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Medical cannabis cuts chronic pain in the elderly without adverse effects

Medical cannabis therapy can significantly reduce chronic pain in patients age 65 and older without adverse effects, according to researchers at Ben-Gurion University of the Negev (BGU) and the Cannabis Clinical Research Institute at Soroka University Medical Centre.

The study found cannabis therapy is safe and efficacious for elderly patients who are seeking to address cancer symptoms, Parkinson's disease, post-traumatic stress disorder, ulcerative colitis, Crohn's disease, multiple sclerosis, and other medical issues.

"While older patients represent a large and growing population of medical cannabis users, few studies have addressed how it affects this particular group, which also suffers from dementia, frequent falls, mobility problems, and hearing and visual impairments," says Professor Victor Novack, a professor of medicine in the BGU faculty of health sciences (FOHS), and head of the Soroka Cannabis Clinical Research Institute. Novack is also the BGU Gussie Krupp chair in internal medicine.

"After monitoring patients 65 and older for six months, we found medical cannabis treatment significantly relieves pain and improves quality of life for seniors with minimal side effects reported."

This older population represents a growing segment of medical cannabis users, ranging from approximately 7% to more than 33%, depending on the country. Recent US polls indicate Americans over 65 represent 14% of the total population and use more than 30% of all prescription drugs, including highly addictive painkillers.

BGU researchers surveyed 2,736 patients 65 years and older who received medical cannabis through "Tikun Olam," the largest Israeli medical cannabis supplier. More than 60% were prescribed medical cannabis due to the pain, particularly pain associated with cancer. After six months of treatment, more than 93% of 901 respondents reported their pain dropped from a median of eight to four on a 10-point scale. Close to 60% of patients who originally reported "bad" or "very bad" quality of life upgraded to "good" or "very good" after six months. More than 70% of patients surveyed reported moderate to significant improvement in their condition.

The most commonly reported adverse effects were dizziness (9.7%) and dry mouth (7.1%). After six months, more than 18% of patients surveyed had stopped using opioid analgesics or had reduced their dosage.

All patients received a prescription after consulting with a doctor who prescribed treatment. More than 33% of patients used cannabis-infused oil; approximately 24% inhaled therapy by smoking, and approximately 6% used vaporisation.

While the researchers state their findings to date indicate cannabis may decrease dependence on prescription medicines, including opioids, more evidence-based data from this special, aging population is imperative.

Abstract
Introduction: There is a substantial growth in the use of medical cannabis in recent years and with the aging of the population, medical cannabis is increasingly used by the elderly. We aimed to assess the characteristics of elderly people using medical cannabis and to evaluate the safety and efficacy of the treatment.
Methods: A prospective study that included all patients above 65 years of age who received medical cannabis from January 2015 to October 2017 in a specialized medical cannabis clinic and were willing to answer the initial questionnaire. Outcomes were pain intensity, quality of life and adverse events at six months.
Results: During the study period, 2736 patients above 65 years of age began cannabis treatment and answered the initial questionnaire. The mean age was 74.5 ± 7.5 years. The most common indications for cannabis treatment were pain (66.6%) and cancer (60.8%). After six months of treatment, 93.7% of the respondents reported improvement in their condition and the reported pain level was reduced from a median of 8 on a scale of 0–10 to a median of 4. Most common adverse events were: dizziness (9.7%) and dry mouth (7.1%). After six months, 18.1% stopped using opioid analgesics or reduced their dose.
Conclusion: Our study finds that the therapeutic use of cannabis is safe and efficacious in the elderly population. Cannabis use may decrease the use of other prescription medicines, including opioids. Gathering more evidence-based data, including data from double-blind randomized-controlled trials, in this special population is imperative.

Authors
Ran Abuhasira, Lihi Bar-Lev Schleider, Raphael Mechoulam, Victor Novack

[link url="https://aabgu.org/medical-cannabis-effective-elderly-patients/"]American Associates, Ben Gurion University of the Negev material[/link]
[link url="http://www.ejinme.com/article/S0953-6205(18)30019-0/abstract"]European Journal of Internal Medicine[/link]

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