Episode 3
Cannabis Use in Older Adults-Vira Pravosud, PhD;
Dr. Vira Pravosud’s study, published in the Journal of the American Medical Association, examined cannabis use patterns among older veterans in the United States. The study found that cannabis use was more prevalent among veterans than the general older population, with almost 60% reporting lifetime use and over 10% reporting past-month use. The study also revealed that over half of the current users were frequent users, highlighting the need for further research on the potential health impacts of cannabis use in this population.
The study on cannabis use among older veterans found that inhaled cannabis use, particularly vaping and dabbing, was associated with cannabis use disorder. The study also revealed that women were more likely to use edibles than men. Future research will focus on the potential adverse health effects of cannabis use, including cardiovascular and mental health outcomes, and whether cannabis serves as a substitute for tobacco smoking.
Transcript
The Cannabis Boomer Podcast is for baby boomers and all adults who are interested in the science of cannabis. Key words for the podcast, in general, are: baby boomers, cannabis, boomers, marijuana, THC, CBD, health, wellness, science, and aging.
For this particular episode key words are: cannabis, sleep, marijuana, THC, CBD, acute pain, chronic pain, substance use, cannabis use disorder, CUD, veterans, and baby boomers.
[: [: [:And what we were expecting based on other studies. And we saw that, , almost 60% of our respondents reported lifetime cannabis use for various reasons. And, uh, uh, about 14% reported. Past year use of cannabis and more than one in 10, uh, participants reported past, uh, 30 day cannabis use, which means that they, the, there were more than, you know, one in 10, participants who were using cannabis in the past months. Uh, and, uh, over half of those current users were frequent users. So they reported daily or near daily use. In the past months,
[: [:And we saw, , more than 10%. So that, let's say it was surprising and not in the sense that we know that cannabis use is increasing and, and, you know, in the past 20 years, because we see a growing legalization of cannabis, right? Not only for medical reasons, but also for operational reasons. So we see more commercial commercialization of cannabis, right?
We see dispensaries in, in the states where cannabis is legal, in almost in every corner, and a lot of advertisement of cannabis. But we didn't think that we would see, almost twice as much of cannabis use in veteran population compared to the general population.
[: [:They were actually veterans who are using VA services. And what we know about patients at the VA is that, we usually. See, you know, this is a predominantly male population, right? So compared to the general population and we will see that these are usually white or black, individuals, we will see that these are people of lower socioeconomic status. They may not be employed or they may not have retirement. They differ from the general population, with worse, uh, physical and mental health. So we'll usually see more chronic, diseases and disabilities in this population, and we will see more mental health concerns and conditions, uh, among them.
For example, you know, suicide ideation rates are higher among this population. Obviously, you know. Things like depression, anxiety, PTSD is higher, and it may be attributed to their, military exposure, military experiences and combat, exposure. For instance, you know, some of the participants were, Vietnam veterans, right?
And they would report, they tried the first, first time in Vietnam.
[: [:For example, uh, a large cohort study where we will recruit, you know, many people based on the academy use status. Let's say, you know, we will ask people, are you using cannabis, right? So are you smoking, for example, cannabis, you use edibles, in any form. And those people who are not using cannabis. And then we may follow these people for a long time, maybe even a lifetime, right?
And we will observe, let's say, what, medical conditions they have, right? Or what chronic conditions they have or just in general what, what, uh, diseases they may develop. And then we'll try to link their cannabis use status to those conditions. if cannabis exposure, cannabis use may affect your, uh, medical conditions in the future, right? We may not have the time to wait for that or, you know, resources. However, right now, you know, with, uh, digitalization of everything, we have really good medical records, or we can try to have medical records that will tell us only the data.
time. You know, we started in:In what forms, how frequent, so we can actually, have very detailed information on that, and we can in the future, you know, five years from now, 10 years from now, 20 years from now. For some of them, we can, uh, we can actually, uh, examine whether cannabis use their lifetime experience using cannabis was associated with any medical conditions that they would develop in the future.
[: [:To look at least at the five full, uh, follow up years to see whether cannabis use, was associated with any, uh, cardiovascular and, mental health conditions, among this cohort.
[: [:And this is about THC, not the CBD. And actually now our analysis, we, uh, we didn't even include, people who were c, b, D only? Well, we were not asking about CB, D only. We were asking for example, you know, people who were, uh, using topicals, which predominantly are CBD products. Not always, but CBD. So we were thinking more about psychoactive effects of, cannabis, right?
[: [:Including for pain management, sleep management, mental health, management of mental health concerns. So, I would say that from, you know, from one standpoint, yes, it's good. It helps for some people. On the other hand, we have to be careful, you know, I think that right now, because legalization is growing, clinicians, you know, healthcare providers, they need to start, you know, having discussions, deep discussions with their patients. About cannabis use and if, let's say, if patients report that it helps them, right? And this is something that. helps them and they prefer cannabis versus other, you know, maybe alternative, standard medication. They need to know what's the dose, uh, that is right for them. Right? How to use cannabis, how to avoid cannabis use in such a way that it, it develops, uh, addiction in the future, right?
That cannabis use other disorder that. We were talking about in our paper what we saw in our respondents, in our population of older veterans is that it's inhaled. cannabis use form that was, likely to be associated with, cannabis misuse compared to, for example, using edibles only. usually we think about frequent use, right? Frequent use products, and perhaps that's why inhaled use, we see that that relationship between inhaled use and. And development of cannabis use disorder is because usually, you know, people who are smoking vaping, debit cannabis, especially those who are vaping and debit cannabis.
They inhale highly concentrated products and you know, it hits you faster. You get high faster, right? Compared to, for example, using edibles that, you know, maybe in the digestive form you, you can't feel the effect that fast.
[: [:Let's say the difference was not, that significant, right? How, how much they smoked. But edibles were more likely among women than men. Mm-hmm. And that, that that's what we see. That's what we see actually in other populations in the general population too. Women are using edibles.
[: [:You know, cognitive impairment is one of the big things right now. So these are the questions we don't know and we want to answer. the. Question that is also very interesting is whether cannabis or is a substitute, for tobacco right now. The lab that I'm working in, they did a study and they saw that the. United States, adults, just in general, the general population. Their, perception of cannabis is that cannabis smoking is healthier, is safer than tobacco smoking. Right? Including for vulnerable populations such as like pregnant women or, you know, adolescents. But what we are interested in is that whether cannabis is something that is, you know, can just be a substitute for tobacco smoking, right?
So if, if we know that there is more of this perception that cannabis becomes safer and this, you know, less, harmful than tobacco, do we see that more people quit tobacco and switch to cannabis? And do we see that in older people? Do we see that at least, you know. Older veterans because this is the data that we have right now. We can have the, uh, that information from medical records. We do tobacco screening, for example, at the va. In contrast, we don't have. Cannabis screening for now. This is, you know, why our study is so important because we collected a very detailed information on cannabis use, that may not be available just for medical records.
[: [: [:The information expressed on this podcast is meant as current opinion in science and should not be considered medical advice .
