Canadian Study Cites Increase in Cannabis Poisoning Among Older Adults
by Don Drake, Connelly Law Offices, Ltd. 5.24.24
"After the legalization of dried cannabis flower and edibles in Canada from October 2018 through December 2022, older adults showed a significant increase in emergency department visits for cannabis poisoning, according to a research letter published in the journal JAMA Internal Medicine," said professional fiduciary and certified elder law Attorney RJ Connelly III. "This rise in cannabis use among older adults is basically due to the popularity of edibles among this demographic and their lack of awareness about the potency and health effects of these products."
A Closer Look at the Study
The study from Canada found that cases of "cannabis poisonings" among older adults in the province of Ontario tripled after the legalization of edibles, compared to the period before legalization. The study, led by Dr. Nathan Stall from Sinai Health and the University Health Network in Toronto, was published in JAMA Internal Medicine on May 20.
The research examined data from the Ontario Ministry of Health regarding emergency department visits for cannabis poisoning during three different periods. The first period was before marijuana legalization in the province (January 2015 to September 2018), the second was after legalization but only for dried marijuana (October 2018 to December 2019), and the third was when edibles were also allowed (January 2020 to December 2022).
The study found that there were over 2,300 emergency department visits for cannabis poisonings among older adults (with an average age of 69.5) over the three time periods. The rate of emergency visits during the initial legalization period was double that of the pre-legalization period, and it tripled after edibles became available.
The researchers highlighted that it's unclear what role edibles played in the significant increase in poisonings, as access to legal marijuana was expanding at the same time. However, they noted that the likelihood of accidental ingestion increases with the availability of edibles, and most of these products do not come with age-adjusted instructions for use.
The study emphasized that older adults are at a particularly high risk of adverse effects from cannabis due to their age, the potential for drug interactions with multiple medications, and any underlying illnesses.
A Quick Look at Cannabis
Cannabis, also known as marijuana, pot, or weed, is a substance derived from the cannabis plant. It is commonly used for recreational purposes due to its mind-altering effects, often referred to as getting "high." Additionally, cannabis is utilized for medical reasons, although further research is necessary to determine its efficacy for most health conditions.
Cannabis contains more than one hundred chemical compounds called cannabinoids, with the two most well-known being Tetrahydrocannabinol (THC) and Cannabidiol (CBD). THC is the primary psychoactive component of cannabis, responsible for inducing the high, and is being researched for potential medical benefits. CBD does not produce a high but can cause drowsiness and is also under scientific investigation for its medical applications. Cannabis is available in various forms, including dried cannabis, cannabis extracts, and cannabis topicals. Additionally, edible cannabis products, such as cannabis-infused food and drinks, are becoming increasingly popular.
A Much Different Product
Over the last few decades, the levels of THC in dried cannabis have risen significantly. In 1995, dried cannabis typically had around 4% THC, but today, it usually ranges up to 17% and beyond and can pose significant health risks. Conversely, there are cannabis products that consist mainly of CBD and contain only minimal amounts of THC. It's important always to check the label to verify the levels and concentrations of THC and CBD in any cannabis product.
Edibles
According to Medical News Today, edibles take longer to kick in compared to inhaling cannabis, but they also tend to have longer-lasting effects. This is because when you smoke, cannabis is absorbed quickly into the bloodstream and reaches the brain rapidly. On the other hand, with edibles, cannabis must go through the digestive system first, which delays the onset of its effects.
Studies indicate that it typically takes 30–90 minutes for the effects of orally ingested THC to begin, with peak effects occurring after 2–3 hours. The time it takes to feel the effects of edibles can be influenced by a range of factors, including the ingredients in the edibles, body weight, metabolism, gender, and when the individual last ate.
Sublingual absorption, where the edible is placed under the tongue, is believed to be faster than going through the digestive system because it is absorbed directly into the bloodstream. Therefore, items like lollipops or tinctures held under the tongue may have quicker effects. According to research, the effects of edibles can last anywhere from 4 to 12 hours, depending on the dose and individual characteristics such as tolerance and metabolism.
The symptoms of THC toxicity closely resemble the typical effects of THC, albeit more severe. These may include heightened levels of confusion or anxiety, increased paranoia or panic, elevated heart rate or blood pressure, occurrences of delusions or hallucinations, and pronounced nausea or vomiting. In certain instances, these effects have been linked to unintentional harm, such as motor vehicle accidents, falls, or other forms of poisoning due to interactions with other medications.
Why Older Adults
As individuals age, alterations in drug and substance metabolism may occur. Individuals aged fifty-five and above may exhibit increased sensitivity to cannabis and a heightened susceptibility to experiencing adverse effects, especially if they have underlying medical conditions. Those with significant liver, kidney, heart, or blood vessel diseases should refrain from cannabis use. Moreover, the combination of cannabis with prescription or non-prescription health products, including biological drugs, pharmaceutical drugs, natural health products, or radiopharmaceutical drugs, may escalate the risk of encountering negative reactions. Seeking guidance from a healthcare professional is imperative before contemplating cannabis use for medical or non-medical purposes.
Preventing Cannabis Poisoning
THC poisonings can occur when an individual consumes an excessive amount of THC or uses a different type of cannabis product than intended. Furthermore, combining cannabis products with alcohol or other drugs can heighten the likelihood of experiencing adverse effects. Here are some tips:
Start small - When first using edibles, older adults must start with small doses, usually less than 5 mg, and wait for the products to take effect before considering more. If you're smoking or vaping cannabis, you'll typically feel the effects within minutes. However, if you're consuming edibles or drinks, it may take up to two hours for the full effects to be felt. It's essential to be patient and not consume more during this waiting period. Regardless of how THC is ingested, its effects can last for several hours before wearing off.
Read the label - When using cannabis products, it's important to read the labels carefully. Pay close attention to the dosage, which is typically measured in milligrams. Make sure to use the intended type of cannabis product, whether it's an edible, tincture, or any other form. Additionally, be aware that different strains of THC (Indica, sativa, or hybrid) can produce significantly different effects, so it's important to understand how each strain may affect you before use.
Avoid THC Analogues - THC analogues should be avoided because they are often created synthetically with dangerous chemicals. Delta-9 THC (whether hemp-derived or not) is the safest and most well-researched version of THC. Analogues to avoid include delta-8 THC, delta-10 THC, or any other analogue of THC, such as THC-P and THC-O.
A Final Word
"There is a need for individuals to understand that many claims about the effectiveness of specific treatments with marijuana lack robust scientific evidence, given that research on the effects of cannabis, both medically and recreationally, is still in its early stages," stated Attorney Connelly. "Articles and promotional materials often overstate potential benefits by relying on in vitro or animal studies and anecdotal reports, mistakenly presenting them as conclusive evidence of clinical effects. We must also recognize that historically, alcohol and tobacco were once marketed as safe and having medicinal properties, so it's important to be aware of the current cannabis research. Like any over-the-counter product or supplement, it is essential to consult with a medical professional before use."
Please note that the information provided in this blog is not intended to and should not be construed as legal, financial, or medical advice. The content, materials, and information presented in this blog are solely for general informational purposes and may not be the most up-to-date information available regarding legal, financial, or medical matters. This blog may also contain links to other third-party websites that are included for the convenience of the reader or user. Please note that Connelly Law Offices, Ltd. does not necessarily recommend or endorse the contents of such third-party sites. If you have any particular legal matters, financial concerns, or medical issues, we strongly advise you to consult your attorney, professional fiduciary advisor, or medical provider.
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