Written by, Renata Filiaci, MSHW, Trained Doula

There has been a stigma around the use of cannabis for many years, especially by those in the older generation. However, I completely understand why, because propaganda made cannabis out to be the DEVILS LETTUCE, you gonna smoke, you gonna die.

Within the arrival of CBD in retail stores, I’ve personally seen a wide demographic of customers coming in to Upstate CBD for information on products and ways of ingestion, with a bulk of them being elderly.

Although few older patients have been enrolled in cannabinoid studies, there have been some research to determine the efficacy on CBD for geriatric customers. A narrative literature review aims to provide a brief introduction for the geriatrician to the potential indications, evidence-base, contra-indications and side effects of medical cannabinoids in older people.

• demonstrating a statistically significant improvement in average daily pain
• have a role to play in reducing refractory chemotherapy-induced nausea
• cannabinoids reduced self-reported spasticity compared to the control (for stroke or neurodegenerative patients)
• changes in weight gain and decreased agitation from synthetic cannabis medication
• may play a potential role in dementia-related behavioral problems
• CBD administration was associated with diminished autonomic arousal leading to a reduced anxiety state
• reported improvements in the major symptoms of Parkinson’s Disease

As you see, administration of CBD in elderly patients can help tremendously with many age-related illnesses. However, as we age, our livers and kidneys may be slower to eliminate drugs from the body. In addition, older patients and those with chronic health problems are more likely to be using multiple medications, so the risk for drug interactions increases.

Drugs are metabolized and eliminated by enzymes in the liver—specifically, the cytochrome P450 (CYP) family of enzymes. Of these, CYP3A4 is the most prevalent CYP enzyme in the liver, and is the one responsible for metabolizing an estimated 50% of prescription medications used in clinical practice. It oxidizes small foreign organic molecules (xenobiotics), such as toxins or drugs, so that they can be removed from the body.

CBD inhibits CYP3A4 and CYP2D6, and can increase levels of drugs metabolized by these isoenzymes. CBD can increase the level in your blood of the blood thinner coumadin, as well. It is essential, as an older person, to talk with your physician or pharmacist before taking a CBD edible.

This sublingual method allows CBD to completely bypass the digestive system and liver metabolism, so the compounds can avoid being broken down by enzymes and reach the bloodstream more quickly. CBD delivered sublingually showed significantly higher bioavailability than the CBD delivered orally.

When CBD is applied topically to the skin, it never reaches the bloodstream, but it can be absorbed through the skin’s surface to interact with nearby cannabinoid receptors. The very nature of skin is to block things from entering your body, but if CBD salves and lotions are applied heavily enough, they can permeate the skin through the pores to have a potentially positive effect.