Should Seniors in Nursing Homes Have Access to Medical Cannabis?

As the population ages, the number of seniors in nursing homes and assisted living facilities continues to rise. These seniors often face a range of chronic symptoms and conditions that significantly impact their quality of life.

This article will explore these chronic symptoms, examine why medical cannabis isn’t currently an option for seniors in nursing homes, and discuss the potential advantages of allowing its use in healthcare facilities.

We will also dive into current restrictions from the federal government that prevent medical cannabis from being administered to patients in long-term care, even when residing in a state with a medical marijuana program.

Chronic Symptoms Faced by Seniors in Long-Term Care

In 2023, approximately 1.4 million Americans lived in long-term care (LTC) facilities such as nursing homes and medically assisted living facilities. These settings provide essential support and care for individuals who can no longer live independently due to age-related issues, chronic illnesses, or disabilities.

The average age of an American residing in an LTC facility is around 79. These facilities offer medical care, assistance with daily living and self-care activities, and social support, ensuring that residents receive comprehensive care for their needs.

Around 85% of LTC residents have one or more chronic health conditions, reflecting the high level of medical and personal care required in these environments. Common chronic conditions among these residents include arthritis, heart disease, diabetes, and dementia, which necessitate ongoing management and support.

Chronic Pain

Chronic pain is one of the most prevalent issues among seniors in nursing homes. Conditions such as arthritis, neuropathy, and musculoskeletal disorders contribute to persistent pain that can severely limit mobility and daily activities.

Managing chronic pain is a complex task, often requiring a combination of medications and therapies, which can lead to additional side effects and complications. Poor management of chronic pain for residents can cause sleep deprivation, anxiety, agitation, and behavioral difficulties and can contribute to cognitive decline and decreased activity.

Epilepsy

Cannabinoids, particularly cannabidiol (CBD), have shown promise in helping patients with epilepsy manage their symptoms. CBD can reduce the frequency and severity of seizures by interacting with the brain’s endocannabinoid system, which plays a role in regulating the activity of neurons and also neuropathic pain.

Several studies and clinical trials have demonstrated the effectiveness of CBD in treating various forms of epilepsy, including drug-resistant epilepsy syndromes like Dravet syndrome and Lennox-Gastaut syndrome. By providing a potential alternative or adjunctive therapy to traditional anti-epileptic drugs, medical marijuana offers hope for improved seizure control and a better quality of life for patients with muscle spasm disorders or epilepsy.

Cachexia (Wasting Syndrome)

Medical marijuana can be a valuable treatment option for patients with cachexia, a condition characterized by severe weight loss and muscle wasting often associated with chronic illnesses such as cancer and advanced heart disease.

Cannabis has been shown to stimulate appetite, which can help patients consume more calories and nutrients, aiding in weight stabilization and muscle maintenance. Additionally, the anti-inflammatory and analgesic properties of cannabis can alleviate pain and improve overall comfort, enhancing the patient’s quality of life. By addressing both appetite and pain, medical cannabis can play a critical role in managing the debilitating effects of cachexia.

Anxiety and Depression

Medical marijuana may help alleviate the symptoms of anxiety and depression for Americans living in long-term care (LTC) facilities. The cannabinoids in cannabis, particularly cannabidiol (CBD), interact with the brain’s endocannabinoid system to modulate mood and stress responses. This can lead to reduced anxiety levels and improved mood stability, offering relief from the persistent feelings of sadness and worry that often accompany life in LTC facilities.

Additionally, cannabis can enhance overall well-being by promoting relaxation and better sleep quality, further contributing to a more positive mental state. By addressing these psychological challenges, medical cannabis can significantly enhance the quality of life for nursing home residents or seniors in long-term care.

Other Common Conditions

Other chronic conditions that affect seniors include insomnia, Alzheimer’s disease, and various forms of dementia, all of which can significantly diminish quality of life. Insomnia, for example, can lead to a cycle of fatigue and mental health issues, while dementia poses significant care challenges.

Medical Cannabis As A Treatment Option When Conventional Therapeutics Fail

Multiple chronic conditions often complicate care plans, requiring coordinated efforts from healthcare providers to effectively address the complex health needs of these individuals. Some patients may have treatment-resistant conditions or have developed a tolerance to conventional pain medications, for example.

The National Institute on Drug Abuse (NIDA) highlights that older adults are particularly vulnerable to the adverse effects of opioids, including tolerance, dependence, and addiction. Long-term opioid use can lead to a need for higher doses to achieve the same pain relief, which places some American seniors at a higher risk of overdose and other adverse effects.

