Senior Health

10/8/2021 | By Annie Tobey

A controversial drug that many older adults recall from their youth (fondly or with reproach!) is now accepted for medical use and is legal in most states. Medical marijuana for seniors can be safe and beneficial, when used wisely. We answer some of the top pressing questions about this substance, including uses and risks.

“As a primary care doctor who has incorporated medical cannabis into his practice, it is notable how many silver-haired patients are coming in to discuss the pros and cons of a trial of medical cannabis,” says Dr. Peter Grinspoon in Harvard Health Publishing of the Harvard Medical School. He sees a range of patients, from those with kidney failure who can no longer take certain pain medications to patients having difficulty sleeping.

While some are comfortable with the idea, he says, “others bring it up quietly, as if they are asking permission to break the law.” According to the Journal of the American Medical Association, cannabis use among those 65 and older has been increasing, from 2.4% in 2015 to 4.2% in 2018.

With most states having approved some form of legal access to medical marijuana and 94% of Americans in support of it, many older patients are asking if it could benefit to them.

Is marijuana different from CBD?

Cannabis plants include both marijuana and hemp, just like Capsicum pepper plants include hot habanero and sweet bell peppers – same family, different effects. Both marijuana and hemp plants contain THC (Tetrahydrocannabinol, the psychoactive ingredient that contributes the “high”) and CBD (aka, Cannabidiol, a compound that is said to provide health benefits without a psychoactive effect or other significant side effects). The important difference is that marijuana contains a high level of THC, while hemp contains plenty of CBD and only trace amounts of THC.

Both CBD and THC are available in smokable products (leaf, flower, and vape), edibles (candies, cookies, etc.), tinctures and oils (oral drops), and for topical use.

In most states, CBD became legal before marijuana and has been marketed for a variety of uses. However, the “tamer” cannabis cousin, hemp-derived CBD, isn’t regulated like legal medical marijuana is. Marijuana regulations mean that patients can be more certain of the product’s safety and efficacy.

What are common uses of medical marijuana for seniors?

The most common uses of medical marijuana for seniors are for pain, insomnia, neuropathy, and anxiety – especially chronic pain.

Other conditions that qualify for medical use include depression, PTSD, cancer treatment, glaucoma, Parkinson’s, multiple sclerosis, fibromyalgia, Crohn’s disease, epilepsy, and terminal illness.

What are the risks?

In a study of elderly patients using medical marijuana, as reported by the National Institutes of Health, nearly 85% reported some degree of improvement in their condition. Of adverse effects, 12% reported occasional dizziness and 11% reported sleepiness and fatigue.

“Medical cannabis is typically well tolerated among older adults,” says Grinspoon. “However, as with all medications, there is no such thing as a free lunch, meaning that there are always side effects and downsides to consider.”

Cardiac health

Cannabis use can temporarily increase heart rate and blood pressure, but there is no evidence linking it with coronary events. Grinspoon counsels against elderly patients with underlying coronary diseases taking very high dosages, which could lead to an anxiety attack that could trigger a coronary syndrome or arrhythmia.

Medication interactions

When considering medical marijuana for seniors, patients and their advisors should always be aware of how THC or CBD would interact with their other medications.

Anti-seizure medications, blood thinners, anesthesia, and post-surgical pain medications can interact poorly with marijuana and CBD. Because of risk, patients should report any cannabis usage to their physician.

Mental repercussions

The American Center for Biosimilars reported on a study that compared older adults using medical cannabis for chronic pain with a control group who didn’t use cannabis. There was no significant difference between the two groups in subsequent cognitive performance. Although marijuana is linked to long-term cognitive impairment in young people who begin using it early in life, older brains have already undergone the growth changes that can be affected.

At the same time, using cannabis for sleep and pain could improve mental functioning by 1) leaving the individual well-rested and less distracted and 2) diminishing or eliminating usage of sleep and pain medications.

Because of the psychoactivity that cannabis can cause, Grinspoon recommends that those who have experienced delirium or psychiatric conditions should exercise caution in marijuana use.


Very heavy cannabis smokers can experience chronic bronchitis. However, using marijuana in edibles removes that risk entirely.


Many people who use marijuana can quit easily, while others become dependent. Patients should work closely with their health care provider to combat the possibility of addiction. However, it’s important to note that the risk of addiction to cannabis is less than for some of the medications it may be replacing, such as opiates, benzodiazepines, and sedatives.

When starting a regimen of medical marijuana, you should “start low and go slow.” In other words, start with the lowest effective dose and slowly work up to a dose that alleviates your symptoms. Stay in touch with your medical providers, especially if you become concerned about side effects or addiction.

It may be comforting to realize that the controversial drug of your youth can now be both legal and beneficial. My, how times change!

Annie Tobey

Annie Tobey has been a professional writer and editor for more than 30 years. As editor of BOOMER magazine, she explored a diversity of topics of particular interest to adult children of seniors. When she’s not writing, she can be found running the trails or enjoying a beer with friends.

Annie Tobey