Marijuana may help those who have Parkinson\u2019s or dementia<\/p><\/blockquote>\n
That means, even in states that have legalized medical marijuana, users are still violating federal law. Currently, the Justice Department defers to state assurances that products are tightly regulated and generally avoids prosecuting medical marijuana users who adhere to state guidelines. But people who use cannabis for medical reasons might want to be aware of the risk they\u2019re taking, should the federal government decide to crack down.<\/p>\n
Further complicating matters, the Food and Drug Administration (FDA) has not approved cannabis for medicinal use. The FDA has very specific rules around the types of clinical studies it requires before approving a drug. Although European and Canadian studies demonstrating marijuana\u2019s medical effectiveness for a wide variety of conditions are available, most do not meet FDA standards.<\/p>\n
Most US studies, to date, have focused on the harmful effects of marijuana and little data exists on older adults who use the drug for health reasons. Before it will consider approving cannabis extracts for medicinal use, the FDA wants more domestic research, which is tough\u2014but possible\u2014to get approved by the government, said Ken Leonard, PhD, director of the Research Institute on Addiction at SUNY Buffalo.<\/p>\n
Both the National Institutes of Health and the American Society of Addiction Medicine have come out against legalizing medicinal cannabis until more studies are completed and approved by the FDA.<\/p>\n
Marijuana as Medicine<\/strong><\/p>\nLegal complications aside, cannabis advocates tout the drug\u2019s use for many aging-related conditions.<\/p>\n
\u201cThere is evidence that it may help slow progress for those suffering from Parkinson\u2019s disease and dementia,\u201d said Ethan Russo, MD, a board-certified neurologist and psychopharmacology researcher in California. It may also aid common aging complaints like aches and pains and disrupted sleep.<\/p>\n
Studies from Europe and Canada have shown that cannabis can be medically effective for pain and spasms from degenerative diseases like multiple sclerosis and for chronic pain from rheumatoid arthritis. Other studies show it may help post-traumatic stress disorder, ease seizures, and control nausea and stimulate appetite in cancer and HIV patients.<\/p>\n
Interestingly, although the FDA has not recognized the cannabis plant as medicine, it has approved two medications (dronabinol and nabilone) containing a synthetic form of the cannabinoid THC, which is responsible for the \u201chigh\u201d effect, and for stimulating appetite and reducing nausea. Many patients don\u2019t tolerate the synthetics well, but do find relief with the natural plant form, Russo said.<\/p>\n
Like all drugs, marijuana has potential risks as well as benefits. There\u2019s a slight risk of addiction, although probably less than with opiates, which are frequently (and legally) prescribed for pain, Leonard said.<\/p>\n
\u201cThere\u2019s likely to be dosage issues as well, since older people react differently to medications than do younger people,\u201d he added.<\/p>\n
Those who take multiple medications should consider marijuana\u2019s side effects, which include rapid heartbeat, low blood pressure, slowed digestion and movement of food through the intestines, dizziness and hallucinations.<\/p>\n
Getting the Drug<\/strong><\/p>\nThe shortage of hard research on health benefits, coupled with the gray area of legality, means some doctors are still uneasy about recommending cannabis to patients.<\/p>\n
Physicians can\u2019t actually prescribe medical marijuana, even in a state where it\u2019s been legalized, because of its status as a Schedule 1 narcotic. Clinicians can only write a recommendation, which permits a patient to obtain a medical marijuana card and purchase cannabis in a dispensary.<\/p>\n
New York is the only state that mandates a four-hour, health-department-approved course\u2014costing $250\u2014for clinicians before they are allowed to make recommendations. Other states offer free, voluntary physician resources but do not require doctors to take specialized training before they recommend marijuana to patients.<\/p>\n
Neither those dispensing the drug nor the doctors recommending it are necessarily up to speed on what\u2019s best for a patient\u2019s specific needs.<\/p><\/blockquote>\n
