The wave of adult use cannabis legalization sweeping North America has attracted a wide range of patients and consumers who otherwise would not consider indulging in hemp or cannabis to treat their medical needs. One of the most affected and engaged demographic groups, in terms of economic activity and need, is seniors.
More than 53 million seniors (age 65 or older) reside in North America, a population that will double by the year 2060. The legal status of cannabis, and the resulting erosion of negative stigma, is motivating many to investigate the merits of the herb in the treatment of a wide range of diseases and conditions that are common in seniors, including arthritis, cancer, and osteoporosis.
This article will consider some of the most common diseases and ailments that afflict seniors and examine the research around how cannabis and its constituent medicinal molecules—cannabinoids and terpenes—may help in their treatment.
Arthritis is a common disease that affects more than 55 million North Americans. This equals about one in five adults and includes 300,000 children. More than 100 varieties of arthritis exist, including gout, juvenile arthritis, lupus, lyme disease, and Ehlers-Danlos syndrome (according to the Arthritis Foundation). It is the leading cause of disability in North America.
Arthritis results from inflammation of one or more of the joints. Common arthritic symptoms include joint pain, stiffness, swelling, and decreased range of motion—which typically worsen with age. The two most common types of arthritis are osteoarthritis and the rheumatoid variety.
Cannabis has been shown to help arthritis sufferers due to its ability to decrease systemic inflammation and act as an analgesic, lowering the joint pain caused by swelling and stiffness. “When I take my [cannabis] medicine, I feel more relaxed, I feel more in charge of my body, and I’m still very coherent to function,” said Cornelia Grunseth, a patient based in California who uses medical cannabis to treat arthritis.
Many medical professionals are recommending to their patients use of cannabis to control the symptoms of arthritis. “There’s been a lot of experimental evidence to show that cannabis can be effective in treating the pains of arthritis, as well as the inflammation and helping with fatigue,” said Dr. Jason McDougall, a professor of pharmacology and anesthesia and chair of the Scientific Advisory Committee of the Arthritis Society.
A 2014 study entitled “Expression of Cannabinoid Receptor 2 and its Inhibitory Effects on Synovial Fibroblasts in Rheumatoid Arthritis” that was published in the journal Rheumatology found that arthritis patients exhibited more CB2 receptors in their joints than regular patients, indicating a central role of the endocannabinoid system (ECS) located throughout the immune system and every organ of the body in the regulation of conditions like arthritis and the prevention of the inflammation that leads to them.
A 2013 study entitled “Cannabinoid CB2 Receptors Regulate Central Sensitization and Pain Responses Associated with Osteoarthritis of the Knee Joint” published in the journal PLOS ONE investigated osteoarthritis (the most common type of the disease, followed by gout and rheumatoid arthritis) in particular.
The researchers reported, “The analgesic effects produced by activation of the cannabinoid (CB) receptor system [ECS] are well documented and mediated by multiple sites of action. It is well accepted that activation of spinal CB2 receptors attenuates pain behaviour in models of neuropathic pain.”
A 2005 study entitled “Cannabinoids and the Immune System: Potential for the Treatment of Inflammatory Diseases?” and published in the Journal of Immunology found cannabis to decrease inflammation via a particular mechanism in the immune system (which is intimately tied to the ECS).
Concluded the researches, “Cannabinoids can modulate both the function and secretion of cytokines from immune cells. Therefore, cannabinoids may be considered for treatment of inflammatory disease.”
More than five million North Americans suffer from the most common form of dementia among those over 60: Alzheimer disease (also known as Alzheimers). According to the Centers for Disease Control and Prevention, “The number of people living with the disease doubles every five years beyond age 65.”
Alzheimer disease is the fifth leading cause of death among those 65 and older and one of the top 10 causes of death in North America. It is estimated that 60-70 percent of cases of dementia manifest as Alzheimer disease.
Symptoms of Alzheimer disease include memory loss, poor judgement, and an overall inability to cope with daily life and handle basic tasks such as money management, driving, and meal preparation. Patients with Alzheimer disease also often experience severe mood shifts and behavioral abnormalities, typically rooted in their loss of memory and the disorientation and frustration that can result.
Research indicates that some cannabinoids may restore neuroplasticity and, with it, memory and social functionality. Studies indicate that cannabis and its constituent medicinal molecules may be superior to conventional pharmaceutical drugs (lacking their sometimes considerable negative side effects).
A 2014 study entitled “β-Amyloid Inhibits E-S Potentiation through Suppression of Cannabinoid Receptor 1-dependent Synaptic Disinhibition” and published in the journal Neuron found that the body’s ECS may inhibit the effects of amyloid plaques and improve neuroplasticity (the ability of brain cells to form new connections and handle different types of communications).
Concluded the researchers, “A pathway through which Aβ can act to modulate neural activity [has been] identified, relevant to learning and memory and how it may mediate aspects of the cognitive decline seen in Alzheimer disease.”
