Review, Feb/23: Impacts of medical and non-medical cannabis on the health of older adults: Findings from a scoping review of the literature

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Impacts of medical and non-medical cannabis on the health of older adults: Findings from a scoping review of the literature

https://pubmed.ncbi.nlm.nih.gov/36800328/ 

Abstract

Background: Cannabis legalization has enabled increased consumption in older adults. Age-related mental, physical, and physiological changes may lead to differences in effects of cannabis in older adults compared to younger individuals.

Objective: To perform a scoping review to map the evidence regarding the health effects of cannabis use for medical and non-medical purposes in older adults.

Methods: Electronic databases (MEDLINE, Embase, PsycINFO, Cochrane Library) were searched for systematic reviews (SRs), randomized controlled trials (RCTs) and non-randomized/observational studies (NRSs) assessing the health effects and associations of cannabis use (medical or non-medical) in adults ≥ 50 years of age. Included studies met age-related inclusion criteria or involved a priori identified health conditions common among older adults. Records were screened using a liberal accelerated approach and data charting was performed independently by two reviewers. Descriptive summaries, structured tables, effect direction plots and bubble plots were used to synthesize study findings.

Findings: From 31,393 citations, 133 publications describing 134 unique studies (26 SRs, 36 RCTs, 72 NRSs) were included. Medical cannabis had inconsistent therapeutic effects in specific patient conditions (e.g., end-stage cancer, dementia), with a number of studies suggesting possible benefits while others found no benefit. For medical cannabis, harmful associations outnumbered beneficial, and RCTs reported more negative effects than NRSs. Cannabis use was associated with greater frequencies of depression, anxiety, cognitive impairment, substance use and problematic substance use, accidents/injuries, and acute healthcare use. Studies often were small, did not consistently assess harms, and did not adjust for confounding.

Discussion: The effects of medical cannabis are inconsistent within specific patient conditions. For older adults, generally, the available evidence suggests cannabis use may be associated with greater frequencies of mental health issues, substance use, and acute healthcare use, and the benefit-to-risk ratio is unclear. Studies with a balanced assessment of benefits and harms may guide appropriate public health messaging to balance the marketing pressures of cannabis to older adults.

Copyright: © 2023 Wolfe et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Conflict of interest statement

DC is Project Lead for the Canadian Coalition for Seniors’ Mental Health (CCSMH) project on development of Canadian Guidelines on Alcohol, Benzodiazepine, Cannabis and Opioid Use Disorders funded by Health Canada (SUAP) 2017-20; Project Lead for CCSMH Project Cannabis Use and Older Adults: Developing E-Learning Modules and Knowledge Translation Tools for Clinicians and Students, funded by Health Canada (2020-2022). BH has previously received honoraria from Eversana Inc for provision of methodologic advice related to the conduct of systematic reviews. This does not alter the adherence to PLOS Medicine policies on sharing data and materials. All other authors have no conflicts to declare. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Full Paper:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9937508/