The Cannabis Boomer Podcast is for baby boomers and all adults who are interested in the science of cannabis. Key words for the podcast, in general ,are: baby boomers, cannabis, boomers, marijuana, THC, CBD, health, wellness, science, and aging.

For this particular episode, key words are: cannabis, baby boomers, older adults, marijuana, THC, CBD, and public health

Baby boomers and older adults are increasingly using cannabis, posing a public health risk due to their vulnerability to health issues like cognitive decline and falls. Studies show that older adults, particularly baby boomers, often smoke cannabis, a method associated with higher health risks, and tend to use it in the afternoon and nighttime, increasing the risk of impaired driving. While many claim to use cannabis for medical reasons, it is often used for self-treatment of mental health conditions, rather than approved medical indications.

The relationship between cannabis legalization and opioid use is complex and inconclusive, with mixed results from studies. While some research suggests cannabis may reduce opioid use, others indicate it could increase the risk of substance use disorders. Older adults, particularly those over 65, face unique vulnerabilities related to cannabis use due to biological factors and potential interactions with medications.

Cannabis use among baby boomers and older adults is increasing, often for general wellbeing rather than specific medical conditions. However, the evidence supporting cannabis’s health benefits, particularly for cognitive function, is sparse. To minimize risks, older adults should limit cannabis use, avoid potent products like concentrates, and be mindful of potential impairments, especially when engaging in activities like driving.

The Cannabis Boomer Podcast is for baby boomers and all adults who are interested in the science of cannabis. Key words for the podcast, in general ,are: baby boomers, cannabis, boomers, marijuana, THC, CBD, health, wellness, science, and aging.

For this particular episode, key words are: cannabis, baby boomers, older adults, marijuana, THC, CBD, and public health.​

And now, the Cannabis Boomer, Alex Terrazas, PhD.

Do you think that legalization of medical or recreational cannabis leads to reduced opioid use?

Or is it kind of the other way around? Where cannabis, as we know, is a potential gateway drug where people who are using cannabis may be actually increasing their risk of opioid use. I'll start with the end. The results are mixed. There are some studies that are showing a reduced effect on opioids.

Some actually large scale epidemiological studies, some from the VA, some from the general population, have shown that the trend of increase in use in cannabis, and this is by the way, not age specific, has caused a reduction in the use of opioids and other opioid related outcomes. For example, opioid related ED visits, opioid-related overdose and other outcomes. Other studies include clinical studies that I know of have actually shown the opposite or have shown no significant changes. So this is very much a question that is kind of still being studied. It's a very important public health question. Unfortunately there's not a clear answer.

We do know that there are certain populations that are more vulnerable for the risks of cannabis. And in certain populations there are less vulnerable. There are certain people who, if they use cannabis, they're more at risk of using other substances and becoming addicted to other substances. And there are other people who can just use cannabis and, and being mono cannabis user, as we call them, you know, not have to use other substances as well at all. We don't see any polydrug use with them. So it's a complex answer to a complex question as you can see.

In recent decades, we've seen that many people who use cannabis, used other drugs as well. Those, those would be called polydrug users. We now, we now see more and more people who are just using cannabis.

You know, and older adults, which is obviously, you know, we're gonna hone on those here, are an example of that population. People who basically either want the health benefits of cannabis or they, you know, they want the euphoric, effective cannabis.

They don't want to use other drugs. They want to be healthy in their use. For example, people who, people who are transitioning from alcohol use because of its obvious adverse health effects to cannabis. There we're seeing populations that are becoming more kind of, they're more mono cannabis users. They use only cannabis.

But there are a lot of studies looking at middle aged adults, 45 to 64, that are also so in some vulnerability when we mention that specific vulnerability of older adults, we talk about it. There are various ways to look at this. First of all, there's a biological vulnerability in terms of adipose tissue. We know that cannabinoids are lipophilic molecules. They'll stay longer when you have more adipose tissue. So we see that in older adults where there's a lingering effect biologically with renal clearance. Is not as good as, you know, in an older person as it was in the, when they were younger.

So we can see that effect. And another important part of it is that older people take medicine. They take drugs for heart disease for blood pressure, and there are certain problems when you combine cannabinoids with certain medications where you can see that the effect of cannabinoids are heightened or they stay for longer in your system when you take certain medications.

So in that sense, we're seeing, and, and of course, you know, the fact that older adults are more prone to general health conditions, for example, cognitive decline, falls, other problems as well. So when you, you intake a psychoactive substance, which could cause various problems, you know cognition wise, balance, other, other health issues, you're likely to see more vulnerability in that sense.

So we see more falls in older adult. We see more problems with driving in older adults when they're under the influence of cannabis. We see most likely more cognitive decline. We can talk about that. I was recently funded to do a study specifically in cognitive decline in older adults. And so in terms of public health, the fact that this is the fastest growing age group of cannabis users nowadays in the past 10 years, 20 years already actually looking at NDU data, which is a large survey. We know that combined and, you know, taken together with the vulnerabilities I just mentioned, this is a serious public health risk and problem. But I will say that when we look at younger adults, they're still the group at most risk, because they're the largest group of users. They use a lot. They use very potent substances.

We can talk in a second about, you know, the way people use this substance, which varies by age group by the way. So they're the more at risk users in terms of their patterns of use. Those younger adults,

So you published including in the American Journal of Drug and Alcohol Abuse on age differences in patterns of cannabis use. Tell me about that study.

And if people who are older and middle adults, you know, they're, they want to use cannabis more safely, probably for medical reasons, you would expect them to try to use the more kind of safe method of administration. But on the contrary, we actually found that most of them smoke. Most of them smoke joints. Most of them combine joints. Their, their, their mix marijuana with nicotine. And there's a, it's, you know, there's a question of why that happens. Why are they smoking? Especially people who are more probably vulnerable to the health risks of, of smoking, right? They're inhaling. It is combustion. Why are you smoking?

