Medical marijuana is now legal in most states, and older adults are reaping many of the benefits. In a survey conducted by the University of California, San Diego, 15 percent of 568 adults ages 65 and older reported having used cannabis within the past three years, mainly for chronic pain or arthritis, sleep problems, depression, or anxiety. As a critical-care nurse turned cannabis nurse and patient advocate, I spend my days teaching patients and doctors alike about this unique plant-based medicine.
Throughout the body there exists a network called the endocannabinoid system (ECS) that helps regulate dozens of bodily functions, including sleep, pain, temperature regulation, inflammation, digestion, emotional processing, and more. The ECS has one overarching goal: to keep the body functioning happily and healthfully. Special cellular receptors designed to make this happen are located in practically every square inch of the body, waiting to latch on to naturally produced neurotransmitters called endocannabinoids.
When something is off-balance physically or mentally due to stress, injury, or disease, the ECS triggers the release of endocannabinoids, which travel to the system in need. There, they fit into the ECS receptors like a lock and key, helping put things back on track. This might involve relieving pain, speeding up or slowing down gastrointestinal motility, boosting immune function, and more.
But the human body isn’t the only thing capable of producing cannabinoids. Cannabis is rich in them, too. Specifically, it contains delta-9-tetrahydrocannabinol (THC, the high-producing component of cannabis) and cannabidiol (CBD, which does not produce a high). More than 100 other cannabinoids exist in the plant. This is why using cannabis has long been associated with feeling relaxed, happy, sleepy, and hungry. Its cannabinoids fit into the ECS receptors, signaling the body to do what it needs to do to move towards balance and health.
When it comes to how and why medical marijuana is able to help so many different types of health issues (see sidebar), one theory is that several disease processes, including ones we don’t fully understand yet, like migraines, fibromyalgia, and irritable bowel syndrome, could be tied to a dysfunctional endocannabinoid system, one that could benefit from additional endocannabinoids beyond those produced naturally by the body. Using THC and/or CBD simply augments your body’s ECS.
But the answer isn’t to ask your grandson to bring you some pot gummies the next time he comes home from college. (Believe me, this happens more often than you would believe.) Unlike Tylenol or Tums, THC is not a one-size-fits-all drug. There are dozens of different strains, some with invigorating effects and others with calming ones. Some can leave you feeling uncomfortably high, and others are known to have potentially harmful impurities.
That’s why it’s important to work with a cannabis clinician who can guide you on how to use medical marijuana safely and effectively. A cannabis doctor or nurse can explain the differences between smoking, eating, or even drinking THC, help you pinpoint the proper dose (including helping people avoid feeling too high), and make sure you’re avoiding potential drug-drug interactions. (For example, cannabis can decrease the circulating dose of clopidogrel [Plavix] and may compromise the efficacy of the cancer drug tamoxifen.)
To find a local cannabis practitioner, use the Society of Cannabis Clinicians website’s Find a Practitioner tool or ask friends and family for recommendations. Pick someone with medical credentials, such as an RN, MD, or DO.
Always tell your health-care provider if you start using THC or CBD. If they’re unsure of how it might impact your current medication regimen, your cannabis clinician will be happy to collaborate. You may even find that, as your medical marijuana begins to work, you need less of certain prescribed drugs, such as antidepressants or pain medications.
Insurance will probably not cover cannabis clinicians, but some patients have success using their flexible spending account or health savings account. A cannabis clinician can also help you apply for a medical marijuana card, which allows you to purchase marijuana legally in most states.
