A new study by researchers at the University of California San Diego School of Medicine has revealed a dramatic spike in emergency room visits related to cannabis consumption among older adults. The study, which was published on Monday by the peer-reviewed Journal of the American Geriatrics Society, revealed a 1,808% increase in marijuana-related trips to the emergency department among California adults aged 65 and older between 2005 and 2019.
Benjamin Han, M.D., the lead author of the study and a geriatrician in the Division of Geriatrics, Gerontology, and Palliative Care in the Department of Medicine at UC San Diego School of Medicine, said that the dramatic increase in emergency room visits related to cannabis consumption among older adults is a concern for many physicians in his field. In an interview with UC San Diego Today, he noted that the increase is significant because older adults are at a higher risk of adverse effects associated with cannabis and other psychoactive substances.
“Many patients assume they aren’t going to have adverse side effects from cannabis because they often don’t view it as seriously as they would a prescription drug,” said Han. “I do see a lot of older adults who are overly confident, saying they know how to handle it — yet as they have gotten older, their bodies are more sensitive, and the concentrations are very different from what they may have tried when they were younger.”
The study, which was funded in part by the National Institute on Drug Abuse, was conducted using a trend analysis of data obtained from the California Department of Healthcare Access and Information. The researchers determined that the number of cannabis-related emergency department visits among adults in California aged 65 and up jumped from 366 in 2005 to 12,167 in 2019. Medical marijuana was legalized in California in 1996, and regulated sales of adult-use cannabis began in the state on January 1, 2018, following the legalization of recreational marijuana by the state’s voters in 2016. The study found that while emergency room visits jumped sharply between 2013 and 2017, they then leveled off, suggesting that the availability of recreational marijuana did not increase the risk of a visit to the emergency department.
Cannabis Use Increasing Among Older Americans With Legalization
Over the past two decades, the consumption of cannabis by older adults has increased sharply as marijuana legalization efforts gained ground across the United States. Older Americans are increasingly using cannabis socially and for a variety of health conditions, leading to a drop in the perceived risk of regular marijuana use.
The researchers say that the new study illustrates that cannabis use among older adults can lead to unintended consequences that require emergency health care for a variety of reasons. The use of cannabis can slow reaction time or impair attention, which may increase the risk of injury or falls. There is also evidence that cannabis can increase the risk of delirium, paranoia, or psychosis and that using marijuana can interact with prescription medications or exacerbate pulmonary or cardiovascular problems.
“We know from work in alcohol that older adults are more likely to make a change in substance use if they see that it is linked to an undesirable medical symptom or outcome — so linking cannabis use similarly could help with behavioral change,” said Alison Moore, M.D., co-author of the study and chief of the Division of Geriatrics, Gerontology, and Palliative Care in the Department of Medicine at UC San Diego School of Medicine. “We truly have much to learn about cannabis, given all the new forms of it and combinations of THC (tetrahydrocannabinol) and CBD (cannabidiol), and this will inform our understanding of risks and possible benefits, too.”
The study reveals the need for older Americans to have honest discussions about their use of cannabis with their healthcare provider. Moore says that such conversations should be an element of routine medical care, but screening protocols often include the use of cannabis with the use of illicit drugs.
“Instead, asking a question like, ‘Have you used cannabis — also known as marijuana — for any reason in the last 12 months?’ would encourage older adults to answer more frankly,” Moore said. “Providers can then ask how frequently cannabis is used, for what purpose — such as medically for pain, sleep, or anxiety or recreationally to relax — in what form (smoked, eaten, applied topically) and if they know how much THC and CBD it contains. Once the provider has this type of information, they can then educate the patient about potential risks of use.”
Han agreed that patients should discuss their cannabis with their doctors before deciding to use it for medical purposes.
“Although cannabis may be helpful for some chronic symptoms, it is important to weigh that potential benefit with the risk, including ending up in an emergency department,” he said.