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Hello, this is Dr. Peter Grinspoon. I'm a primary care doctor at Massachusetts General Hospital and the cannabis specialist here to talk about cannabis use in older Americans today. Among all demographic groups, the use of medicinal cannabis is growing more rapidly in Americans in their 50s, 60s, 70s, and 80s.
Now, why is that? It's because people are hearing from their friends, from their family members, from their neighbors that others are using medical cannabis to alleviate their symptoms. And people are wondering, especially older Americans, are wondering, is medical cannabis appropriate for me? Is it safe? And do I have legal access to it? And I'm here today to answer a few of these questions.
Uh, first of all, two things happen as we age. As a psychiatrist friend of mine said, aging is not for sissies. As we age, we accumulate diagnoses, and we accumulate medications. The diagnoses is people get older, they suffer from chronic pain, insomnia, anxiety. They can have trouble maintaining their weight. They can have depression. They can have trouble with abdominal symptoms. And then, as we age, the doctors make a very, uh, good faith effort to treat all these conditions. But I have people, patients in their 50s, 60s, 70s, 80s that are on 10, 15, 20 medications. This is called polypharmacy, and it's actually very confusing to try to manage all those medications. It's very expensive, and it can be dangerous if you make a mistake with your medications, which again, is why some people are investigating the use of medical cannabis, which is very effective in supplanting and replacing many of these medications.
Now, with medical cannabis, what do I see in my clinic? I'll see people with chronic pain. Some of them even have kidney problems from the chronic pain from taking too many of the non-steroidals. People think that the non-steroidals are safe because they're over the counter. But your Advil, your Motrin, your Naprosyn, your diclofenac, your Aleve, these medications, you could take once in a while. But if you take day after day after day, you could end up giving yourself a heart attack. Ten thousand people a year die from heart attacks from non-steroidals, or you could end up having a bleeding ulcer. But if you survive those, you end up harming your kidneys, uh, decades later. I see so many people with kidney problems. They don't need to have kidney problems just because they've relied too much on the non-steroidals. But anyways, so I see a lot of people in clinic with chronic pain.
Now, uh, what are the options? And nobody wants to be on opiates. Uh, we've had more than a hundred thousand overdose deaths from opiates in the last 12 months. And even if you're a good candidate for opiates, which many people are, it's sort of a nightmare trying to get them from your doctor. Uh, Tylenol does very little. Excuse me, I'm using my other, um, favorite plant-based, uh, psychoactive medication here. Um, and then so Tylenol doesn't do anything. Uh, nobody wants opiates, and the non-steroidals are, as I just mentioned, incredibly dangerous. A lot of people are finding cannabis to be a helpful, gentle alternative to their chronic pain. Now, cannabis doesn't work for very strong pain, like you break a bone or you're right after surgery. But for the mild to moderate pain that many Americans are suffering from as they get older, cannabis is a very, very safe and effective option.
The second thing is, uh, insomnia. Tons of people have trouble sleeping. Now, if someone has insomnia, we get them to drink less caffeine, to exercise, to do all the right things you should be doing to set yourself up for a good night's sleep. But then you look at the medications we give people in general, but particularly for older Americans, people in their 60s, 70s, and 80s. I mean, Ambien is really dangerous. The benzodiazepines, your Valium, your Klonopin, it's very dangerous as well. Belsomra, trazodone, all these medications have difficulties. And again, I truly think that for many people, and I've experienced this a ton in my clinic, a small, gentle dose of medical cannabis could really take the place of many of these medications.
Now, medical cannabis in older Americans, just like it is for other Americans, it's not entirely safe. First of all, you have to do it in a state where it's legal, or you face entanglement with law enforcement, which fortunately is changing, but we aren't there yet all over the country. Second of all, cannabis, like all medications, can have its side effects. It can affect your memory for the short term, not permanently, but your memory, your balance. It can give you a sense of confusion. Um, it's not without harms, though. Many of these harms can be alleviated or prevented in the first place, uh, by two simple mechanisms. One is, if you work with your doctor and have open and honest and transparent communication with your doctor, many of the side effects of medical cannabis can be avoided. And then there are many studies coming out from Israel, in particular, where the, the cannabis research is on fire because they don't have as many, uh, sort of arbitrary, ridiculous restrictions on research as we do in the United States. Studies are coming up that they're using it in older people and they're having very, very few side effects. Like some people got a little lightheaded, and some people had dry mouth. But compared to the side effects of these major, heavy-duty, um, medications that people are taking sort of day to day from their doctors, the side effects of cannabis can be managed quite easily. Again, no medication works for everybody, but, um, you might want to really consider it as worth a try.
Now, just in my personal life, my father died at age 92 a couple years ago, and he had a full and wonderful life. He was actually a very legendary psychiatrist at Harvard Medical School with a specialty in cannabis and psychedelics and had incredible contributions, but that's for another day. My dad, as he was nearing his end of life, we did have him on hospice, but we made a big point to use cannabis instead of opiates. In fact, we only used three doses of morphine to get him from this realm into the next realm, wherever that is. And because of that, in the last two, three, four, five weeks of his life, instead of being snowed under with morphine, you know, morphine makes you itchy and constipated and sort of barely, barely awake. I've seen this a million times in my clinical practice in the hospital. Because my dad was on cannabis instead of morphine, he was alert, awake, interactive. I mean, the night before he died, we didn't know at the time it was the night before he died, but he participated in a Zoom birthday party with all of his kids and all of his grandkids. He even made a joke. He loved it. Now, this would have never happened if, uh, he were taking tons and tons of opiates like morphine. Uh, so I think cannabis also has a very, very important role in end-of-life care and in people keeping people, um, very comfortable.
So anyways, thank you so much for listening. Uh, medical cannabis doesn't work for everybody, and it is to be started, you know, we start low and go slow, to be used with caution. I'm a big component, component of open conversation between doctor and patient about medical cannabis. But at the same time, uh, many of us have heard mostly, uh, in negative stories about marijuana, the devil's lettuce, uh, the evil weed. But increasingly, it's becoming legal, and doctors and patients are understanding that it really and truly can alleviate many of these symptoms. So I just wanted to discuss the pros and cons. This is Dr. Peter Grinspoon. Thank you so much.