May 13, 2022 – As older adults turn to cannabis to relieve chronic symptoms, or for fun, an increasing number are winding up in ERs with side effects from the drug.

Researchers in California found the rate of cannabis-related ER visits among adults over age 65 in the state increased by 18 times from 2005 to 2019.

Older adults have higher risks for bad reactions to cannabis, so addressing potential harms of using the drug “is urgently required,” the researchers reported May 12 at the 2022 annual meeting of the American Geriatrics Society in Orlando, FL.

People living with multiple chronic conditions and taking multiple medications are especially likely to be at risk for harm, says researcher Benjamin Han, MD, a geriatrician at the University of California San Diego.

Han says that “very little” is understood about the risks and benefits of cannabis for the elderly, and more studies are needed.

California legalized medical marijuana in 1996 and recreational pot in 2016.

ER Trips Up Sharply Among the Oldest Tokers

The researchers used diagnostic code data from California’s non-military acute care hospitals, collected by the state’s Department of Healthcare Access and Information, to calculate annual rates of cannabis-related visits per 10,000 ER visits.

Rates of cannabis-related visits increased significantly for all older adult age ranges, the researchers say. Among those aged 65 to 74 years, the rate increased by about 15 times, from 44.9 per 10,000 visits in 2005 to 714.5 per 100,000 in 2019; for ages 75 to 84, the rate increased by about 22 times, from 8.4 to 193.9 per 10,000; and for those 85 and older the rate jumped by nearly 18 times, from 2.1 to 39.2 per 10,000, they found.

The greatest increase happened for visits categorized in diagnostic codes as cannabis abuse and unspecified use. Cannabis dependence and cannabis poisoning accounted for only a small fraction of cases, Han’s group found.

The researchers did not have data on specific reasons for a visit, or whether patients had smoked or ingested marijuana products. They also could not discern whether patients had used THC, which has psychoactive properties, or cannabidiol, commonly known as CBD, which typically does not have the same mind-altering effects.

Han says the data may not present a full picture of marijuana-related ER visits.

Older adults have lived through the “war on drugs,” with very negative language around drug use including cannabis, so they may not tell ER workers they had used drugs, he says.

A 2017 study linked cannabis use among older adults with more injuries, which in turn led to more ER visits.

Brian Kaskie, PhD, associate professor in health management and policy at the University of Iowa, Iowa City, says that the new findings show a state-specific, but alarming trend, and that more research is needed.

“Were these first-time users who were not familiar with anxiety-inducing aspects of cannabis use and took high potency products? Did they complete any education about how to use cannabis?” says Kaskie, who was not involved in the new study.

“Were the ER visits for relatively benign, non-emergent reasons or were these … visits an outcome of a tragic, harmful event like a car accident or overdose?”

Show Sources

JAMA Internal Medicine: “Trends in Cannabis Use Among Older Adults in the United States, 2015-2018.”

Benjamin Han, MD, University of California, San Diego.

American Geriatrics Society 2022: “Trends in Cannabis-Related Emergency Department Visits Among Older Adults in California.”

The American Journal of Drug and Alcohol Abuse: “Older adults’ marijuana use, injuries, and emergency department visits.”

Brian Kaskie, PhD, associate professor in health management and policy, University of Iowa, Iowa City.

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