In long-term care facilities, the goal is to ensure resident safety, comfort, and care. Patients with chronic pain may not find the relief they need from pharmaceuticals. Doctor-supervised cannabis (dispensed by a healthcare provider) could be a lower-risk option for some patients.

Why Doctor-Supervised Cannabis Isn’t an Option for Seniors in Nursing Homes

In states where medical cannabis use has been legalized, you may think that it is an option for all residents. However, at the time of writing, the federal government’s classification of cannabis as a Schedule I prohibited substance prevents medical marijuana products from being dispensed to eligible patients in assisted living communities.

Here are some of the reasons why patients in long-term care facilities cannot be provided with cannabis products:

Federal Funding Restrictions

One of the primary reasons medical cannabis is not an option for seniors in nursing homes is the federal prohibition of cannabis. Since many long-term care facilities receive federal funding through Medicare and Medicaid, they must comply with federal laws, which classify cannabis as a Schedule I drug.

This classification indicates that cannabis is considered to have no accepted medical use and a high potential for abuse despite growing evidence to the contrary. The discussion around rescheduling cannabis to Schedule III on the Controlled Substances Act may change that; however, when or if that happens remains uncertain.

Safety Concerns

There are also safety concerns regarding the use of cannabis in nursing homes. These include potential drug interactions, side effects, and the need for proper dosing and monitoring. Care facilities must ensure the safety and well-being of all residents, and the lack of standardized guidelines for medical cannabis use complicates its adoption.

The variability in individual responses to cannabis and the need for careful monitoring pose additional challenges. For example, cannabis is contraindicated or conflicts with many different prescription drugs and can cause potentially life-threatening interactions.

Lack of Clinical Research

The lack of extensive clinical research on the effects of cannabis in elderly populations further hinders its acceptance. Without robust data, healthcare providers are hesitant to recommend cannabis, fearing potential risks and legal repercussions. More studies are needed to establish guidelines for safe and effective use in seniors.

Advantages of Allowing Medical Cannabis in Long-Term Care

Smokable or inhaled cannabis use is not an option for patient use in clinical environments. However, many other alternatives exist, including edibles, tinctures, capsules, and tablets. Clinical inhalers can also be used to provide metered doses to patients.

While administrating medical marijuana to patients in long-term care facilities is illegal and violates federal law, many potential advantages could improve the quality of life for senior living residents if it was legalized for use in healthcare facilities.

Effective Non-Opioid Treatment Options

One of the significant advantages of medical cannabis is its potential as an effective non-opioid treatment option. Opioids, commonly prescribed for chronic pain, carry risks of addiction and overdose. Cannabis, on the other hand, has shown promise in managing pain without the same level of risk.

By offering a non-opioid alternative, nursing homes could reduce the reliance on potentially harmful medications and provide better treatment outcomes for seniors.

Affordability

Medical cannabis may be more affordable compared to some prescription medications. Many seniors face financial constraints, and the high cost of pharmaceuticals can be a burden. The average annual cost of drugs for long-term care patients in the United States can range from $3,000 to $7,000 per person. These costs can be even higher for individuals with multiple chronic conditions requiring complex medication regimens.

Doctor-supervised cannabis, if insurance coverage evolves as it did in Canada to reimburse some of the medical cannabis expenses, then it may offer a more cost-effective alternative. Lowering medication costs by authorizing medical marijuana use could help patients and family members save money.

Improvement in Mood and Mental State

Cannabis has been noted for its potential to improve mood and alleviate symptoms of anxiety and depression. This could translate to a better overall mental state and a higher quality of life for seniors in nursing homes.

The mood-enhancing effects of cannabis could help reduce feelings of isolation and improve social interactions among residents. In some jurisdictions, state marijuana laws allow for mental health conditions such as post-traumatic stress disorder, moderate to severe anxiety, and treatment-resistant depression (TRD) as a qualifying health condition.

Excellent Pain Relief Option

Cannabis has been recognized for its pain-relieving properties. Medical cannabis interacts with the body’s endocannabinoid system, which can help to reduce pain and inflammation and provide a viable alternative to traditional pain medications.

For patients in senior living communities with chronic pain, this could mean improved mobility and the ability to engage in daily activities with less discomfort. This could significantly enhance the quality of life for many nursing home residents.

Does Medical Cannabis Use In Nursing Homes Make Sense?

Allowing seniors in nursing homes to access doctor-supervised cannabis could provide significant benefits, from effective pain relief to improved mental health. However, the current legal and safety concerns must be addressed to make this a reality.

As research continues and societal perceptions shift, it is crucial to consider the potential advantages of medical marijuana for one of the most vulnerable populations. Ensuring that seniors in long-term care have access to the best possible treatments should be a priority, and medical cannabis may play a vital role in achieving this goal.