CBD is being studied as a treatment for a wide range of conditions. Find out more about how CBD can help you and what risks to consider. Almost one in five Americans over 50 now use some kind of CBD product. Cannabis specialist Dr. Danial Schecter discusses what older adults need to consider when they start using CBD.
What to Know About CBD Oil For Elderly
CBD is a chemical found in marijuana. CBD doesn’t contain the ingredient that produces a high, which is known as tetrahydrocannabinol (THC). Typically CBD is available as an oil, but CBD is also sold as an extract, a vaporized liquid, and an oil-based capsule. Numerous CBD-infused food, drink, and beauty products are available online.
Many people use CBD oil to curb symptoms of many common health issues, including some elderly people. According to a 2020 nationally representative Consumer Reports survey, 20% of Americans 65 years and older said they’d tried CBD oil, up from 14% from the prior year in 2019. However, it’s important to keep in mind what conditions CBD oil can help and whether it’s safe for the elderly to use.
Is CBD Oil Effective?
Each of us has something called an endocannabinoid system. The endocannabinoid system works to keep you in a stable condition where everything in your body works at its best. For instance, if it is hot outside or if you are exercising vigorously, your endocannabinoid system will help steady your heart rate and keep your body temperature within a healthy range by making you sweat.
Your body works best when everything is balanced, and your endocannabinoid system helps maintain that balance, despite what might be going on in your external environment.
When something is out of balance, like an inflamed joint due to arthritis or injury, CBD oil helps support your endocannabinoid system so your body can better handle and relieve the problem.
Is CBD Oil Safe for Seniors?
We need more research, but CBD oil seems to be an up-and-coming treatment solution for the elderly.
While CBD and THC are both found as parts of the cannabis plant, significantly higher THC amounts are found in marijuana. Some seniors might be prescribed medical marijuana by their doctor, although medical marijuana is not legal in every state, and some people don’t want to experience a “high.” In those cases, CBD can be a great alternative.
CBD doesn’t produce a high, and it’s legal throughout the United States. It’s sourced from a hemp strain of cannabis and contains .3% THC or less. This means you get all of the benefits without having to worry about feeling a high.
Benefits of CBD Oil
There are numerous benefits of CBD oil:
- Relieves arthritis pain
- Relieves chronic pain
- Reduces inflammation
- Reduces muscle spasms
- Improves sleep
- Prevents or reduces symptoms related to Alzheimer’s disease
- May reduce cancer cell growth
- Reduces nausea and vomiting for cancer patients being treated with chemotherapy
Pain relief. CBD oil has also proven to be an effective, non-habit-forming treatment for pain. One study found that CBD reduces pain 30% more than traditional medication or medical marijuana (THC) alone.
General anxiety and performance anxiety. One study of individuals with a social anxiety disorder and fear of public speaking gave some people a single dose of CBD an hour and a half before they participated in public speaking. Those given the CBD experienced a significant reduction in their anxiety, with less discomfort and stress.
In short, CBD has been proven effective in enhancing the quality of life, preventing cognitive decline, reducing blood pressure in stressful situations, and more.
What to Consider When Buying CBD
Decide why and what form. Think about what you’ll be using CBD for and how you’d prefer to use it. CBD is often available as an oil, pill, drop or lotion.
Consider the amount of THC. Some CBD products contain THC, although it’s in very small amounts. If you’re looking for CBD with no TCH in it at all, consider looking for CBD made from hemp.
Find where it was made. Not all CBD products are made the same way. Colorado has very robust, trusted CBD manufacturing facilities, but if you buy CBD online and it comes from somewhere overseas, it may not have gone through any safety testing.
Read the label. Always read the label of any CBD product to check for additional ingredients that could affect your health or safety.
Stay cautious. Some CBD brands will make claims that CBD can cure cancer or help with heart disease. Huge health claims like that are illegal and are not verified. If a brand is advertising unrealistic benefits, beware.
