Several groups say cannabis may help aging Americans manage pain

For the first time ever, more Americans are using marijuana daily than those who drink alcohol every day. 

That’s according to the Society for the Study of Addiction. 

One group that has sharply increased its marijuana use is senior citizens over the age of 65. Many are using the substance for ailments in place of prescription drugs, but they are having difficulty accessing medical cannabis.

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"There is very real psychopharmacology associated with cannabis, and I hadn't learned anything about that in medical school," said Dr. Zachary Palace, a board-certified geriatrician. 

"As I started to learn more about it, I realized it's a medication that can really be used very safely in the geriatric population."

Palace is featured in a new video, alongside other physicians, patients and politicians, by the Commonwealth Project. Howard Kessler is founder of the effort, which is working to make medical marijuana more widely available, especially for senior citizens.

"Every day we are letting people suffer when we don’t have to," Kessler said.

Other doctors are now specializing in treatment using cannabis. OB-GYN Dr. Melanie Bone says she sees success every day when it comes to treating senior citizens with marijuana.

"Status quo was either to not teach at all or maybe a lecture," she said. "It’s safe, it’s efficacious." Her patients say it helps them sleep, makes them feel less drowsy than other prescription drugs and others were able to stop taking morphine or opioids.

"For 40 years, I always had pain with something, and now I don't have it," said one of Dr. Bone’s patients.

Since the Nixon administration, cannabis has been designated by law as a schedule 1 substance by the Drug Enforcement Association.

"America’s public enemy number one in the United States is drug abuse," President Richard Nixon said in 1971 amid a crackdown on drug use.

Other schedule 1 substances include heroin, LSD and ecstasy.

"Schedule 1 says there's no medical use for this substance, and it's highly addictive and dangerous," said Robert Kent, former White House general counsel of National Drug Control Policy.

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The classification is more restrictive than Schedule 2, which includes cocaine, fentanyl and meth.

"Schedule 3 means there is a medical use," former Massachusetts HHS Secretary Marylou Sudders said.

The Health and Human Services Department first recommended rescheduling for marijuana in August of last year. The agency determined cannabis had a use in the medical realm but that there were concerns about possible abuse or dependence on the substance.

"It’s an important move toward reversing longstanding inequities," President Joe Biden said as the Drug Enforcement Administration moved to re-classify the drug in May.

The DEA announcement was the last major hurdle for rescheduling. The move becomes official after the Office of Management and Budget signs off, followed by a public comment period.

Kent has helped develop drug policy for almost 20 years. He worked as part of President Joe Biden’s White House Office of National Drug Control Policy.

"Everyone seems to be focused on commercial recreational marijuana. What I've been really hopeful for is it will open the door for so much more research to occur, and it'll be much easier to do research," Kent said. 

"I'm particularly interested in research where we can look at use of cannabis, marijuana, as an alternative to prescribed opioids for treating pain and other medical conditions."

Kent says some of the most promising benefits could be the reduction of overdoses.

"It is heartbreaking. Even [in] the most recent numbers from the federal CDC, we're losing over 100,000 people a year to prescribed opioids," Kent said.

Many senior citizens are now using cannabis to treat chronic pain, nausea from cancer treatment and other ailments.

"Geriatric patients can be on 10 or more meds very easily, and there's such a high risk of side effects," Palace said. "The most impactful effect we saw was pain management. In most cases, they were able to either eliminate or significantly reduce the amount of opioids they were taking, and we didn't see any side effects."

The Commonwealth Project proposes a large-scale demonstration model in the state of Massachusetts, similar to Medicare.

"The government takes full responsibility for the health care of people 65 and over, period," Kessler said. "That’s their job."

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Throughout the study, major payer providers would provide guidance and education to caregivers, pay for approved cannabis therapies for people 65 and over, and record the results.

"All it’s going to do is, in a structured, observed and controlled way, validate what we already know," former Blue Cross Blue Shield Massachusetts CEO William Van-Faasen said.

Kessler says tens of millions of people could be helped with the project — but others say more evidence is needed.

"I'm not sure that rescheduling — a lot of people think we're going to have research falling from the sky as a result. I hope they're right. But I'm a little skeptical because I think it takes money, more than anything, for that research to happen. And so far, bio companies — they don't see marijuana as a super viable product," said Kevin Sabet, president and CEO of Smart Approaches to Marijuana.

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Sabet served as an adviser to the Clinton, Obama and Bush administrations. His organization believes cannabis should not be a substitute for medicine before treatments are FDA approved.

"Maybe it’s possible that the opioid manufacturers wouldn’t want it. I think we’re all open to it. Let’s study it, but let’s get the facts out right now. Seventy-five percent of people think that it’s harmless," Sabet said. 

"And they’re not realizing that it stays in your system for a while. It can cause these mental health breakdowns."

Some doctors say rescheduling could lead to more studies and awareness about the benefits of cannabis.

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"I think the danger is right now, because you have so many states where there are products on the market," Kent said. 

"We should all understand there are seniors who are using — they're going to these dispensaries in states that have legalized the use. And so it's already occurring. I think actually Howard's proposal would control it in a much more significant way."