As more regions legalize marijuana, policymakers and health officials have been increasingly concerned about its health risks to adolescents. However, a new study suggests that seniors are also at significant risk. Published Monday in JAMA Internal Medicine, the study found that after Canada legalized marijuana, the number of emergency room visits for cannabis poisoning among people aged 65 and older surged dramatically.
The study, led by Dr. Nathan Stall, a geriatrician at Mount Sinai Hospital and researcher at Women’s College Hospital in Toronto, revealed that cannabis poisonings doubled following the legalization of cannabis flower sales and tripled 15 months later when Canada legalized the sale of edibles. “It’s often a baked good, a chocolate, or a gummy,” Dr. Stall noted, explaining that seniors often consume these products intentionally but sometimes by accident, mistaking edibles for regular food.
Symptoms of cannabis poisoning include dizziness, confusion, nausea, loss of coordination and balance, drowsiness, and hallucinations. Dr. Stall pointed out that these findings align with other research conducted in the United States, underscoring the need for more attention to senior drug use and its health impacts.
The study analyzed 2,322 emergency room visits for cannabis poisoning among seniors in Ontario from 2015 through 2022. This timeframe allowed researchers to observe trends before and after October 2018, when Canada legalized dried cannabis sales, and January 2020, when edibles were legalized. In 2015, there were 55 emergency room visits due to cannabis poisoning. This number steadily increased to 462 by 2021 before slightly declining to 404 in 2022.
Dr. Stall’s motivation for the study came from a personal experience in the emergency room. He was called to consult on an elderly patient exhibiting severe confusion and strokelike symptoms. Multiple tests revealed no clear cause until Dr. Stall ordered a toxicology test, which found cannabis in the patient’s urine. A family member then realized that the patient had mistakenly consumed their edible cannabis product.
The patient was hospitalized and received supportive care, as there is no specific treatment or antidote for cannabis poisoning. The study did not investigate the reasons behind senior overdoses, but Dr. Stall suggested that both accidental ingestion and intentional use for recreational or medicinal purposes were factors.
Several reasons contribute to seniors’ vulnerability to cannabis overdose. Modern cannabis strains are far more potent than those from previous decades, and seniors who used the drug earlier in life may underestimate the THC concentrations. Edibles, in particular, take about three hours for their effects to fully unfold, which might lead users to ingest too much in anticipation.
Additionally, older adults metabolize cannabis differently and eliminate it more slowly than younger people. Seniors are also more likely to take other medications, including psychoactive drugs for sleep, which can interact problematically with cannabis. Preexisting conditions like confusion or a tendency to fall can be exacerbated by cannabis use.
To mitigate these risks, Dr. Stall emphasized the importance of keeping edibles in locked locations and clearly labeled packaging to prevent unintentional exposure. Policymakers should also promote senior-specific dosing information and public-education campaigns highlighting the conditions and circumstances that increase risks for older adults using cannabis.
Seniors trying cannabis for the first time should adopt a cautious approach, drawing from a mantra in geriatric medicine: “Start low and go slow.” This means beginning with lower doses and increasing slowly, more so than a younger population might.
While the legalization of marijuana has brought various health concerns to light, it’s crucial to recognize and address the specific risks it poses to seniors. Ensuring safe usage practices and providing targeted education can help mitigate these risks and protect the health of older adults.