Regulations for growing and use vary too from state to state. Some states tightly control which strains are grown and where, what types of products are permitted and who can legally buy them for a narrow range of medical disorders. Others, such as California and Colorado, are more relaxed; medical cards are easier to obtain and patients are allowed to grow a few plants at home for personal use.<\/p>\n
Currently, patients must live in a state where medical cannabis is legal and be under the care of a qualified clinician to purchase it. There\u2019s confusion over whether legal medical users who live in one state can carry and use it in another state where it\u2019s also legal. Some states permit it, but not all. It\u2019s advisable to check specific regulations in your state and in any state you plan to travel to and verify what, if any, use is acceptable.<\/p>\n
The conflicting federal and state laws leave some patients\u2014primarily older adults living in long term care facilities\u2014in limbo. Many institutions receive at least some federal funds and are hesitant to flout national laws by allowing residents to use medical cannabis in any form on premises, even if the drug is legal in the state. Some facilities may allow restricted use or forbid staff to handle the drug, said Courtney Allen-Gentry, RN, of the Center for Integrative Nursing and Cannabinoid Science in Omaha, NE.<\/p>\n
But this can be unfair to those who find cannabis to be a good alternative to traditional painkillers, Allen-Gentry said.<\/p>\n
\u201cYou would be surprised at how many seniors in nursing homes or assisted living already use or are open to the idea of using,\u201d she said. Many have successfully reduced their need for other pain medication or antidepressants.<\/p>\n
Medicare and Medicaid won\u2019t pay for the drug because of its federal classification. Neither do private insurers. That may change if cannabis\u2019 status changes, but for now patients must pay for it out of their own pockets. The marijuana itself can cost several hundred dollars a month, in addition to a marijuana card registration fee. These costs can be problematic for low- or fixed-income patients, including many older adults.<\/p>\n
At the Dispensary<\/strong><\/p>\nOnce a person does get past the many hurdles of the legal and medical systems, the next challenge is figuring out what type of cannabis to actually take.<\/p>\n
Licensed dispensaries are the only authorized points of product distribution for medical marijuana. Dispensaries are tightly regulated; several states have \u201cseed to sale\u201d requirements to track each individual plant throughout the growing, manufacturing, transportation, distribution, testing and retail dispensing processes, according to CheatSheet.com. Depending on the state, dispensaries may be under the auspices of the health department, liquor control board or other regulatory agency. Owners and staff must go through extensive background checks, present written operations plans that include patient record keeping, and set up security for both transportation and the dispensary itself.<\/p>\n
\u201cBudtenders\u201d staff the dispensaries and guide patients or caregivers in choosing the right product, strain and potency for their specific symptoms. Some budtenders have medical backgrounds; others may pay for private courses that teach them the finer points of medical marijuana\u2019s effects.<\/p>\n
Medical marijuana is available in many forms: it can be smoked or vaporized, or it can be made into oils, salves, tinctures, teas and edibles, like candy. Specific state regulations determine what types, such as oils, teas or edibles, and for which conditions they can be sold. The medium can affect how quickly the marijuana takes effect.<\/p>\n
Jane said choosing the right product for her ankle was overwhelming. \u201cI didn\u2019t have the knowledge or vocabulary to know what to ask for, but the folks at the dispensary were very helpful.” She chose a tincture, which helps with pain during the day, then added an edible remedy that she uses mostly at night due to its strength.<\/p>\n
However, neither those dispensing the drug nor the doctors who are recommending it are necessarily up to speed on what form and strength are best for a patient\u2019s specific needs.<\/p>\n
\u201cThe industry is poorly regulated at this point, and the average physician has virtually no training,\u201d said Russo, who is a member of the Society of Cannabis Clinicians. Patients are left to rely on dispensary budtenders\u2019 or friends\u2019 advice. <\/p>\n