A 2006 study entitled “Marijuana’s Active Ingredient Shown to Inhibit Primary Marker of Alzheimer Disease” and published in the journal Molecular Pharmaceutics employed computer modeling and biochemical assays. It reported, “With its strong inhibitory abilities, THC may provide an improved therapeutic for Alzheimer disease” that treats “both the symptoms and progression” of the condition.
The researchers concluded, “We also found that THC was considerably more effective than two of the approved drugs for Alzheimer disease treatment, donepezil (Aricept) and tacrine (Cognex), which reduced amyloid aggregation by only 22 percent and 7 percent, respectively, at twice the concentration used in our studies. Our results are conclusive enough to warrant further investigation.”
Cancer is a group of more than 100 diseases that kills more than 600,000 people each year, with nearly two million new cases annually (according to the National Cancer Institute). The most common form is breast cancer, with nearly 300,000 new cases of this variant annually.
Cancer is characterized by cells in a particular area of the body, such as the lungs, brain, or pancreas, that become unstable and erratic. Once-healthy rogue cancer cells begin to multiply rapidly. Normally, new cells are created on an as-needed basis, only as old cells die. Cancerous cells, however, not only are created unusually rapidly (depending on type), but also do not die off like normal cells.
Cannabinoids and terpenes in cannabis, including tetrahydrocannabinol (THC), sometimes cause cancer cells to undergo a genetically pre-programmed death, akin to cellular suicide, that is called apoptosis. The constituent molecules in cannabis have been found to not only kill cancer cells and reduce tumor size, but also are helpful in the treatment of the side effects of the disease and its conventional treatments. Several studies over many decades, dating back to 1975, have revealed the anti-cancer efficacy of the cannabinoids and terpenes produced by hemp and cannabis.
A 2010 study entitled “Cannabinoids Reduce ErbB2-driven Breast Cancer Progression Through Akt Inhibition” that was published in the journal Molecular Cancer found THC to reduce tumor growth, including the number of tumors.
The researchers reported, “Our results show that both Δ9-tetrahydrocannabinol [THC], the most abundant and potent cannabinoid in marijuana, and JWH-133, a non-psychotropic CB2 receptor-selective agonist, reduce tumor growth, tumor number, and the amount/severity of lung metastases in MMTV-neu mice.” The researchers concluded, “Taken together, these results provide strong preclinical evidence for the use of cannabinoid-based therapies for the management of ErbB2-positive breast cancer.”
A 2006 study entitled “A Pilot Clinical Study of Δ9-tetrahydrocannabinol in Patients with Recurrent Glioblastoma Multiforme” that was published in the British Journal of Cancer involved nine human participants and claimed to be the “first clinical study aimed at assessing cannabinoid antitumoral action, specifically a pilot phase I trial in which nine patients with recurrent glioblastoma multiforme were administered THC intratumoraly.”
The study found THC to be safe for use by patients. Concluded the researchers, “In view of the fair safety profile of THC, together with its possible antiproliferative action on tumour cells reported here and in other studies, it would be desirable that additional trials—on this and other types of tumours—were run to determine whether cannabinoids—as single drugs or in combination with established antitumoral drugs—could be used, other than for their palliative effects, to inhibit tumour growth.”
Depression is a mood disorder that affects people of all ages, but is especially prevalent in seniors. Often, this is due to the loss of loved ones, an inability to engage in regular work or income generation, or the stress of disease (including pain, memory loss, and limited mobility).
Depression is characterized by a persistent feeling of hopelessness, loss of interest, and sadness that affects nearly 20 million people in North America (about seven percent of the population). Major depressive episodes are experienced by more women (8.7 percent) than men (5.3 percent).
Conventional treatments for depression include pharmaceutical drugs, psychotherapy, and lifestyle improvements such as exercise and socialization. Many patients experience negative side effects when taking traditional drugs, however, or find only temporary relief from their depression.
For nearly half a millenium, cannabis has been used to treat patients suffering from depression and other mood disorders. In 1621, British clergyman Robert Burton proclaimed that cannabis was effective for this common condition. In 1887, Hobart Amory Hare noted how cannabis could ease anxiety and, thus, improve the mood of his patients. “The patient, whose most painful symptom has been mental trepidation, becomes more happy,” wrote Hare.
Modern physicians echo these sentiments—now with the backing of science and formal research studies. “I think cannabis has a lot of potential in the treatment of mental illness,” said Dr. Lester Grinspoon, professor of psychiatry at the Harvard School of Medicine.
A 2018 study entitled “A Naturalistic Examination of the Perceived Effects of Cannabis on Negative Affect” that was published in the Journal of Affective Disorders reported that human participants experienced, when smoking small quantities of cannabis, “a 50 percent reduction in depression and a 58 percent reduction in anxiety and stress.”
