Cannabis for common conditions

The use of cannabis amongst older adults in Canada continues to increase, with much of this use being for medical purposes. Although some benefits can be seen with the use of cannabis and cannabis-based products for common conditions such as cancer, nerve pain, and inflammatory bowel disease, they are hindered by potential negative side effects.

Currently, the quality of the evidence is low and more high quality research is needed to establish more definitive recommendations on use.

If you are considering the use of cannabis or cannabis-based products for medical reasons, be sure to speak with your healthcare provider first, so you can assess whether the benefits outweigh the possible harms, ask questions, get answers, and develop a treatment plan.

Following the legalization of cannabis use in Canada, older adults 65 years old and over have become the fastest growing age group of cannabis consumers in the country. What are older adults using cannabis for? It turns out the majority, 52 per cent to be exact, use cannabis solely for medical purposes, 24 per cent use it only for nonmedical purposes, and 24 per cent use it for a combination of both. With an increased interest in cannabis to help treat or cope with various health conditions and side effects of treatments, it is important to be aware of whether or not the evidence supports these claims and the safety of cannabis use. Let’s take a deeper dive into the evidence-base around cannabis use for three common conditions: cancer, chronic nerve pain, and inflammatory bowel disease (IBD).

Cannabis for side effects of cancer treatment?

The majority of cancer patients undergoing chemotherapy experience distressing side effects like nausea and vomiting. The standard approach for dealing with these side effects is the use of anti-sickness medications. Cannabinoids, which are active chemicals found in cannabis, arean alternative approach. Research shows that cannabinoids may help people going through chemotherapy manage the accompanying nausea and vomiting, and may even be as effective as the standard approach. However, potential benefits may come with an increased risk of other side effects, such as dizziness, sedation, disorientation, or uneasiness. These findings are based on studies of low to moderate quality. As such, more research that is of higher quality and takes into account newer cancer therapies and anti-sickness medications is needed to increase our certainty in the results.

Cannabis for chronic nerve pain?

Nerve pain is caused by nerve damage that stems from a variety of factors, including illness, injury, and even surgery. It is often treated using pain relieving medications such as non-steroidal anti-inflammatory drugs or opioids, although not generally with a great degree of success. Research demonstrates that cannabis-based medications may relieve pain and reduce pain intensity, psychological distress, and sleep problems in adults with chronic nerve pain. But, once again, alongside these potential benefits may come unwanted side effects such as confusion, psychosis, and sedation. These findings are grounded in very-low to moderate quality evidence. Therefore, more high quality research is needed to establish effectiveness and safety, especially studies focusing on older populations.

Cannabis for Crohn’s disease and ulcerative colitis?

Crohn’s disease and ulcerative colitis are chronic inflammatory conditions that impact an individual’s digestive tract. Both are a type of IBD. Treatment often consists of prescription medications that induce and maintain disease remission, but come with an increased risk of serious side effects such as liver problems and cancer. Research illustrates that cannabis cigarettes and cannabis oil do not appear to help with remission or inflammation in people with active Crohn’s or colitis; however, cannabis cigarettes may reduce disease activity in both IBD subtypes, while cannabis oil may enhance quality of life. Certain improvements were accompanied by increased side effects in people with Crohn’s—such as drowsiness, memory loss, and issues with concentration—and colitis—such as headaches, fatigue, and dizziness. It is also important to be aware that these results were based on a small number of studies with a very small number of participants. So, ultimately, no concrete conclusions can be made at this time, and further research is needed.

Considerations for cannabis use

Overall, evidence on the use of cannabis and cannabis-based products for cancer, nerve pain, and IBD is limited and comes from fairly low quality research. This makes it difficult to make strong conclusions on effectiveness and safety. The big question you might be asking is, “what does this all mean for me?” First, it means trying to stay up-to-date on the evolving evidence-base around this topic, especially as new research comes out. Second, if you are contemplating using cannabis for medical purposes, remember to discuss the issue with your healthcare provider before commencing. Lastly, always weigh out the pros and cons for you as an individual. For some people the side effects might outweigh any benefits, while for others the opposite may be true (e.g., people not responding to traditional treatments). This assessment process is something a health professional can help you with, as is the development of a tailored treatment plan. CS

From the McMaster Optimal Aging Portal. Visit their website (www.mcmasteroptimalaging.org) for the latest evidence-based information to support healthy aging.

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