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

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.

Download Full-text

Comparing Cannabis Use Across Diagnosed Conditions: Apples and Oranges?

Innovation in Aging ◽

10.1093/geroni/igab046.1960 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 510-511

Author(s):

Brian Kaskie

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Social Activity ◽

Well Being ◽

Cannabis Use ◽

Prescription Opioid ◽

Medical Cannabis ◽

Opioid Use ◽

Prescription Opioid Use

Abstract 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 participated in the Illinois medical cannabis program. We tested for significant differences across psychological well-being, quality of life and three behavioral outcomes, and also considered effects of co-occurring prescription opioid use. A majority of all individuals used cannabis to address pain and improve quality of sleep. PwMS reported lower levels of productivity, exercise and social activity, and cannabis was less helpful with improving these particular outcomes. Most persons used cannabis for sleep or digestive problems and we found no differences across groups in terms of well-being and quality of life. This comparative evaluation suggests cannabis mechanisms are not specific as much as they impact common processes.

Download Full-text

Assessment of Fatigue in Multiple Sclerosis

Neurology International Open ◽

10.1055/s-0043-104752 ◽

2017 ◽

Vol 1 (02) ◽

pp. E79-E85 ◽

Cited By ~ 2

Author(s):

Carina Sander ◽

Hans-Ulrich Voelter ◽

Hans-Peter Schlake ◽

Paul Eling ◽

Helmut Hildebrandt

Keyword(s):

Multiple Sclerosis ◽

Cognitive Performance ◽

Causal Relation ◽

Subjective Assessment ◽

Clinically Isolated Syndrome ◽

Professional Activity ◽

Quality Of Sleep ◽

Clinical Criteria ◽

Clinical Interviews

AbstractOne of the most frequent symptoms in multiple sclerosis (MS) is fatigue. It has a major impact on quality of life as well as on professional activity. Even nowadays it is still unclear what constitutes an adequate assessment of the perceived fatigue.The following overview will discuss different possibilities to assess fatigue with the help of questionnaires, clinical interviews or the objective measurement of cognitive performance. Furthermore, a structured guideline for the assessment of fatigue will be proposed. Clinical criteria for MS related fatigue include the main symptoms, their everyday relevance, the possible causal relation with the cause of disease (the underlying MS), as well as an exclusion of other possible somatic or psychological reasons. It is recommended to use the “Würzburger Erschöpfungs-Inventar bei Multipler Sklerose (WEIMUS)” (English: Würzburg Fatigue Inventory for Multiple Sclerosis) and especially the “Fatigue Scale for Motor and Cognitive Functions” (FSMC), as these questionnaires distinguish between motor and cognitive fatigue and due to the larger number of research studies using the FSMC. Moreover, the presence of depression, quality of sleep and daytime sleepiness should be assessed. In addition, general cognitive performance as well as performance during monotonous stimulation (vigilance) should be assessed. This may be relevant for the evaluation of a patient’s capacity to work, and for determining prognosis, as there are indications for a relation to relapse frequency, a change from a clinically isolated syndrome (CIS) to an MS diagnosis with an increase of brain atrophy.All in all, it can be said, that despite the growing convergence of diagnostic criteria, the available studies of the objective as well as the subjective assessment of fatigue are still not sufficient and further research is needed.

Download Full-text

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.

Download Full-text

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

Download Full-text

The Effect of Medical Cannabis on Pain Level and Quality of Sleep among Rheumatology Clinic Outpatients

Pain Research and Management ◽

10.1155/2021/1756588 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

George Habib ◽

Fadi Khazin ◽

Suheil Artul

Keyword(s):

Quality Improvement ◽

Sleep Quality ◽

Favorable Effect ◽

Pain Level ◽

Medical Cannabis ◽

Quality Of Sleep ◽

Rheumatology Clinic ◽

Chronic Pain Conditions ◽

Level Reduction

Introduction. Medical cannabis (MC) is becoming increasingly popular for the treatment of chronic pain conditions. In this study, we evaluated the effect of MC treatment on pain level and quality of sleep of patients with different medical conditions at the rheumatology clinic. Methods. Patients licensed for the use of MC at the rheumatology clinics at different settings were located and contacted. Their demographic and clinical parameters were documented, including type of medical cannabis consumed, way of consumption, and current monthly consumed amount. These patients were contacted by phone and asked about the effect on pain level and quality of sleep. Results. A total of 351 patients were located, and 319 completed the questionnaire. Mean age was 46 ± 12 years, 76% were female, 82% had fibromyalgia, ∼9% had mechanical problems, ∼4% had inflammatory problems, ∼4% had neurological problems, and ∼1% had other problems. The average monthly consumed dose of MC was 31, 35, 36, and 32 g, with mean pain level reduction of 77%, 82%, 83%, and 57%, and mean sleep quality improvement of 78%, 71%, 87%, and 76% among patients with fibromyalgia, mechanical, neuropathic, and inflammatory problems, respectively. Mean THC and CBD contents were 18.38% ± 4.96 and 2.62% ± 4.87, respectively. The THC concentration, duration of MC consumption, and MC consumption dose had independent significant correlations with pain reduction while only the duration of MC consumption had an independent significant correlation with sleep quality improvement. Conclusions. MC had a favorable effect on pain level and quality of sleep among all spectrums of problems at the rheumatology clinic.

Download Full-text

Description of Quality of Sleep and Sleep Disorder Among Indonesian Multiple Sclerosis Foundation Members

Multiple Sclerosis and Related Disorders ◽

10.1016/j.msard.2018.10.044 ◽

2018 ◽

Vol 26 ◽

pp. 242-243

Author(s):

G.N. Saputra ◽

R. Estiasari ◽

Y. Dikot ◽

N. Laliyya ◽

U. Gamayani ◽

...

Keyword(s):

Multiple Sclerosis ◽

Sleep Disorder ◽

Quality Of Sleep

Download Full-text

Patterns of Medical Cannabis Use among Patients Diagnosed with Multiple Sclerosis

Multiple Sclerosis and Related Disorders ◽

10.1016/j.msard.2021.102830 ◽

2021 ◽

Vol 50 ◽

pp. 102830

Author(s):

J.B. Guarnaccia ◽

A. Khan ◽

R. Ayettey ◽

J.A. Treu ◽

B. Comerford ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cannabis Use ◽

Medical Cannabis

Download Full-text

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

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph19010109 ◽

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.

Download Full-text

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

Innovation in Aging ◽

10.1093/geroni/igab046.1959 ◽

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.

Download Full-text