By MICHAEL C. PATTERSON

In the United States, cannabis use is growing faster with seniors than any other age group. A 2016 study from the National Survey of Drug Use and Health showed a ten-fold increase in cannabis use among people 65 years or older. However, according to researchers, a lack of communication with their doctors and the continued stigma of cannabis keep barriers higher to getting this natural medicine.

In Florida as of July 26, 2019, there were over 330,000 patients who have qualified to use medical marijuana (MMJ). The average age of a MMJ patient is 50 years old. Florida has one of the oldest populations in the United States. As more Seniors become familiar with the benefits of MMJ, more will use it, with or without physician involvement.

A recent study published in May 2019 in the Journal of Drugs and Aging looked at how older Americans use cannabis and the outcomes they experience. The study was conducted at the University of Colorado School of Medicine. The goal of the study was to understand how older people perceive cannabis, how they use it, and positive and negative outcomes associated with cannabis use. "Older Americans are using cannabis for a lot of different reasons", said Hillary Lum, MD, PhD, co-author and assistant professor at the Colorado School of Medicine. "Some people use it to manage pain while others use it for depression or anxiety."

The research team held 17 focus groups in multiple settings (senior centers, health clinics and cannabis dispensaries) in 13 Colorado counties. These focus groups included more than 130 people over the age of 60, which included some non-cannabis users as well. Lum verbalized that participants identified "five major themes" which are as follows:

• Lack of research and education about cannabis
• Lack of provider (physician) education about cannabis
• Lack of access to medical cannabis
• Lack of outcome information about cannabis use
• Reluctance to discuss cannabis use

Some participants in the study told researchers that they were nervous talking to their physician about questions regarding the use of medical cannabis, which Lum said points to a "failure of communication between health care providers and their patients." Other participants told researchers that they bypassed their physician and went straight to buy recreational cannabis (since it is legal in Colorado), because their physician would not provide them a recommendation for cannabis, or they did not feel comfortable asking their physician for a recommendation.

"I think (doctors can) be a lot more open to learning about it and discussing it with their patients," said one focus group respondent. "Because at this point, I have told my primary care I was using it on my shoulder. And that was the end of the conversation. He didn't want to know why, he didn't want to know about effects, didn't want to know about side effects, didn't want to know anything."

The study adds to the growing literature on the diversity of marijuana use patterns in older adults, said co-author Sara Honn Qualls, PhD, ABPP, professor of psychology and director of the Gerontology Center at the University of Colorado Springs.

"Older adults who use marijuana are ingesting it in a variety of ways for multiple purposes," she said. "This and other papers from the same project show growing acceptance of marijuana use for medical purposes by older adults, and a clear desire to have their primary health providers involved in educating them about options and risks.

Hillary Lum agrees. "From a physician's standpoint this study shows the need to talk to patients in a non-judgmental way about cannabis," she said. "Doctors should also educate themselves about the risks and benefits of cannabis and be able to communicate that effectively to patients."

In the very near future, all physician practices will be affected by medical cannabis in some way. Based on mounting evidence, patients will seek out MMJ with or without physician involvement. The physician groups who provide cannabis recommendations, or at least an openness to discuss using MMJ as a medicine, will maintain and increase the number of practice patients and patient satisfaction. The physicians who continue to leave their "head in the sand" and ignore MMJ as a treatment will lose patients and ancillary services (lab, x-ray, anti-aging treatments, etc.) associated with those patients.

Michael C. Patterson, founder and CEO of U.S. Cannabis Pharmaceutical Research & Development of Melbourne, is a consultant for the development of the medical marijuana industry nationwide and in Florida. He serves as a consultant to Gerson Lehrman Group, New York and helps educate GLG partners on specific investment strategies and public policy regarding Medical Marijuana in the U.S. and Internationally. He can be reached at mpatterson@uscprd.com