Updated on October 16, 2020.
Medical content reviewed by Dr. Joseph Rosado, MD, M.B.A, Chief Medical Officer
Approximately 20% of people who purchase cannabis in the United States are over 60 years old. One of the concerns that federal health regulators often cite is the lack of longitudinal studies on the impact of medical cannabis on health. Particularly for seniors.
Until the legalization of cannabis in thirty-four states (at the time of writing), acquiring that research was nearly impossible. Funds for cannabis research were difficult to get for researchers from government agencies. Additionally, clinical studies that required cannabis for patient trials had difficulty getting cannabis to dispense as needed for evaluation through legal channels.
There is an infinite number of global health studies that report the wellness benefits of cannabis. Studies have examined chronic diseases, including cancer, diabetes, Parkinson’s Disease, and mental health disorders such as treatment-resistant depression and anxiety. Legalization at the state level has reduced many of the barriers to clinical research.
The data is compiling worldwide at a rate that is hard to deny or ignore, as favorable results in health studies continue to grow. Federal authorities have stated that they are not reassured of the safety of medical cannabis use. And one of the reasons is that no long-term studies on the health impacts had been provided.
A new study released in 2020 may change that. And provide an answer and rebuttal to one of the last rationales supported by the federal government. One that allows them to medically justify the categorization of cannabis as a Schedule 1 drug.
Petitioning to Reschedule Cannabis in the Controlled Substances Act
In the past three years, patient advocacy and pro-cannabis organizations have increased petitions’ volume to the federal government. The efforts have been to change cannabis from Schedule 1 to a Schedule 3 or unscheduled drug on the Controlled Substances Act.
At the time of writing, 34 states have legalized medical marijuana for patient care. Today, more states evaluate legislating new medical marijuana programs, supported by the Compassionate Care Act (S.2961) of 2016.
How are long-term side effects related to decriminalizing cannabis and providing medical cannabis programs in every state for patients? One of the holdout arguments repeated by the FDA and the DEA relates to long-term side effects as a reason to continue legislation that prohibits cannabis at the federal level.
Until very recently, funds for cannabis research were difficult, if not impossible, to get for researchers. Additionally, clinical studies that required cannabis for patient trials had difficulty getting cannabis to dispense as needed for evaluation. That is changing. Not only is the FDA encouraging more evidence-based research into cannabis, but it has also commissioned research into other alternative medicines like psilocybin (psychedelic mushrooms).
The FDA Has Approved Cannabis for Medical Use with the Pharmaceutical Industry
Understandably, federal regulators would want to know that cannabis is safe for consumers even though it has approved other products that have been demonstrated to be unsafe for long-term human consumption. Such as alcohol and tobacco products.
There are many contradictions. On the one hand, federally, agencies perpetuate a belief (and backing it up legislatively) that cannabis is a ‘dangerous drug,’ the FDA has licensed several cannabis-derived drugs. So, if cannabis is dangerous, why did the FDA permit pharmaceutical companies to develop prescription drug derivatives?
The ‘pot’ thickens.
The FDA approved one cannabis-derived drug and three synthetic cannabis-related drugs. The four drugs have been released for immediate prescribing and sale.
Epidiolex (Cannabidiol) For the treatment of Lennox-Gastaut syndrome (LGS), Dravet syndrome, or tuberous sclerosis complex (TSC) for patients aged one-year or older. The average dose delivers 100 milligrams (mg) of CBD per (mL) of the solution, taken twice daily to control seizures.
Marinol, Syndros, and Cesamet (Dronabinol) To treat chemotherapy-induced nausea and treatment of anorexia from AIDS.
The FDA approved drugs that are available by prescription now (and covered by health insurance) mimic the same medicinal benefits (and in some cases, psychoactive effects) of natural cannabis. Yet the FDA has not addressed the concern in approving the four drugs because of being “unsure of long-term effects.”
If the FDA and federal regulators were able to approve synthetic cannabinoids, without concern about long-term (longitudinal) medical studies, they “should” be able to do it for medical cannabis.
The Long-Term Study That Could Move the Dial on Legalization of Medical Cannabis
A new study from a research team in Israel has found that adults should not expect any “ill cognitive differences when compared to non-users” of cannabis. Israel is becoming a global leader in cannabis health research.
“Considering the accumulating evidence showing efficacy of cannabis use for multiple health conditions common in older individuals, the lack of adverse effects on the brain in the current sample of individuals with chronic pain who were older than 50 years can contribute to a better risk–benefit assessment of [medical cannabis] treatment in this population.”
Why is this relevant? Physicians in the United States in 2017 wrote 191 million for pain medications or a rate of 58.8 prescriptions for opioids per 100 Americans. Relief of chronic pain is a common reason that opioid medications are prescribed.
The bad news? There are comprehensive medical studies that reported significant cognitive decline among patients who use opioid medications long-term. So much for the argument about cannabis leading to problems with focus, memory, and other cognitive functions.
The study above does not talk about other areas of health. But it does go a long way to debunk some of the fears and misinformation about medical cannabis as a cause of senility after long-term use.
If Synthetics Are Legal and “Safe,” Why Not the Real Deal?
If you live in a legalized state and have a chronic health issue, you may be thinking about getting your medical marijuana card. There is increased interest from patients who have been prescribed opioid medications.
Can medical cannabis provide a step-down therapy and healthier alternative for pain management? That is why many seniors explore medical cannabis, for effective symptom relief and as a safer alternative. Some states have already legalized cannabis for opioid addiction therapy. A new approach to winning the war against opioid abuse, addiction, and overdose. And one with fewer side-effects.
Interestingly, yet another drug called Nabiximols (cannabinoid), a mouth spray created from whole-plant extract (THC/CBD ratio), is on the way. It is currently available in Canada and Europe. The FDA is still being evaluated for the treatment of cancer pain, muscle spasms from diseases like multiple sclerosis, and epilepsy.
It will get approved before raw cannabis does for medicinal use, which is a head-scratcher. Particularly for patients with chronic diseases and debilitating symptoms who may live in states where medical marijuana has not been legalized.
The bias toward approving pharmaceutical derivatives and synthetics while prohibiting the organic source doesn’t make sense. And the political problems are creating an obstacle to the medical benefits that cannabis may provide to patients. A natural therapeutic remedy that could improve the quality of life for millions of Americans with chronic diseases.