Exploring Potential Benefits of Medical Marijuana Utilization by Older Adults

 

Exploring Potential Benefits of Medical Marijuana Utilization by Older Adults

By: Lori L. Straley, LPN

After working in the healthcare field 20+ years, this writer has seen the pain & suffering of many residents of multiple nursing homes and assisted living facilities who could benefit from medical marijuana or full-strength THC cannabis oils being legalized on a federal level throughout the U.S.  In addition, insurance companies must be willing to cover the costs, as with other pharmaceutical medications.  Many research studies examine the ways in which medical marijuana is being effectively used in treating various disease processes, but most importantly for pain relief.  Those medical issues include: muscle tightness, inflammation, nerve pain, joint pain, osteoarthritis, cancer, muscle spasms as well as multiple sclerosis.  Among additional conditions: fibromyalgia, neuropathy, Parkinson’s related tremors, and seizures from epilepsy (Teitellbaum, 2019).  Suffering from untreated pain may cause insomnia, depression, anxiety, and related illness.  These conditions may all benefit by using medical marijuana.  

Many elderly patients think chronic pain is part of the aging process and they will just have to deal with it for the rest of their lives – that it is “normal” and “to be expected” as they grow older.  It is believed that pain goes underreported many times because this population of adults tends to be more stoic than younger generations.  The elderly population comprises the fastest growing group of people in the world’s population.  In 2019, about 16.5 % of the American population was 65 years old or over.  This figure is expected to reach 22 % by 2050 (Census.gov).  “In 2016, the population grew to be 49.2 million and represented 15.2% of the total population” (ACL, 2018).  Many of these older patients suffer daily from rheumatoid arthritis, osteoarthritis, bursitis, cancer pain, angina, ischemic pain, neuropathy pain, shingles, neuralgia, and gout just to name a few.  Pain may also be related to complications associated with deconditioning, gait abnormalities, accidents such as falling often, polypharmacy and cognitive decline. 

This author cares for elder patients who present with increased fat mass, decreased muscle mass, and decreased body water, which impact drug distribution (Bielowief et al., 2020).  Being in constant pain, patients do not get the needed sleep to keep the body renewing itself and making the collagen it needs to keep the bones from deteriorating and possibly breaking with falls, along with potential tissue damage and poor wound healing.  The eventual consequences of this pain include impaired activities of daily living (ADLs), ambulation, depression, and strain on the U.S.  health care economy (Manchikanti, 2009).  One study found that 66% of geriatric nursing home residents have chronic pain, but in almost half of these cases (34%), it was not detected by the treating physician (Sengstaken, 2009).  This same study indicated that many times the residents had been treated for depression when all they needed was pain relief.  Pain doctors need to screen for symptoms in older patients, such as burning, aching, soreness, tightness, discomfort, sharp, dull, and throbbing sensations.  They must take cues from the behaviors of patients such as crying, groaning, changes in gait or posture, or withdrawn/agitated behaviors.  The intensity, character, frequency, location, and duration of the pain should be examined by all healthcare workers.

This writer wishes to point out that in Ohio, the Ohio Nurse’s Association recognizes   medical cannabis as beneficial in certain patient treatment courses.  Their position statement indicates their recommendation that medical cannabis be relisted as a Schedule II substance in the hopes of more research, developing prescribing standards, as well as showing evidence-based proof in its therapeutic use.   Patients using the drug need to be protected from civil and criminal penalties on a federal level, as well as nursing homes & assisted living facilities being protected from losing their Medicaid & Medicare funding if a patient wishes to use medical marijuana (ONA, 2019).

After conducting extensive research into the use of medical marijuana with the older adult population, this author believes more research is needed in order to determine reasons that it has not been legalized – at the Federal level and only at certain state levels. As previously noted, there are numerous examples of how it can significantly help within the geriatric population. Stigmas associated with medical marijuana usage still exist, especially among elders.  After working eight years in nursing homes and assisted living facilities, this writer has had only one patient prescribed medical cannabis.  That patient also had her drug card, doctor, and dispensary account.  Research studies suggest many benefits from its use with older adults, and these findings must be recognized.

We have a new President, and all three branches of government are controlled by the Democrats.  House Democrats recently passed the MORE Act, which would federally legalize cannabis.  Senate Majority Leader, Chuck Schumer, has stated that the MORE Act will be his priority in the U.S. Senate going forward. He is hopeful of the eventual signing into law by President Biden. (Smith, 2021).

Based on research findings, this author recommends contacting those in Congress and advocating on behalf of elders who suffer with chronic pain, multiple medical conditions, and disease processes.  The lobbyists need to take the initiative to get this done with policymakers.  In addition, this writer recognizes the potential benefits for older adults and advocates getting medical marijuana legalized in all U.S. states.    Once the Bill is passed and then signed into law, the next step will be to get buy-in from insurance companies, paying for it as with other medications.   Hopefully, this will be one bill that becomes law, soon.

References

Administration for Community Living, (2018).  2017 “Profile of Older Americans”.  United States Census Bureau.  Retrieved from https://acl.gov/sites/default/files/Aging%20and%20Disability%20in%20America/2017OlderAmericansProfile.pdf.

Census.gov (2021).  “65 and Older Population Grow Rapidly as Baby Boomers Age”.  Retrieved from https://www.census.gov/newsroom/press-releases/2020/65-older-population grows.html.

Manchikanti L., Boswell M. V., Singh V., et al. Comprehensive review of epidemiology, scope, and impact of spinal pain.  Pain Phys. 2009;12((4)): E35–70

Ohio Nurse’s Association (2019).  “ONA Position on Marijuana in Ohio”.  Retrieved from https://ohnurses.org/wp-content/uploads/2018/10/Revised-Medical-Marijuana-Statement.pdf.

Sengstaken E. A., King S. A.  The problems of pain and its detection among geriatric nursing home residents.  J Am Geriatr Soc. 2009;41((5)):541–544.

Smith, A. (2021).  “Federal Cannabis Legalization: Policy Issues to be Addressed”.  Foley Hoag LLP.

Teitelbaum, J. (2019).  A Hemp oil, CBD, and Marijuana Primer: Powerful Pain, Insomnia, and Anxiety-relieving Tools!  Alternative Therapies in Health and Medicine, 25(S2), 21–23.

About the Author

With a background in Business Management, Lori Straley, LPN serves Adams Heritage in Indiana.  In addition, she recently completed her MHA degree from Saint Joseph’s College / Maine.  This blog post was adapted from her graduate “Capstone” research.