Navigating Conversations About Medical Marijuana with Aging Parents

If you are someone who has parents in their sixties or seventies, you may be taking an active role in their care. Your parents may be curious about adding medical marijuana to their treatment strategies for chronic pain relief or to help manage other symptoms that impact their quality of life.

With empathy and openness, the conversations about medical cannabis can help unlock better symptom management for seniors. Older adults may have friends who are successfully using doctor-supervised cannabis and getting good results and wonder if they can achieve the same outcome.

There are many potential benefits that seniors can experience from medical marijuana use. However, given the fact that almost 9 out of 10 seniors (89%) take one or more prescription medications, guidance from a cannabis healthcare provider is critical. Some prescription medications can be contraindicated (or conflict) with cannabis.

Have your parents asked you about medical cannabis or indicated they are interested in learning more about it? There are many medical reasons why patients try alternative health options to improve symptom management. So, here are some tips to help you have a positive conversation about medical marijuana with your senior parents and other older Americans.

Addressing Generational Bias Against Cannabis Treatments

There have been a few instances where senior relatives have had conversations with me about using medical cannabis. Each time, the topic was broached in a very hushed manner, as though talking about the option of using cannabis for symptom management was taboo. The hushed nature of the conversation was difficult to understand.

It took me some time to realize that there is a prevailing generational bias about cannabis. The Baby Boomers may have been at Woodstock (or wished they had attended), but after that, given the legal consequences and social stigma about marijuana, cannabis use was brushed under the rug.

Why Do Seniors Feel Uncomfortable Talking About Medical Cannabis Use?

Baby Boomers were heavily influenced by the cultural stigma of cannabis, which started during the Anslinger era in the 1930s. The anti-cannabis propaganda painted cannabis users in a very negative light. There were blatantly prejudiced themes communicated at that time, which targeted black and brown Americans and immigrants.

A sit-down conversation to review state laws can help seniors understand that medical cannabis use is not illegal if they are qualified patients. This is also a good time to discuss cannabis laws in general, such as maximum quantities of possession, maintaining a valid medical marijuana card, and where consuming cannabis is prohibited by state laws.

Once your parents or a senior seeking your advice understands the ground rules and the cannabis laws in your state, they may feel empowered to take the next step and try medical marijuana for chronic symptoms.

Step 1: Does Your Parent Have a Qualifying Health Condition?

Any patient who applies for a medical cannabis card must have one or more qualifying health conditions. To be eligible, the patient must have a formal diagnosis for the health condition or chronic symptoms, which is required by state law.

No matter what state you live in, the first step is to make sure your parent or relative has one of the accepted qualifying health conditions. DocMJ provides resources for the states we serve, but you can research the information easily online by visiting the medical cannabis authority and program website.

Some seniors may have a diagnosis that was given several years ago. Before you help them schedule an in-clinic or telemedicine medical marijuana card certification appointment, make sure they can supply health records from their primary care physician to prove they have an eligible diagnosis.

Where health records may not be available, you can schedule an appointment with the patient’s provider, who can provide a letter of confirmation outlining the diagnosis and associated symptoms. This is required to complete the medical card health evaluation.

Step 2: Review Current Prescription Medications

One of the important reasons why patients must consult with a physician to be approved for medical marijuana is to check for medication conflicts. While cannabis is well tolerated by most patients, older adults may be taking one or more prescription drugs that may be contraindicated with cannabis.

There are a few categories of prescription medications that are known to conflict with cannabis. Medical marijuana could lower the efficacy of the following drugs:

1. Central Nervous System Depressants

Some drugs have a depressant effect on the human body, and cannabis use can compound sedative effects. Depending on the product and potency, cannabis can act as both a stimulant and a depressant.

Central nervous system depressants include benzodiazepines, opioids, and alcohol. When combined with cannabis, it may cause respiratory suppression (slowed breathing) and higher levels of impaired cognitive functioning. This causes an increased risk of adverse effects and overdose.

2. Blood Thinners or Anticoagulants

Patients may take blood thinners (anticoagulants) for a variety of reasons. This class of medication is used to prevent the formulation of blood clots for patients who have experienced or have a high risk of heart attack, stroke, or deep vein thrombosis (DVT).

Some patients take anticoagulant medications to help manage arterial fibrillation (irregular heartbeat) and reduce the risk of developing blood clots in the heart. Other patients may require blood thinners to reduce the risk of a blood clot traveling to the lungs (pulmonary embolism) or for preventative care to prevent pulmonary hypertension.

Cannabis can amplify the effects of anticoagulant medications, increasing the risk of uncontrolled bleeding, which can be life-threatening. Physicians will not certify a patient for medical cannabis if they are currently taking blood thinner medication.

3. Antidepressants and Antipsychotics

Some people choose to explore medical cannabis to help with mental health symptoms, such as anxiety or depression. If the individual is currently taking antidepressant, antianxiety, or other psychotropic medications, it is important to consult with a physician before medical cannabis use.

Medications commonly prescribed for depression are selective serotonin reuptake inhibitors (SSRIs). Cannabis can cause increased adverse effects, including dizziness, changes in mood or behaviors, and confusion.

