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Cannabis and the aging population – Can they benefit?

The aging population is one of the most prominent challenges in Canada because we have yet to find a viable solution to sustain government and health-care spending. For the first time, the number of seniors living in Canada outweigh the number of children. According to the 2016 Statistic Canada’s census, there are now 5.9 million Canadian seniors (65 years and older), compared to 5.8 million Canadian children (14 years and under); and this dramatic population imbalance will rise in the years to come.1 By 2031, about 23% of Canadians could be seniors and by 2061, there could be 12 million seniors to just 8 million children in Canada.1

Figure 1: Percentage of the total population, comparing children (0-14 years old) and seniors (65 years and up).2

Most common indication for prescribed medication in the aging population

Prescription drugs make up a significant portion of health-care spending. On average, seniors use more prescription drugs than any other age group, largely due to their increased susceptibility to chronic conditions. In 2016, approximately 65.7% of seniors were prescribed 5 or more different drug classes and 8.4% of seniors were prescribed 15 or more drug classes.3 Some of the most common indications that are treated in seniors with prescription medication include:3

  • High cholesterol
  • GERD (Gastroesophageal reflux disease)
  • Peptic ulcer disease
  • High blood pressure
  • Hypothyroidism
  • Management of moderate to severe pain
  • Diabetes
  • Seizures
  • Anxiety
  • Insomnia

Cannabis as an alternative to prescription medication?

An emerging area of research is using Cannabis as an alternative to prescription medication in treating symptoms. A study performed in 2017 in the United States found that among 1248 respondents, common classes of drugs substituted with cannabis were narcotics/opioids for pain, anxiolytics/benzodiazepines for anxiety, antidepressants for depression and sedatives/hypnotics for sleep disorders.4

Figure 2: Number of reported prescription drug substitutions with cannabis by drug category in 2016.

An Israeli prospective study was published by the European Journal of Medicine in 2018, assessing the use of medical cannabis in the elderly population (age 65 and older) between January 2015-October 2017. With over 2500 patients that participated, the most common indication for cannabis treatment were for pain (66.6%) and chemotherapy-induced nausea and vomiting (24.2%).5 In just 6 months of treatment, 93.7% of patients reported an improvement in their symptoms and indicated that their pain level was reduced from a median of 8 on a 0-10 pain scale to a median of 4. After 6 months of treatment, 18.1% of patients stopped using opioids to treat their pain, or their dose was reduced. The use of cannabis was not associated with serious adverse events and had a low discontinuation rate by patients.5

Although more research and clinical studies must be performed to solidify the use of medical cannabis in the elderly, the emerging data on using cannabis to treat prevalent symptoms amongst the elderly and possibly reducing the number of prescription medications is promising. Further investigation is necessary to better understand the long-term role that cannabis may play in treating symptoms of pain, anxiety, depression and other indications. With the recent recreational legalization in Canada, more people including seniors are more open to try cannabis and therefore a key demographic in which to further assess the use and efficacy of medical cannabis in the senior population.

References

  1. Statistics Canada. Age and Sex, and type of dwelling data: Key results from the 2016 Census.. Published May 2017. Accessed January 11, 2019.
  2. Grenier, E. Canadian Seniors now outnumber children for 1st time, 2016 census shows. CBC news. https://www.cbc.ca/news/politics/2016-census-age-gender-1.4095360. Published May 2017. Accessed January 11, 2019.
  3. Canadian Institute for Health Information. Drug use Among Seniors in Canada, 2016. https://www.cihi.ca/sites/default/files/document/drug-use-among-seniors-2016-en-web.pdf. Published 2018. Accessed January 11, 2019.
  4. Corroon, J. M., Mischley, L. K., & Sexton, M. (2017). Cannabis as a substitute for prescription drugs – a cross-sectional study. Journal of pain research10, 989-998. doi:10.2147/JPR.S134330
  5. Abuhasira, R., Schleider LB., Mechoulam R, Novack V. (2018). Epidemiological characteristics, safety and efficacy of medical cannabis in the elderly. European Federation of Internal Medicine, doi: 1016/j.ejim.2018.01.019.

Written by David Nguyen – Pharmacy Intern at Solace Health

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