Podcast promotes healthy aging, cannabis use | News

Welcome to the inaugural edition of The Cannabis Boomer, a series of monthly articles about cannabis use and healthy aging. Why is this an important topic? Baby boomers are the fastest-growing demographic of cannabis users in the United States (JAMA Internal Medicine, 2020).

The reasons for this increase are as much about medicine as they are about “getting high.” Baby boomers who use medicinal cannabis do so for pain relief, the treatment of arthritis, insomnia, depression, and anxiety. Unfortunately, many users of cannabis — both young and old — don’t fully understand the types of cannabis to use for their specific maladies nor do they know how to find the correct dosage. 

Your doctor wouldn’t (hopefully) send you home with a bottle of pills without some guidance on how many to take and when; yet, that is often the way cannabis is used. Understanding and preventing the adverse effects of cannabis are important for its safe and effective use. 

The goal of this monthly article — and its accompanying Cannabis Boomer Podcast — is to take a hard look at the science of cannabis. 

While this series is primarily focused on older adults, the science I will present applies throughout the lifespan. The podcast will offer a more in-depth look at the topics presented in this monthly article, including interviews with scientists who study cannabis and the most up-to-date findings in the cannabis research field.

Who is the Cannabis Boomer?

So, who is the Cannabis Boomer? I am a neuroscientist, psychologist and, yes, a baby boomer. I earned my PhD in Cognition and Neural Systems from the University of Arizona, where I studied the role of a brain region called the hippocampus in memory and aging. I was also a Fellow at the National Institutes of Health (NIH), where I conducted brain imaging studies in schizophrenia and other psychiatric disorders. I want to understand the emerging science of cannabis, how cannabis works and the safe ways to take advantage of this important plant-based medicine. I want readers who use cannabis for recreational or medicinal purposes to understand all the options and safety information so that they can make informed decisions. As I continue to learn, I want to share that information with you.

A brief history of cannabis as medicine

The medicinal use of cannabis dates back 5,000 years. The Chinese used cannabis for treating gout, rheumatism, malaria, and even “absent-mindedness.” In ancient India, cannabis was considered one of the five sacred plants used in Ayurvedic medicine and was used to treat conditions like pain, nausea, epilepsy, and anxiety.

More recently, the Federal Drug Administration (FDA) has approved cannabis-derived drugs for several uses. I emphasize cannabis-derived because the FDA has never approved cannabis itself for the treatment of any disease or condition. FDA-approved cannabis-derived drugs are based on both tetrahydrocannabinol (THC) and cannabidiol (CBD) cannabinoids (see Box 1 for more detailed information) and include Epidiolex (a CBD-derived drug without psychoactive effects) that has been approved for treating seizures. Marinol and Syndros, which are synthetic THC-based medications, have been approved to lessen the severity of nausea and vomiting associated with cancer chemotherapy, and have also been used to stimulate appetite for people living with AIDS. 

Many people use cannabis for health and wellness (whether it is prescribed or not)

Primary among these uses is chronic pain. Research suggests there are benefits to using cannabis to treat chronic pain; however, pain is a complex phenomena and most of the research to date has varied in the types of pain addressed and the types of cannabis used. Systematic reviews of the research literature have found modest evidence for the benefit of cannabis-based treatments in the management of neuropathic pain (e.g., radiating pain due to diabetes). The use of different kinds of cannabis for the treatment of pain is the subject of the first Cannabis Boomer Podcast, which is available now. In short, some types of cannabis can reduce inflammation, diminish the action of pain receptors and improve the ability to cope with pain. 

Cannabinoids in the treatment of multiple sclerosis (MS) 

Multiple randomized controlled trials show that cannabis-based medicines, particularly a THC and CBD combination known under the product name Sativex can reduce muscle stiffness in MS patients. These studies have led to regulatory approval of Sativex in 25 countries–but not the United States — as a treatment for MS-related muscle stiffness. Other studies indicate cannabis may help with neuropathic pain associated with MS. Sativex is not approved in the US; however, a randomized controlled trial found smoked cannabis — in place of Sativex — was superior to placebo in symptom and pain reduction for patients with treatment-resistant muscle stiffness.

Treatment of post-traumatic stress disorder (PTSD)

One area where patients have really led the charge is in the use of cannabis to treat some symptoms of PTSD. A 2024 article in the journal Frontiers in Psychiatry (Nacasch, et al. Medical cannabis for treatment-resistant combat PTSD) found that patients with treatment-resistant, combat-related PTSD who were treated with cannabis exhibited significantly improved PTSD symptoms and sleep. 

Potential in neurodegenerative diseases 

Recent research has begun to focus on cannabis as a potential treatment for neurodegenerative diseases, such as Alzheimer’s disease. These studies are pre-clinical; however, the theory is that THC and CBD may protect neurons from damage through antioxidant and anti-inflammatory mechanisms. These early results are promising, but one should keep in mind these studies are laboratory studies and not randomized controlled clinical trials.

Treatment of other conditions 

The evidence is more mixed for the therapeutic benefits of cannabis in anxiety, sleep disorders and appetite; however, many of these studies have been small and suffer from methodological challenges, including route of administration (edible, vaporizing, and smoking, for example), dosage and type of cannabis used. A topic for future discussion is the previously mentioned entourage effect, where the combinations of terpenes and other cannabinoids may have a greater effect than any one compound in isolation. 

Side effects and risks

This series is not only about the possible benefits of cannabis, it is also about how to make good decisions about its use. There are many potential side effects, and I promise to highlight these risks and present some ways to mitigate them. Among adults older than 65, cannabis-related emergency department visits in California increased from 366 in 2005 to more than 12,000 in 2019 (Journal of the American Geriatrics Society, 2023). The THC arms race may be driving these emergency department visits. Common side effects of THC-dominant cannabis include dizziness, drowsiness, dry mouth, impaired short-term memory and altered cognition. Balance problems are an important concern, particularly for older users. More serious potential risks include liver injury, elevated liver enzymes and tachycardia (an elevated heart rate). Smoking is known to increase risk for many types of cancer. Psychoactive effects may be disturbing for some users, especially those trying THC-containing products. 

And, because many seniors use multiple prescription drugs, there are more potential drug interactions. While many people are reluctant to discuss their cannabis use with their doctors, it is highly recommended that they do so. It is also recommended that edibles and all supplies or other forms of cannabis, be kept away from dogs, children and unwitting adults.