Abstract
Use of medical marijuana is increasing in the United States and older adults are the fastest growing user group. There is little information about the characteristics and outcomes related to medical marijuana use. This study is a descriptive analysis of older adults (aged ≥50 years old) who were early adopters of a medical marijuana program in the U.S. state of Florida. Per state legislation, initial and follow-up treatment plans were submitted to the University of Florida College of Pharmacy. Data collection included demographics, clinical history, medical conditions, substance use history, prescription history, and health status. Follow-up treatment plans noted changes in the chief complaint and actions taken since the initial visit. Of the state’s 7548 registered users between August 2016 and July 2017, N = 4447 (58.9%) were older adults. Patients utilized cannabidiol (CBD)-only preparations (45%), preparations that had both tetrahydrocannabinol (THC) and CBD (33.3%) or were recorded to use both CBD-only and THC + CBD products (21.7%). The chief complaints indicating medical cannabis treatment were musculoskeletal disorders and spasms (48.4%) and chronic pain (45.4%). Among other prescription medications, patients utilized antidepressants (23.8%), anxiolytics and benzodiazepines (23.5%), opioids (28.6%), and cardiovascular agents (27.9%). Among all drug classes with potential sedating effects, 44.8% of the cohort were exposed to at least one. Patients with follow-up visits (27.5%) exhibited marked improvement as assessed by the authorizing physicians. However, the patient registry lacked detailed records and linkable information to other data resources to achieve complete follow up in order to assess safety or efficacy. Future improvements to registries are needed to more adequately capture patient information to fill knowledge gaps related to the safety and effectiveness of medical marijuana, particularly in the older adult population.
Highlights
Cannabis use is increasing among medically complex individuals
This study described the characteristics of older adult patients, aged ≥50 years old, who were licensed to use medical marijuana during the early implementation period of the Florida medical marijuana program between 2016 and 2017 and followed these individuals from treatment initiation to the point of a follow-up encounter
Physician-assessed conditions indicated that most patients were moderately ill or worse and low-THC cannabis (i.e., CBD) was the most common treatment choice (45%) compared to medical cannabis (33.3%) or a combination of the two (21.7%)
Summary
Cannabis use is increasing among medically complex individuals. The vast majority of cannabis use is recreational; there is an increasing number of adults who use cannabis and cannabis-derived substances for medical and complementary health purposes. Increased use corresponds with expanding access through state medical cannabis programs, broad consumer marketing and use of cannabidiol (CBD) products. There is a continued increase in public support of legalization at the individual state level, whereas cannabis remains illegal (i.e., Schedule 1) at the national level [1,2,3]. 11 states have legalized recreational cannabis for use by adults [1]. Florida was the 22nd state in the U.S to legalize access to medical marijuana—the third largest state with one of the largest and fastest growing populations of older adults
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