Interestingly, the study noted differences between CBD and THC, reporting that cannabis rich in CBD (>9.5 percent) and low in THC (<5.5 percent) “was associated with the largest changes in depression ratings.” However, the study also noted that cultivars that are both CBD-rich (>11 percent) and contain potent amounts of THC (>26.5 percent) “produced the largest perceived changes in stress.”
Concluded the researchers, “Cannabis reduces perceived symptoms of negative affect in the short-term, but continued use may exacerbate baseline symptoms of depression over time.”
A 2015 study entitled “Possible Use of Medical Marijuana for Depression” that was published in the journal Science Daily found a connection between chronic stress and depression. The study theorized that stress leads to a decrease in the production of endocannabinoids, the body’s internally produced cannabinoid molecules (including anandamide and 2-AD).
“In the animal models we studied, we saw that chronic stress reduced the production of endocannabinoids, leading to depression-like behavior,” reported the researchers. The study concluded, “Chronic stress is one of the major causes of depression. Using compounds derived from cannabis to restore normal endocannabinoid function could potentially help stabilize moods and ease depression.”
The study also pointed out that patients with Post Traumatic Stress Disorder often gain relief from their symptoms—including depression, anger, insomnia, and nightmares—from the use of cannabis.
Glaucoma is a disease that affects nearly 5.5 million new people each year and was suffered by more than 60 million people globally in 2010, with a projected 80 million by 2020. It is the leading cause of blindness in those more than 60 years of age. This common condition, which attacks the optic nerve, occurs as a result of a fluid buildup in the front of your eye that increases ocular pressure. This pressure, in turn, damages the optic nerve. Severe cases of glaucoma often result in blindness.
Cannabis has been shown to reduce this optic pressure in the eye, preventing the damage of glaucoma. “For some [glaucoma] patients who have failed lots of treatments, [cannabis] is the only thing that keeps them from going blind,” wrote Dr. Sunil Aggarwal, a leading cannabis researcher based in Seattle, Washington.
A 2016 study entitled “Cannabinoids for Treatment of Glaucoma” that was published in the journal Current Opinion in Ophthalmology reported that recent research has revealed what has been known for the past 40 years: Cannabis has a positive effect on lowering intraocular pressure in glaucoma patients.
Concluded the researchers, “Marijuana is an effective ocular hypotensive agent. However, cardiovascular and neurological effects are observed at the same dose and may theoretically reduce the beneficial effect of lowering intraocular pressure by reducing ocular blood flow.”
A 1975 human trials study entitled “Marijuana Smoking and Reduced Pressure in Human Eyes” that was published in the journal Investigative Ophthalmology involved participants who consumed cannabis via smoking. The study found that pressure within the eye was reduced after smoking “a socially relevant dose of marijuana (12 mg. delta-9 tetrahydrocannabinol).” The study also revealed that the pressure reduction experienced by glaucoma patients occurred only in those who smoked “light to moderate” amounts.
Osteoporosis is a disease that affects approximately 200 million people worldwide, according to a 2017 research study. It results in bones becoming weak and brittle and affects seniors more than younger people and women more than men.
Symptoms of osteoporosis include bones so frail that a fracture can be incurred by the simple act of coughing or bending to retrieve an object. Fractures resulting from osteoporosis most commonly occur in the hip, spine, and wrists. The mechanism behind osteoporosis is relatively basic: It results from the body’s inability to replace old, dying bone cells. When the death of old bone cells outpaces their replacement, the structural integrity and solidity of bones decreases, resulting in fragility and the incidence of fractures and breaks.
A 2015 research study entitled “Cannabidiol, a Major Non-Psychotropic Cannabis Constituent Enhances Fracture Healing and Stimulates Lysyl Hydroxylase Activity in Osteoblasts” that was published in the Journal of Bone and Mineral Research found that the cannabinoid cannabidiol (CBD) helped heal the bones of laboratory rats.
“We found CBD alone to be sufficiently effective in enhancing fracture healing,” reported the researchers. These data show that CBD leads to improvement in fracture healing and demonstrate the critical mechanical role of collagen crosslinking enzymes.”
This study also reported that CBD is an effective preventative treatment due to the fact that it mineralizes bones. “After being treated with CBD, the healed bone will be harder to break in the future,” wrote the researchers.
A 2009 study entitled “Cannabinoids and the Skeleton: From Marijuana to Reversal of Bone Loss” that was published in the journal Annals of Medicine identified the role of the CB2 cellular receptor in the ECS in maintaining bone health. “It appears that the main physiologic involvement of CB2 is associated with maintaining bone remodeling at balance, thus protecting the skeleton against age-related bone loss,” reported the researchers.
The study concluded, “Taken together, the reports on cannabinoid receptors in mice and humans pave the way for the development of 1) diagnostic measures to identify osteoporosis-susceptible polymorphisms in CNR2, and 2) cannabinoid drugs to combat osteoporosis.”