“The ultimate goal of medicine isn’t just to add years to a person’s life, but to add quality and vitality to those final years. Medical cannabis can be a profoundly helpful tool in this journey.”
By Peter Grinspoon, Harvard Medical School
As a primary care physician, I see it every day in my clinic: seniors are increasingly turning to cannabis to find relief from the medical indignities of aging.
Whether it’s the grinding discomfort of chronic pain, the “gray” fog of late-life anxiety or the persistent, soul-crushing frustration of insomnia, older adults are discovering that the cannabis plant can often do what many of our standard prescriptions cannot—provide genuine relief without a laundry list of debilitating side effects.
Our elders are finding an exit ramp from the “polypharmacy” treadmill, seeking to decrease their reliance on traditional pharmaceuticals that can often come with more baggage than benefit.
The demographic shift is nothing short of a sea change. Older patients are currently the fastest-growing group of cannabis users in the country. To put some hard data behind that: roughly 25.8 percent of medical cannabis patients are 65 or older, and a staggering 34.5 percent fall into the 50–65 range.
This shift is occurring despite fifty years of misinformation and one-sided science, courtesy of our “War on Drugs,” that has needlessly stigmatized this plant-based medicine.
We have left much of the medical establishment unequipped to educate patients about these treatments. Because of a persistent lack of practical, clinical knowledge, many physicians find themselves unable to answer basic questions, leaving patients to navigate these waters on their own. For lack of better options, patients seek medical advice from well-intentioned “bud-tenders” who have no medical training.
A Legacy Of Healing
For me, this isn’t just an academic or professional interest; it is woven into the fabric of my life.
When I was just eight years old, my brother Danny passed away from childhood leukemia. I watched my parents, desperate to lessen his suffering, cross legal lines in the early 1970s, to procure medical cannabis for him.
It was the only thing that could alleviate the brutal nausea, vomiting and wasting associated with his chemotherapy. It was extraordinarily effective; it gave Danny the ability to eat, to maintain his weight and, most importantly, to meaningfully participate in his life during his final year.
Witnessing that transformation fixed in my mind a truth that no amount of prohibitionist or DARE-era rhetoric could erase: cannabis can be a powerful medicine.
That journey came full circle with my father, Dr. Lester Grinspoon, who was a legendary cannabis expert and scholar at Harvard Medical School. He spent his career fighting to educate physicians and the public alike about the medicinal benefits of cannabis. When in his eighties and nineties, he used cannabis himself to manage chronic pain and cancer-related symptoms, maintaining a quality of life that would have been impossible otherwise.
For the last 25 years, I have carried that mission forward in my own practice, helping thousands of patients integrate medical cannabis into their lives safely and effectively.
Navigating Risk With Clinical Pragmatism
It is important to be honest about the clinical nuances of treating people with medical cannabis.
Cannabis is not a panacea, and it isn’t a “miracle cure” for every ailment. It certainly doesn’t work for everyone. Like any medication in my black bag, it has its legitimate indications and its potential harms. Like other medications, it can be use in a more or less safe manner.
Some patients—particularly those who are “cannabis-naive”—simply cannot tolerate the impairment or “high” that comes with higher doses of THC. Like other medications used for pain and sleep, cannabis can cause dizziness, affect a patient’s balance, and can temporarily impact short-term memory. And we cannot ignore the fact that for a modest percentage of users, cannabis can be addictive.
These challenges must be viewed in their proper context. When I look at the entirety of the available scientific literature and the thousands of patients I’ve treated over the last quarter-century, a clear picture emerges.
When used with skill, caution and proper guidance, cannabis often presents fewer harms than the traditional pharmaceuticals we so readily prescribe to our seniors. Unlike many of those drugs, cannabis does not destroy the liver or kidneys, it doesn’t cause gastric ulcers or chronic constipation and it does not contribute to the development of dementia. If patients are followed by a cannabis-savvy clinician and are educated to “start low and go slow” when getting started, they tend to do extremely well.
We owe it to our older patients to walk with them past the shadows of the last fifty years. Our job as care providers, including family members, is to meet patients where they are, armed with evidence and empathy. With proper education and guidance, we can help our seniors use medical cannabis to reclaim their quality of life.
The ultimate goal of medicine isn’t just to add years to a person’s life, but to add quality and vitality to those final years. Medical cannabis can be a profoundly helpful tool in this journey.
Dr. Peter Grinspoon is an addiction specialist at Massachusetts General Hospital and an instructor in medicine at Harvard Medical School. He is the author of the book, “Aging Well with Cannabis: Feel Better, Live Better and Sleep Better with Marijuana and CBD.”