A cannabis healthcare provider may suggest slowly tapering off psychotropic medications before trying medical cannabis use. Never stop taking prescribed medications until you have consulted with a practitioner and discuss your intention to try cannabis in lieu of prescription medications for symptom relief.

4. Cardiovascular Medications

Beta-blockers, calcium channel blockers, and antiarrhythmic drugs are commonly prescribed to patients who have cardiovascular conditions. Cannabis can temporarily increase heart rate and blood pressure, impacting cardiac functioning.

Because the effects of elevated heart rate and hypertension are temporary, this is not a concern for most patients. However, those with heart-related conditions should not use cannabis without consulting a physician. The combination of cannabis with cardiovascular medications has a higher-than-average risk of causing potentially life-threatening adverse effects.

5. Immunosuppressant Drugs

Older family members who are curious about medical cannabis but are taking immunosuppressant drugs may not be eligible for a medical card. This category of medications is prescribed to people who have received an organ transplant and patients who are undergoing cancer treatment.

Immunosuppressant drugs are also prescribed for other conditions, such as:

• Rheumatoid arthritis
• Lupus
• Multiple sclerosis
• Inflammatory bowel diseases (Crohn’s or ulcerative colitis)
• Asthma
• Psoriasis, eczema, and other treatment-resistant skin conditions.

Cannabis may interact with immunosuppressive medications by reducing the efficacy of the drug. This may lead to autoimmune flare-ups and increase inflammation, causing potentially serious health complications.

Step 3: Preview Dispensary Products Online

If you have a medical card, you may want to visit a dispensary with your parents or senior relatives if they are interested in trying medical cannabis use. Visiting a dispensary for the first time may be an intimidating or overwhelming experience.

Think about how much has changed regarding cannabis use in their lifetime. Walking into a licensed dispensary to browse cannabis products may feel a little weird to them, growing up in a generation that had to hide their cannabis use.

Before you head to the dispensary, spend some time discussing the different types of cannabis products available for medicinal use. Culturally, most people are familiar with the process of smoking weed. But when it comes to other intake methods, seniors may be less knowledgeable.

Provide Guidance on the Various Types of Intake Methods

Many seniors may think smoking cannabis is the only option, and since they are non-smokers, the intake method doesn’t appeal to them. However, increasingly, seniors are aware of other methods, including edibles, which are more convenient to use and equally effective for symptom relief.

Browse products online and explain some key points to your parents, such as:

• Non-smokable medical cannabis products, including edibles, tinctures, topicals, and capsules. Also, discuss how to measure or take the appropriate suggested dose.
• Cannabis beverages (liquid mixes or powdered) can be taken with coffee, tea, or juice.
• The maximum amount of cannabis that is legal to purchase and possess. Explain how dispensaries have a statewide tracking system to monitor maximum purchase quantities.
• How long it takes for the psychoactive and physical effects of cannabis to be felt varies by intake method.

Many people who are new to using medical cannabis may not know that you can choose different products for different symptoms. Some make the mistake of trying only one strain, for example, when the best course of action is to purchase small quantities of a variety of different strains to learn which ones work best to help relieve symptoms.

For example, a patient may choose an Indica dominant strain for evening use to help with pain and insomnia. In comparison, a non-sedative Sativa dominant hybrid strain may be better for daytime use. Since refunds from a dispensary are rare (unless there is a product flaw), purchasing smaller quantities can reduce waste and save money while patients are first learning to use medical cannabis.

Dispensaries will ask for a medical marijuana card before allowing customers to enter. If your parent has just received their card, take them for a tour and help them make their first purchase. However, if your parent is in the process of applying for a card, visit the website of a local dispensary to review the products that are available.

Step 4: Assist with the Medical Cannabis Card Application Process

Some cannabis healthcare providers do not provide ongoing support for patients who are applying for a medical cannabis card. Patients who schedule an appointment with DocMJ receive step-by-step instructions that make it easy for qualified patients to complete the process.

Applying for your medical card takes four general steps:

• Schedule your appointment with DocMJ.
• Provide medical records for the practitioner to review prior to your appointment.
• Attend the appointment and find out if you can be certified.
• Pay the annual fee to the state medical cannabis program to complete the process.

Once your family member has received their medical marijuana card, they may visit any licensed dispensary in the state to purchase products. Follow-up appointments are required annually for some states and every seven months for patients living in Florida.

Step 5: Ask If They Want Help The First Time They Try Cannabis

There is a learning curve when it comes to taking cannabis for medical or recreational purposes. Some seniors may feel nervous about taking their first dose alone or be anxious when anticipating the psychoactive effects of cannabis use.

If you have older family members who feel nervous about using medical marijuana for the first time, ask them if they want some company. Sit with them to help answer questions and administer a low dose. Encourage them to keep a patient journal to record different products, strains, and potencies. Keeping a journal is helpful, and patients can make notes on the efficacy of the products for symptom relief.

Many older adults experience significant side effects from prescription medications and are curious about trying medical cannabis for the first time. If you are an experienced patient, you can provide information and support to help your senior parent explore medicinal cannabis safely.