Cannabis should be used to help older adults with chronic pain, sleep difficulties, reduced appetite, nausea or post-traumatic stress disorder, Israeli researchers said, as they set out a new roadmap for using the substance as treatment.
The researchers call for the implementation of their treatment protocol in clinical practice “to evaluate the benefit of cannabis treatment” and to eventually reduce the use of other drugs such as opioids, benzodiazepines and other psychotropic or analgesic medications.
Older adults might benefit from cannabis treatment for conditions that are not adequately addressed using current medically approved therapies, researchers at Ben-Gurion University of the Negev (BGU) and the Cannabis Clinical Research Institute at Soroka University Medical Center said.
In the new study, “Medical Cannabis for Older Patients—Treatment Protocol and Initial Results,” published in the Journal of Clinical Medicine, the researchers present their suggestions, developed in collaboration with NiaMedic Healthcare & Research Services Ltd.
“Since well-established and evaluated protocols for treatment of older adults with medical cannabis do not exist, we developed our own approach based on close follow-up of effects, adverse events, and slow introduction of THC oil, CBD oil or a combination,” Dr. Ran Abuhasira of the BGU Faculty of Health Sciences and Soroka’s Cannabis Clinical Research Institute said in a statement. Tetrahydrocannabinol (THC) and Cannabidiol (CBD) are two components of the weed.
In the paper, the researchers present a roadmap for evaluation of symptoms and the ways cannabis could potentially alleviate these symptoms. During the study period, 184 patients with a median age of 82 began cannabis treatment at a specialized geriatric clinic. After six months of treatment, 58.1% of the patients were still using cannabis.
Of these, 84.8% reported moderate to significant degrees of improvement in their general condition; 33.6% reported adverse events, the most common of which were dizziness (12.1%) and sleepiness and fatigue (11.2%).
The treatment protocols urge special caution in older adults, in case of multiple drug interactions, pharmacokinetic changes, nervous system impairment, and increased cardiovascular risk, the researchers said.
“Once treatment is initiated and the therapeutic dose is achieved, we recommend at least monthly follow-up at first to assess adverse events and treatment efficacy,” said Dr Abuhasira. “If treatment is effective and well-tolerated, consideration can then be given to revising the current concomitant drug regimen, especially with respect to the use and dosage of opioids, benzodiazepines and other psychotropic or analgesic medications.
“Our experience shows that cannabis has the potential to lead to a reduction in the use of these medications. Therefore, we call for the implementation of our protocol in clinical practice to evaluate the benefit of cannabis treatment.”
This research was partially funded by NiaMedic, a medical data company offering healthcare, research and consultation services, and focusing on integrating medical cannabis treatment with conventional care in older adults. NiaMedic had no influence on the data collection, analysis or manuscript preparation, the researchers said in the statement.