Cannabis as an Opioid Replacement for Elderly Pain

By: Elena Schmidt October 9, 2019 • 5 minutes

Pain is the number one reason Americans seek medical attention today and adults over the age of 65 represent one of the largest groups of people who are suffering. Pain is more common than diabetes, heart disease, and cancer combined. Pain not only hurts, but it also seeps into every aspect of life, causing daily distress and even straining relationships.

More than 11 million seniors are living with chronic pain, and nearly 30% of all adults experience it, according to the CDC, and many are turning to opioids for relief. Alongside the epidemic of chronic pain, opioid use has increased by 9X between 1996 and 2010. Opioids can be incredibly effective to quell pain initially, but they also come with a long list of side effects, risk of abuse, and the potential to cause death — 47,600 in 2017 to be precise. The dangers of opioids and the need for safe pain management are major reasons that elderly patients are the largest growing population that are turning to cannabis. But is cannabis safer than opioids and can it really be a viable alternative?

How Do Opioids Work?

Opioids work to halt pain by attaching to opioid receptors on nerve cells in the brain, spinal cord, gut, and other parts of the body. When this happens, opioids block pain messages that the body sends to the brain. While they are initially effective, opioids are limited by the fact that your body quickly becomes tolerant to the medication. As soon as that happens, you’ll need to increase the dosage, which can create a vicious cycle that often leads to addiction.

In fact, 35% of patients over the age of 50 report that they’ve misused opioids and other pain killers in the last month, according to the Psychiatric Times. Misuse of opioids, as well as unintended side effects, are primary factors why the elderly hospitalization rate has increased by 5X in the last two decades. Senior citizens are especially vulnerable to such side effects due to age-related decline in renal function that prevent their bodies from effectively processing and clearing the drug from their systems.

Opioid Side Effects

Think for a moment about the last prescription drug commercial you watched and the long list of side effects that sounded suspiciously worse than the original condition. Opioids have an almost endless list of unwelcomed effects including severe (and common) nausea, constipation, kidney failure, irregular heart rate, increased pain sensitivity, and increased risk of falls. An increased risk of falling is especially alarming because the elderly population is already at a higher risk without taking opioids. One older adult dies every 19 minutes from a fall, according to the National Council on Aging. In addition to physical side effects, elderly patients commonly experience cognitive issues such as difficulty concentrating and remembering. Despite extensive pain research and widespread use of opioids, the efficacy of most drugs is incomplete at best, and patients continue to search for safe and successful pain management. 

Cannabis Research For Pain

Human Research

Many elderly patients are turning to cannabis, which is the #1 reason that patients of all ages consume medical marijuana. In a recent study published by the Pain Journal, 984 patients reported on their experience with medical cannabis. Of the patients who utilized cannabis for pain, every single person marked a 7 or higher (on a 10-point scale) when asked how effective it was. Patients were also asked, what do you like most about medical cannabis? The most common answer was related to pain relief but not every response indicated that cannabis directly eliminated the sensation. Patients commonly responded that cannabis changed their perception and experience of chronic pain, making the discomfort bearable by changing their relationship to it. This finding implies that cannabis may work both physiologically and mentally to reduce the somatic feeling and the emotional distress of pain. 

Animal Research

Cannabis’ chemical compounds — called cannabinoids — such as THC and CBD, have shown promise in animal studies according to the analysis published in Marijuana as Medicine. Experiments show that the body’s peripheral nerves that detect pain also contain chemical receptors that bind to cannabinoids. When cannabinoids bind to receptors, cannabis helps block the sensation of pain. More studies must be done — particularly on humans — but this research helps provide an understanding of why so many people report positive results when using cannabis for pain.

Moreover, the Institute of Medicine agrees with the hypothesis concluding that cannabinoids can provide mild to moderate pain relief at least on par with the effects of codeine. But is cannabis safe for the elderly population? Due to the differences in how older adults process narcotics and their increased risks for falls, studies must also focus on safety and efficacy for adults over the age of 65.

Elderly Research

Recognizing the need for this type of research, Tikun Olam analyzed all of the older patients who were treated with Tikun’s medical cannabis between 2015 to 2017. General pain and cancer-related pain were two major reasons for use. In 2018, the European Journal of Internal Medicine published the results.

Key Patient Improvements after 6 Months of Cannabis Treatment:

  • 94% of patients showed mild to major symptom relief
  • 88% reported a reduction in high pain intensity
  • 35% of patients decreased overall medication use
  • 18% stopped using opioid pain relievers or reduced their dose
  • 75% more patients reported a “good quality of life” than at baseline

Out of the 2,736 patients, less than 9% of patients reported an undesirable side effect. Adverse effects were mild, generally including dizziness and dry mouth. Despite rare reports of dizziness, cannabis did not cause any increase in falls throughout the six-month period. 

These findings are promising and may offer hope for you or an older adult you know who’s reliant on ineffective and addictive narcotics. There is no magic bullet to wipe pain out of the body and mind, but medical cannabis shows potential as a safer, natural alternative to help you live your best quality of life.

Have questions about how to transition from opioids to cannabis for pain? Reach out to our medical team at askthedoc@tikunolam.com.