽  
The Face ◽  
Cannabis Policy ◽  
Recreational Use ◽  
Harmful Effects

As is the case for most drugs, cannabis use has costs and benefits, and so do the policies that attempt to minimize the first and maximize the second. This article summarizes what we know about the harmful effects of recreational cannabis use and the benefits of medical cannabis use under the policy of prohibition that prevailed in developed countries until 2012. It outlines three broad ways in which cannabis prohibition may be relaxed, namely, the depenalization of personal possession and use, the legalization of medical use, and the legalization of adult recreational use. It reviews evidence to date on the impacts of each of these forms of liberalization on the costs and benefits of cannabis use. It makes some plausible conjectures about the future impacts of the commercialization of cannabis using experience from the commercialization of the alcohol, tobacco, and gambling industries. Cannabis policy entails unavoidable trade-offs between competing social values in the face of considerable uncertainty about the effects that more liberal cannabis policies will have on cannabis use and its consequences for better or worse.

scholarly journals Disparity between Perceptual Fall Risk and Physiological Fall Risk in Older Cannabis Users: A Pilot Study

2021 ◽  
Vol 19 (1) ◽  
pp. 109
Author(s):  
Craig D. Workman ◽  
Jacob J. Sosnoff ◽  
Thorsten Rudroff
Keyword(s):  
Older Adults ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Dynamic Balance ◽  
Cannabis Use ◽  
Group Differences ◽  
Strong Correlations ◽  
Medical Cannabis ◽  
Future Studies

Aging is associated with cognitive decline and increased fall risk. Cognitive impairment is associated with cannabis use, which is increasing among older adults. Perceptual and physiological fall risk are discordant in some older adults, but whether cannabis use influences this association is unknown. The purpose of this study was to investigate possible disparities between perceptual and physiological fall risk in older cannabis users. Eight older medical cannabis users and eight sex- and age-matched non-users provided data on perceptual and physiological fall risk. Group differences were assessed, and perceptual fall risk was correlated with physiological fall risk. Perceptual risk and most of the physiological fall risk variables were equivalent between the groups. However, cannabis users performed significantly worse on unipedal stance than non-users. In addition, perceptual fall risk had weak correlations with physiological fall risk in the users (Spearman’s rho = 0.17–0.41) and moderate-strong correlations in non-users (rho = −0.18–0.67). Cannabis users might have a discrepancy between perceptual and physiological fall risk. Because both concepts play a role in quality of life, identifying strategies to improve them may have significant benefits. Future studies investigating additional perceptual (e.g., cognition, fear of falling, depression, anxiety), physiological (e.g., more challenging static and dynamic balance conditions), and general fall risk are warranted.

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

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 510-510
Author(s):  
Brian Kaskie
Keyword(s):  
Older Persons ◽  
Substance Misuse ◽  
Qualitative Interviews ◽  
Cannabis Use ◽  
Prescription Opioids ◽  
Medical Conditions ◽  
Medical Cannabis ◽  
Convenience Sample ◽  
Program Administrator ◽  
Methodological Approaches

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.

scholarly journals Mental Health and Cognition in Older Cannabis Users: a Review

2020 ◽  
Vol 23 (3) ◽  
pp. 237-244
Author(s):  
Blanca E. Vacaflor ◽  
Olivier Beauchet ◽  
G. Eric Jarvis ◽  
Alessandra Schiavetto ◽  
Soham Rej
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Adverse Effects ◽  
Low Dose ◽  
Community Dwelling ◽  
Cannabis Use ◽  
Cognitive Effects ◽  
Medical Cannabis ◽  
Short Term ◽  
The Impact

Background The impact of cannabis use on mental health and cognition in older adults remains unclear. With the recent legalization of cannabis in Canada, physicians will need up-to-date infor­mation about the mental and cognitive effects of cannabis use in this specific population. Method A narrative review was conducted to summarize the literature on mental health and cognitive effects of cannabis use in older adults using Medline (OvidSP). Results A total of 16 studies were identified, including nine cross-sectional studies on mental health comorbidities reported by older cannabis users. The self-reported prevalence of mental and substance use disorders is approximately two to three times higher in older adults who report past-year cannabis use, compared to older adults who report using more than one year ago or never using. The remaining seven clinical trials found that short-term, low-dose medical cannabis was generally well-tolerated in older adults without prior serious mental illness. However, mental/cognitive adverse effects were not systematically assessed. Conclusion Although preliminary findings suggests that low-dose, short-term medical cannabis does not carry significant risk of serious mental health and cognitive adverse effects in older adults without prior psychiatric history, epidemiological studies find a correlation between past-year cannabis use and poor mental health outcomes in community-dwelling older adults. These findings may indicate that longer term cannabis use in this population is detrimental to their mental health, al­though a direct causal link has not been established. Larger, longitudinal studies on the safety of medical cannabis in older adults are needed.

scholarly journals Danish cannabis policy revisited: Multiple framings of cannabis use in policy discourse

2021 ◽  
pp. 145507252110186
Author(s):  
Thomas Friis Søgaard ◽  
Maj Nygaard-Christensen ◽  
Vibeke Asmussen Frank
Keyword(s):  
Drug Policy ◽  
Medical Problem ◽  
Organised Crime ◽  
Cannabis Use ◽  
Law And Order ◽  
Medical Cannabis ◽  
Crime Problem ◽  
Policy Problem ◽  
Recent Developments ◽  
Cannabis Policy

Aim: This article traces recent developments in Danish cannabis policy, by exploring how “cannabis use” is problematised and governed within different co-existing policy areas. Background: Recently, many countries have changed their cannabis policy by introducing medical cannabis and/or by moving toward legalisation or decriminalisation. Researchers have thus argued that traditional notions of cannabis as a singular and coherent object, are being replaced by perspectives that highlight the multiple ontological character of cannabis. At the same time, there is growing recognition that drug policy is not a unitary phenomenon, but rather composed by multiple “policy areas”, each defined by particular notions of what constitutes the relevant policy “problem”. Design: We draw on existing research, government reports, policy papers and media accounts of policy and policing developments. Results: We demonstrate how Danish cannabis policy is composed of different co-existing framings of cannabis use; as respectively a social problem, a problem of deviance, an organised crime problem, a health- and risk problem and as a medical problem. Conclusion: While the international trend seems to be that law-and-order approaches are increasingly being replaced by more liberal approaches, Denmark, on an overall level, seems to be moving in the opposite direction: Away from a lenient decriminalisation policy and towards more repressive approaches. We conclude that the prominence of discursive framings of cannabis use as a “problem of deviance” and as “a driver of organised crime”, has been key to this process.

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