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Cannabis for Seniors – Miami Community News

Michelle Weiner, DO, MPH

On February 19, 2017, the New York Times published an article titled "When retirement is accompanied by a daily dose of cannabis." It was discussed how a 98-year-old woman living in a nursing home used medical marijuana for her neuropathy. She may buy medical marijuana from a pharmacy, keep it in a box in her room, and administer it to herself. Over the past year, there has been a 250% increase in the use of marijuana for medical professionals over the age of 65. In the state of Washington, assisted living has a medical marijuana policy due to its increasing popularity. Patients in non-formal states who live in care or nursing homes may not have access solely because of their place of residence, although they may be candidates for medical cannabis.

Unfortunately, I think if formal guidelines are not adopted, patients may choose to use marijuana without their facility, doctor or nurse being aware of it. The reduction could be due to the fact that most nursing homes are state-administered and funded by Medicare and Medicaid, and medical marijuana is still federally illegal. Moreover, medical cannabis is not covered by insurance, so patients in these institutions would have to buy it themselves.

Research has shown that medical marijuana is therapeutic for treating a variety of conditions that are not uncommon for the elderly population such as nausea and vomiting, chronic pain, muscle spasms and neuropathy. It helps in sleep, increases appetite, has anti-inflammatory, antioxidant, anxiolytic and neuroprotective. Americans over the age of 65 account for fourteen percent of the country's population, but use more than 30 percent of all prescription drugs. Medicare saved more than $ 165 million in prescription drugs in Washington DC in 2013 and 17 states where cannabis could be used as a medicine. If every state in the nation legalized medical marijuana, the study predicted that the federal program would save more than $ 468 million a year on medicines for disabled Americans and those over 65 years old.

In my personal practice, I have seen many elderly people with chronic pain who can not tolerate opiates because of sedation, cognitive impairment, and constipation, who have done well with little THC and / or medical cannabis. Later, the responses of the caregivers and the family also included an additive benefit of improving sleep, reducing anxiety / depression. Donald Smith is a 96-year-old man whom I met in January 2016 at the Aventura Hospital and Medical Center. I had a kyphoplasty for a lumbar compression fracture that he suffered from a fall. He was discharged from hospital with a prescription for Percocet and returned a few weeks later after another fall, resulting in a recurrent lumbar compression fracture and multiple rib fractures. We performed a paravertebral block for pain relief and tried topical analgesics. His daughter insisted on not using opioids such as hydrocodone and tramadol as a result of confusion, multiple falls, and constipation.

I saw Donald in the office after he was released and he was unhappy. He had stubborn pain with every inspiration and a high risk of developing pneumonia. He could not find a comfortable position and his daughter was frustrated looking for help. I started Donald with a topical and sublingual CBD hemp oil that seeks to layer the effects and comply with the current law, which states that a doctor should have a 90-day relationship with him before recommending medical marijuana the patient must have. He had minimal relief from these alternatives and his motivation and mood worsened. I started it with a low THC tincture that minimally improved his pain, sleep, and mood. His daughter and I decided to quickly escalate to medical cannabis because it seemed he had limited time. Within a few days of launching Trulieve's Medical Cannabis Syringe, his daughter replied in a text, "20% THC seems to make a big difference, and we are so grateful that he can enjoy his life without pain and without opioids. "He recently celebrated a birthday and anniversary with his wife, in which his daughter sent me a picture of them, ate the ice cream cones and smiled. I saw him in the office recently, just to see that he jokes and expresses his gratitude with such positive, pulsating energy. The biggest fear of his daughter is now out of the products and she looks forward to an early opening of a pharmacy nearby. My only caveat is that I can not stress how important it is to monitor these patients and communicate with their families to educate them about the right way to use medical cannabis, dosing, and its many delivery routes. The family must support this decision and communicate with a physician who is competent in cannabis medicine.

Learning about cannabis has been addictive as it has changed my current treatment algorithm. For example, cannabidiol (CBD) may be the preferred treatment for neurodegenerative diseases because it is non-psychoactive. CBD reduces nitric oxide synthase, suppresses inflammation and reduces lipid peroxidation, and influences tau phosphorylation, which is involved in the progression of Alzheimer's disease (AD). In addition, activation of CB1 receptors may promote axonal growth response and neurogenesis.

THC inhibited the aggregation of plaques that are the hallmark of AD, and autopsy studies have shown an increase in the expression of CB1 and CB2 receptors in these plaques. Caregivers' delusions, agitation, aggression, irritability, apathy, sleep and worry were reduced when THC was added to alleviate the symptoms of dementia in a recent Israeli study in 2016. The current treatment of AD includes medicines known as AChE Inhibitors and cause GI problems as well as hepatotoxicity.

Edibles may be the best option for seniors complaining that they do not want to take another pill, as poor nutrition and dehydration can contribute to infection, constipation and damage to health. Perhaps a small chocolate would be pleasant and therapeutic as a delivery route, more emphasis must be placed on making food choices appealing and preparing soft, tasty options to increase appetite, and edible products have the advantage of taking longer than other routes of administration , therefore, an edible na Allow a patient to sleep well during the night.

Many other medical conditions that affect the elderly, such as cancer, osteoporosis and Parkinson's, are well researched terms of the therapeutic use of cannabis in treating symptoms or reducing the progression of the disease. The beauty of medical cannabis, especially in the elderly, is the inability to overdose or, unlike many pharmaceuticals, cause death. Unfortunately, many wonderful options and guidelines are not born until you suffer a personal, near-home tragedy, and I hope that it does not take a family member to suffer, but witness a family or a friend, because of this possible Use of medical cannabis survives

Dr. Michelle Weiner, is the director of PRIME Wellness in South Florida. She completed her residency and fellowship training at the University of Miami. It individualises medical cannabis treatments based on patient-specific factors with the aim of maximizing quality of life, reducing overall pharmaceutical use and side effects. She is experienced in the diagnosis and treatment of vitamin and micronutrient deficiencies and uses nutraceuticals and IV-vitamin therapy to strengthen the immune system and nervous system and increase energy. Dr. Weiner's practice also treats various other sources of pain.

Dr. Weiner has offices throughout South Florida, including Miami, Hollywood and Boca.
For more information, visit www.primeimed.com or call (305) 907-7412

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