Bold reality check: as cannabis becomes more accessible, older adults are increasingly ending up in emergency departments with serious adverse effects from cannabinoid-containing products. A new study led by Dr. Jerry H. Gurwitz of Harvard-affiliated institutions, and involving the Centers for Disease Control and Prevention, analyzes ED visits from 2016 to 2023 among U.S. adults aged 50 and up linked to medical cannabis, CBD, and hemp-derived products. The findings show a rise in emergency visits tied to these products, from 4,408 in 2020–2021 to 7,490 in 2022–2023. But this likely only scratches the surface since it captures only ED visits and misses urgent care visits, doctor’s office calls, or cases where medical attention wasn’t sought.
Why is this trend increasing? Greater access plays a big role. Medical cannabis is legal in most states, and recreational cannabis is legal in roughly half of the states plus DC. Yet more availability does not equal safety. These products often lack robust FDA evaluation, and they can contain multiple active compounds with uncertain contents, making their effects unpredictable.
The issue hit close to home for Gurwitz when a family member in her 90s used a cannabis product for back pain and experienced side effects. That personal experience underscored a broader concern: many older patients may be using cannabis without their clinicians’ awareness.
What risks are we really talking about? Common adverse effects documented in the study include confusion, anxiety or paranoia, fainting (syncope), gastrointestinal symptoms, and an increased risk of falls and injuries. These aren’t minor side effects; they’re potentially preventable issues geriatricians strive to mitigate, especially given that older adults often react more strongly to many medications. The takeaway is clear: if an older person is considering cannabis, they should be warned about these risks and discuss them with a healthcare provider.
Who is using cannabis and why? National survey data suggest roughly 12% of U.S. adults aged 50–80 report cannabis use. Many turn to cannabis as an alternative to prescription pain medications or sedatives, but substitution doesn’t guarantee safety and can introduce new harms.
It’s important to note that the study focused on legally used medical products, not recreational cannabis. There are many older adults who use cannabis recreationally, and combining cannabis with alcohol may amplify the risk of adverse events.
How should you talk to a doctor and how can you use cannabis more safely? If you’re over 50 or caring for someone in that age group and are considering cannabis, have an open, explicit conversation with a clinician. Consider asking:
- Is this the best option for me, or do the risks outweigh the benefits?
- What alternatives exist, including non-pharmacological options such as physical therapy for pain or behavioral strategies for insomnia?
- Which side effects are more likely in older adults, including confusion, falls, fainting, and gastrointestinal symptoms?
Gurwitz emphasizes a cautious, evidence-based approach: medications should be prescribed only when there is clear, patient-specific evidence that benefits outweigh risks. In this area, certainty is still elusive.
A call to clinicians: screen regularly for cannabis use during routine visits, especially for older patients with chronic pain or sleep disturbances. If a patient develops new symptoms, inquire about cannabis use as part of the assessment. The overarching goal in elder care is to minimize preventable morbidity.
What’s next? The study highlights the need for more rigorous FDA evaluation of these products, improved labeling, and enhanced education for both patients and healthcare providers. Until we have a firmer understanding of what’s in these products and how they affect older adults, a careful, informed, and individualized approach is essential.
Key takeaway: cannabis use among older adults is rising in a landscape of uneven regulation and uncertain product contents, making proactive dialogue with healthcare providers and cautious use paramount for safety.
