Many people may think young people are the main group enjoying the freedom of legalized weed, but in Canada, the greatest increase in users after legalization was among older adults — and sometimes it’s sending them to the hospital, according to new research.
The rate of emergency department visits for cannabis poisoning in older adults during the period of legalization of dried cannabis flower and edibles — October 2018 through December 2022 — in Canada was significantly higher than that of the pre-legalization period, according to a research letter published Monday in the journal JAMA Internal Medicine.
Edibles, which include baked goods, candies and beverages, are increasingly popular, said lead research author Dr. Nathan Stall, a geriatrician and clinician scientist at Sinai Health in Ontario. But some older adults may be unaware of the strength of today’s weed, and little is known about the health effects of legalizing edible cannabis on older adults — the age group with the largest growth in overall cannabis use a year after dried cannabis flower was legalized in Canada, Stall said.
“There’s a bit of an age-related bias that many health care practitioners, and frankly society, hold that older adults are not using drugs. And that’s not true,” Stall said. “We found that the largest increases in emergency department visits for cannabis poisoning among seniors occurred after edible cannabis became legal for retail sale in January 2020.”
The authors used the Ontario Ministry of Health’s administrative data to examine the rates of emergency room visits for cannabis poisoning among older adults during the pre-legalization period — January 2015 to September 2018 — and the two legalization periods: October 2018 through December 2019, which permitted the sale of dried cannabis flower only, and January 2020 through December 2022, which marked the legalization of cannabis edibles.
When people have cannabis poisoning, according to Stall, they may experience confusion; psychosis, including hallucinations; anxiety or panic attacks; rapid heartbeat; chest pain; nausea; and vomiting.
During the eight-year study period, there were 2,322 emergency department visits for cannabis poisoning in older adults who were age 69 on average. Nearly 17% of those adults were simultaneously intoxicated with alcohol, about 38% had cancer and 6.5% had dementia. Compared with pre-legalization, legalization period No. 1 saw a twice higher rate of emergency department visits for cannabis poisoning. The rate during the second legalization period tripled that of pre-legalization.
“This study provides a cautionary tale of legalization of substances without adequate research, education, and counseling of users regarding adverse effects and safe usage, particularly in older adults,” said Dr. Lona Mody and Dr. Sharon K. Inouye, who weren’t involved in the research, in a commentary on the research.
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