Anyone who is considering using medical cannabis should proceed slowly, cautioned Allen-Gentry. The concentration of active ingredients, called cannabinoids, can vary widely depending on the strain, form and how it\u2019s grown. For older adults, who metabolize substances differently than younger people, it takes time to build up a tolerance to any side effects of cannabis, she said.<\/p>\n
Marian Their, 76, of Boulder, CO, applies a cannabis-based salve for chronic pain from a shoulder injury. Cortisone shots didn\u2019t help and she didn\u2019t like the side effects of prescription painkillers. \u201cNot only is it better but it\u2019s kinder on you,\u201d she said.<\/p>\n
To Use or Not to Use<\/strong><\/p>\nA recent Pew survey found a slight majority of Americans (53 percent) support legalizing marijuana. Baby boomers were about evenly split, with 50 percent in favor, 47 percent opposed and the remainder undecided. In comparison, 68 percent of millennials and 29 percent of adults age 70 to 87 support legalization.<\/p>\n
Jane was perfectly comfortable with the idea of using marijuana for medical purposes when other measures failed to bring her pain relief.<\/p>\n
\u201cMost of us [boomers] smoked pot in college, so when medical marijuana came up, it wasn\u2019t a shock,\u201d she said.<\/p>\n
Doctors seem open minded about cannabis too. A 2014 national survey of physicians found that 67 percent support having medical marijuana as an option for their patients and 56 percent think it should be legalized nationwide. In Florida, which has a medical marijuana measure on the ballot in 2016, nearly 90 percent of the population supports the idea.<\/p>\n
Shelly Lindeman, 72, of Aventura, FL, is in favor. \u201cWhat’s the difference between that and getting a prescription for something? I’m not using it to go to a party and enjoy myself, I’m using it to help with a disease. Absolutely I’d use it.\u201d<\/p>\n
Shelly\u2019s sister, Elaine Boyarsky, 76, is less certain. \u201cI\u2019ve never needed anything to make me feel OK. For medicinal purposes, yes. But I\u2019m thinking that people might abuse it.\u201d<\/p>\n
Advocacy groups like the Marijuana Policy Project and NORML hope to get medical marijuana initiatives on more state ballots and to broaden laws already on the books. For now, with the patchwork of state laws, mixed messages from the federal government, and insufficient information about the safety and effectiveness of medical marijuana in older adults, it\u2019s not surprising that people might find it hard to make up their minds about using cannabis. But it\u2019s certainly something that everyone, of all ages, is taking seriously.<\/p>\n
For Marion Their, her decision to use medical marijuana was less about age than it is about shifting priorities.<\/p>\n
\u201cAs we age, I think we become a little less cautious about what people think,\u201d she said. \u201cBack then, I smoked because it was cool and forbidden. Now, it\u2019s a matter of getting relief.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"
After Jane broke her ankle, walking even short distances was a painful challenge. The 63-year-old had been an avid hiker and gardener and was stifled by her limited mobility. To make matters worse, she couldn\u2019t tolerate the side effects of prescription painkillers.<\/p>\n
Read more Is Medical Marijuana Good Medicine for Older Adults? It\u2019s Complicated<\/span> ›<\/span><\/a><\/div>\n<\/p>\n","protected":false},"author":2,"featured_media":576,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0,"_FSMCFIC_featured_image_caption":"","_FSMCFIC_featured_image_nocaption":null,"_FSMCFIC_featured_image_hide":null,"footnotes":""},"categories":[7,21,20],"tags":[],"class_list":["post-574","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-healthspan","category-lifes-endings","category-supports"],"cc_featured_image_caption":{"caption_text":"","source_text":"","source_url":""},"wps_subtitle":"The facts\u2014scientific and legal\u2014about marijuana\u2019s status as a medication","_links":{"self":[{"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/posts\/574","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/comments?post=574"}],"version-history":[{"count":5,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/posts\/574\/revisions"}],"predecessor-version":[{"id":5383,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/posts\/574\/revisions\/5383"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/media\/576"}],"wp:attachment":[{"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/media?parent=574"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/categories?post=574"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/tags?post=574"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}