With increasing acceptance of cannabis across the United States – nearly half the states have legalised recreational use and 15 more for medicinal purposes – a concerning trend is emerging: a rise in cannabis use among older adults. While the legal landscape shifts, research is uncovering potential health risks associated with this demographic's growing consumption. This article explores the rising prevalence of cannabis use in older Australians, the emerging evidence of potential harms, and what this means for healthcare providers and individuals.

The Grey Market: Cannabis Use Among Older Australians

Traditionally, cannabis use was associated with younger generations. However, recent data indicates a significant increase in consumption among Australians aged 50 and over. Factors contributing to this shift include changing societal attitudes towards cannabis, easier access due to legalisation in some states, and the perception of cannabis as a safer alternative to traditional pharmaceuticals for managing chronic pain, anxiety, and sleep disorders.

Emerging Health Risks: What the Research Shows

While anecdotal evidence often highlights potential benefits, a growing body of research is shedding light on the potential health risks associated with cannabis use, particularly in older adults. Older individuals often experience age-related physiological changes that can impact how their bodies process cannabis. These changes can lead to:

• Increased Sensitivity: Reduced liver and kidney function can slow down the metabolism of THC, the psychoactive compound in cannabis, leading to prolonged and intensified effects.
• Drug Interactions: Older adults are more likely to be taking multiple medications, increasing the risk of adverse interactions with cannabis. These interactions can affect everything from blood pressure to cognitive function.
• Cognitive Impairment: Long-term cannabis use has been linked to cognitive decline, including problems with memory, attention, and executive function. This risk may be amplified in older adults who are already experiencing age-related cognitive changes.
• Cardiovascular Concerns: Cannabis can increase heart rate and blood pressure, potentially exacerbating existing cardiovascular conditions.
• Mental Health Risks: While some use cannabis to manage anxiety, it can also trigger or worsen mental health conditions, particularly in individuals with a pre-existing vulnerability to psychosis or depression.

Navigating the Risks: Recommendations for Healthcare Providers and Individuals

Given the rising prevalence of cannabis use among older Australians and the emerging evidence of potential harms, it's crucial for healthcare providers to proactively address this issue. Recommendations include:

• Open Communication: Encourage open and honest conversations with older patients about their cannabis use, without judgement.
• Comprehensive Assessment: Conduct a thorough assessment of patients' medical history, medication list, and potential risk factors.
• Education and Counselling: Provide patients with accurate information about the potential benefits and risks of cannabis use, tailored to their individual circumstances.
• Monitoring and Follow-up: Regularly monitor patients for any adverse effects or drug interactions.

For older Australians considering or using cannabis, it’s essential to:

• Consult with a Healthcare Professional: Discuss the potential risks and benefits with a doctor or pharmacist before starting cannabis use.
• Start Low and Go Slow: If cannabis is deemed appropriate, start with a low dose and gradually increase it as needed, under medical supervision.
• Be Aware of Interactions: Carefully review all medications and supplements with a healthcare professional to avoid potential interactions.
• Monitor for Side Effects: Pay attention to any adverse effects and report them to a healthcare provider.