So. We don't know exactly why that's happening. We asked some of them why, and there are a lot of hypotheses around this. One of the more popular ones is that these are people who, let's take baby boomers for example, okay? The baby boomer generation. These are people who grew up in the sixties and more kind of liberal times around smoking joints. That was the main form of smoking. You didn't really have a lot of edibles back there, or vapes, concentrates lotions, tinctures, things like that. It was mainly, you know, you're gonna smoke a joint so. These are people who are kind of used to that mode of consumption, and people are kind of, I guess, in many ways prone to stay with one method.

If they're used to something, they'll stay with that. And it doesn't really matter if you're 65 years old, you've been smoking for the past 40 years, or if you're 65 years old and you just recently took it up again. Or just started for the first time, you're more likely to smoke. And that's an important finding, we feel because it has public health impacts.

You're seeing people who are smoking it have various other side effects. We also find, for example, that most of these people smoke not during the daytime, which is not super surprising. We would expect younger adults to smoke throughout the daytime and night. These are people who mostly smoke in the afternoon and nighttime hours, which makes sense, but that does also in increase in other kind of risk related to driving.

Okay. You're not as good a driver during the nighttime if you're an older adult. As you are in the daytime, especially if you're using cannabis in the nighttime or in the afternoon time. So these are some of the findings that we found. I don't know of any other studies that actually looked at so com, you know, comprehensive patterns in older adults.

We're continuing to do those kind of studies. We're asking more questions. For example, the question is about medical use versus recreational use. I don't know if we wanna talk about that right now if we have a question coming up, but that's another pattern that we try to look at.

They're not actual medical users of who wanna look at proper medical users. We need to look at the indications for each. Medical cannabis is approved in most of the US states where it's approved, which are a lot of neurologic conditions, rheumatologic conditions, various health conditions. Not so much for mental health conditions.

There are many states in which it's approved for PTSD or for certain criteria or for certain symptoms within PTSD, but not for depression anxiety. There are only a few states in which it's legalized for depression, anxiety. That's an indication. Many older adults are just using it to feel better for their overall wellbeing. Yes, it's true. Some are using it to treat their chemotherapy induced nausea or their rheumatic symptoms or, you know various orthopedic symptoms. But most of them are just using it for a general kind of improvement in their wellbeing. They feel it, it'll probably help them with their sleep architecture when in fact there are quite a lot of studies that are showing the opposite. The evidence for cannabis actually improving many of the disorders for which it's approved is very sparse. And that's, that's shocking. There's this very strong misconception around the, the health benefits of cannabis especially among older adults who just wanna feel better. So they're using it.

So you were the recent recipient of a K 23 career development award from the NIH. Congratulations.

What are you gonna be doing with your grant, and what kind of research experiments do you have planned?

Nowadays cannabis, we have people who we call continuous users. People who, through their twenties, thirties, forties, fifties, and sixties have just been using cannabis. You know, a lot, a little, we don't know, but have continuously been using cannabis. Then we have stopover users, what's been called in literature, where people who smoked or used to use cannabis back in their twenties and thirties stopped for a good amount of years. You know, they had married life, they had kids, they worked, they had careers, and then somewhere in there. Sixties, seventies, they take it up again. And then we have new users, new onset users who just started kind of for the first time at age 65 or or over. And I'm trying to kind of understand the differences in patterns of use and in their risks.

And specifically I've been funded to look at the effect on cognition. 'cause there's a, there's a, the pretty big gap in literature today around the question of does cannabis increase certain cognitive domains? Does it decrease certain cognitive domains? Some people say that it actually makes them be able to focus more, many people, and there's quite a lot of evidence showing that it causes some kind of cognitive decline on various domains.

So that's kind of where I am going to focus my work. I'm gonna look at the effect of cannabis on cognition in older adults.

I would say first of all, do not use a lot of cannabis because we know, and this has been shown throughout many, many studies over the recent, over past years, many, many years, that the more you use the more you increase your risk of various health, negative health outcomes. So that's number one. Do not smoke a joint every day.

Try not to smoke a joint even every few days. If you have to smoke, maybe smoke a joint once a week, maybe twice a week. Try to. You know, do even less of that when you do smoke. Do not smoke in one sitting a lot. You know, take a puff here, a puff there. I would say know what you're smoking or try to know what you're smoking.

You know, it's the wild West in many dispensaries. You don't really know what you're using. The fact that a provider will authorize one thing doesn't mean that that's what you'll get in dispensary. You know, most people don't know the ratio of a CBD to THC that they're using. So I would say try to limit it.

Try to use less potent products. For example, we now have concentrated materials, what's called concentrates. These are kind of liquid where you put usually vape. These, you know, these are very, very potent products. Very potent and they're associated with very bad negative outcomes compared to any other form of cannabis that you would find on the market today.

Try not to use those. Try to use when you do use cannabis, if you have to use, try to use them in a time during the day where you're not putting yourself or others at risk, not before you're going to drive. Some people are, are agnostic or have an agnosia. They don't really know. They can't really appreciate the neurologic deficit that they have after using cannabis. They think they're fine. But when we test them, we see there's actually quite a lot of neurological deficit that they were not aware of. So there's a, you know, there's a lack of awareness to the effect of cannabis on your on your, on your abilities to function, including driving.

So even if you dab or if you use concentrates or tinctures or anything else it's, it's, it's very hard to trust people's assessment of their use.

People who choose to use cannabis need to be aware of what they consume. This podcast is intended to make users better informed about cannabis and its effects. The information shared on this podcast is meant as current opinion in science and should not be considered medical advice.