Cannabis for pain in elderly

Chronic pain is a common complaint among elderly individuals, often affecting quality of life, mobility and overall wellbeing. Traditional treatments, such as prescription painkillers or anti-inflammatory medications, are not always effective and can carry undesirable side effects. As a result, more senior adults and their carers are exploring alternative therapies, including medical cannabis, to manage persistent pain more naturally and safely.

In recent years, cannabis has gained attention as a viable option for pain relief across various age groups. However, its use in the elderly population deserves special focus due to unique physiological and medical considerations. This blog explores the potential benefits and risks of cannabis for pain in elderly people, supported by current research and practical guidance.

Understanding pain in older adults

Pain in older adults can result from a wide range of conditions, including arthritis, neuropathy, osteoporosis, post-surgical recovery, and general wear and tear. It can be acute or chronic, with chronic pain defined as lasting longer than three months. This type of pain can become debilitating, leading to depression, anxiety, social withdrawal and sleep disruption.

The ageing process also affects how pain is experienced. Older adults often underreport pain or consider it a normal part of ageing. Additionally, they may be more sensitive to certain medications or at greater risk of adverse reactions, especially when taking multiple prescriptions simultaneously (polypharmacy).

These challenges create a strong case for exploring gentler, plant-based options like cannabis.

How cannabis may help with pain

Cannabis contains a variety of active compounds known as cannabinoids. The two most well-known are tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is psychoactive, meaning it can cause a ‘high’, while CBD is non-intoxicating and has a broader reputation for therapeutic benefits.

Both THC and CBD interact with the endocannabinoid system, a complex network of receptors found throughout the body that helps regulate pain, inflammation, sleep and immune response.

For elderly patients, cannabis may offer pain relief in the following ways:

• Anti-inflammatory effects: Many chronic pain conditions in the elderly involve inflammation, such as arthritis. CBD has been shown to reduce inflammatory responses and may help manage joint pain without causing gastrointestinal upset, a common side effect of NSAIDs.
• Neuropathic pain relief: Nerve pain, or neuropathy, is particularly difficult to treat using traditional medications. Studies have suggested that cannabis may be effective for neuropathic pain, which is prevalent in conditions like diabetes or postherpetic neuralgia.
• Improved sleep: Pain often disrupts sleep, and lack of sleep can worsen pain sensitivity. Some cannabinoids promote better sleep patterns, indirectly aiding pain management.
• Muscle relaxation: Cannabis may help relieve tension and muscle spasms, providing comfort in conditions like multiple sclerosis or post-stroke spasticity.

What the research says

While research on cannabis use specifically in the elderly is still growing, several studies have shown promising results.

A 2020 study published in the European Journal of Internal Medicine followed over 2,700 elderly patients who used medical cannabis for pain. After six months, over 93 percent reported improved symptoms, and a significant proportion reduced their use of opioids or other medications.

Another review, published in Drugs & Aging, concluded that medical cannabis could be a valuable tool for treating chronic pain in older adults, provided that care is taken with dosing and monitoring.

However, researchers consistently highlight the need for more age-specific studies to better understand optimal dosages, long-term effects and interactions with other medications.

Benefits of cannabis for elderly patients

When used responsibly and under medical guidance, cannabis may offer several benefits over traditional medications for elderly patients dealing with chronic pain.

• Reduced dependence on opioids: Opioid medications carry a high risk of addiction, tolerance and serious side effects. Cannabis may allow some elderly patients to reduce or eliminate their opioid use.
• Lower risk of gastrointestinal issues: NSAIDs, commonly used for inflammation and pain, can irritate the stomach and increase the risk of ulcers and bleeding. Cannabis does not appear to carry the same risk when administered correctly.
• Improved mental health: Chronic pain often leads to low mood or anxiety. Some patients report that cannabis helps lift their mood, although this effect varies depending on the cannabinoid profile and dose.
• More holistic pain management: Cannabis may provide broader symptom relief, addressing not just pain, but also associated issues like poor sleep, stress or appetite loss.

Potential risks and side effects

Although cannabis has many potential advantages, it is not without risks, especially for older users. It is important to weigh these considerations before beginning treatment.

• Dizziness or drowsiness: Older adults are more prone to balance issues and falls. Some forms of cannabis, particularly those high in THC, may increase this risk.
• Cognitive effects: THC can cause confusion, memory lapses or altered judgement, which may be particularly concerning in patients with dementia or mild cognitive impairment.
• Interactions with medications: Cannabis can interact with blood thinners, sedatives and other commonly prescribed drugs. Always consult a healthcare professional before starting.
• Inconsistent quality and dosing: Without professional supervision, dosing can be unpredictable, especially with edibles or oils. Choosing a reputable, medical-grade provider is essential.

Forms of cannabis for elderly users

There are many ways cannabis can be administered. The most suitable method often depends on the individual’s preferences, medical condition and tolerance.

• Oils and tinctures: These allow for precise dosing and are taken under the tongue for relatively fast relief. They are ideal for beginners and those who prefer a smokeless method.
• Capsules: These provide consistent dosages and are easy to integrate into daily routines.
• Topical creams: Applied directly to painful areas, they are useful for localised arthritis or joint pain, without psychoactive effects.
• Vapourisers: Inhaled cannabis offers quick relief but may not be suitable for those with respiratory conditions.

It is strongly advised that elderly patients avoid smoking cannabis due to the potential harm to the lungs and increased risk of cardiovascular issues.

Legal considerations in the UK

In the UK, medical cannabis was legalised in 2018. However, access through the NHS remains limited. Most patients currently obtain cannabis prescriptions through private clinics specialising in medical cannabis.

To be eligible, patients must typically have a qualifying condition such as chronic pain, and have exhausted conventional treatment options. It is important to work with a reputable clinic that adheres to UK regulations and provides ongoing support.

Starting cannabis treatment safely

For elderly patients considering cannabis for pain management, a cautious and informed approach is essential.

• Start low, go slow: Begin with the lowest possible dose and gradually increase under medical supervision to find the right balance.
• Track symptoms: Keeping a symptom diary can help monitor progress, side effects and make informed adjustments.
• Choose the right strain: Different cannabis strains have different cannabinoid ratios. High-CBD, low-THC options are usually better suited for elderly users.
• Involve healthcare professionals: Speak to a GP or specialist about any potential interactions with existing medications.

Final thoughts

Cannabis holds growing potential as a therapeutic option for managing chronic pain in older adults. With the right guidance, proper dosing and attention to individual health needs, it may provide a safer, more holistic alternative to traditional medications.

While more research is needed, early findings suggest that medical cannabis can help improve not just pain levels, but also quality of life in elderly populations. As awareness and access increase, cannabis may become a valuable tool in age-inclusive healthcare.

If you or a loved one is considering cannabis for pain relief, always consult a medical professional and explore certified clinics that specialise in personalised, evidence-based treatment plans.