Risks of CBD Oil
Currently, the only CBD product approved by the Food and Drug Administration is a prescription oil called Epidiolex used to treat epilepsy. Although CBD is currently being studied as a potential treatment for other conditions like Parkinson’s disease, schizophrenia, multiple sclerosis, and diabetes, the research is limited.
CBD also carries some potential risks and may cause:
- Dry mouth
- Tiredness and fatigue
- Reduced appetite
- Potential negative interaction with other medications
Because CBD is mostly available as an unregulated supplement, it is challenging to pinpoint effective doses or know exactly what you’re getting. For this reason, it’s important to talk with your doctor before taking CBD.
CBD Awareness Project: “Benefits of CBD.”
Consumer Reports: “A Guide to CBD and Cannabis for Older Adults”, “How to Shop for CBD.”
Journal of pain and symptom management: “Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC:CBD extract and THC extract in patients with intractable cancer-related pain.”
Mayo Clinic: “What are the benefits of CBD—and is it safe to use?”
Neuropsychopharmacology: “Cannabidiol Reduces the Anxiety Induced by Simulated Public Speaking in Treatment-Naïve Social Phobia Patients.”
CBD Safety For Seniors
Almost one in five Americans over 50 now uses some kind of CBD product, according to a recent Gallup poll. And they are doing so undeterred by the total lack of FDA oversight or guidelines. But to what extent is CBD use a public health concern for seniors? And what do older adults need to consider when they start using CBD?
Fake product alert
Hemp-derived CBD oil is now poised to overtake olive oil in the category of most counterfeited plant extract on the planet, making authenticity a prime concern for older consumers. Random samplings of CBD products consistently detect misrepresentation between their labels and their contents. In some cases, the nominal cannabinoid is entirely absent, in others, more nefarious substances have been found.
One of the many organic, third-party lab-tested CBD products on the market.
Hence, until the FDA gets its regulatory house in order, responsibility for finding a safe product lies with the consumer. According to the Brightfield Group, seniors tend to prefer ingesting CBD in oils, vape cartridges and edibles, which entails a lot of label-reading for seniors. When evaluating a CBD product, make sure it uses CBD from organic hemp, preferably grown in the United States, and that it is third-party lab tested to verify the CBD content and rule out the presence of contaminants.
Once you get it, how do you use it?
While CBD products have never been easier to access in the US, actually getting the desired results from them can be more complicated.
I spoke with Dr. Danial Schecter, an Ontario-based family physician who is the co-founder of a network of cannabis-based medicine clinics that have served over 60,000 patients in Canada, and who recently became Director of Global Medical Services at Canopy Growth Corporate, about the guidance he suggests for seniors interested in using CBD.
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Danial Schecter (DS) I’ll start with a few basics: CBD is a molecule derived from the cannabis plant. It is what we call non-euphoric-inducing, in that it doesn’t cause you to feel high, but it is still what we call psychoactive, meaning that it has an effect on the neurotransmitters and the chemistry of your brain, just like an antidepressant or a sleep aid would have.
Abbie Rosner (AR): How do you approach CBD dosage for seniors?
DS: When we’re talking about CBD, in terms of dosing it in particular, we know that doses of CBD are very safe, that there has been no documented overdose of CBD, that it does not cause euphoria and that it is safe to be used in quite high quantities. We have studies where it’s been used in as low as 5-10 mgs per day, and studies that are using it in as high as 1500 mgs a day.
The supposed effects of CBD are that it has anti-inflammatory, antidepressant and anxiolytic (anti-anxiety) properties – but we still don’t really know exactly how it works. Yet there have been studies done in humans, for example, where subjects were given 600 mg of CBD in a single dose or a placebo, and then had them do a simulated public speaking exercise. And those who had the CBD had a significantly easier time, with less anxiety.
But, in clinical practice, we never give doses like that. It’s just not affordable. What I see in my clinical practice is that the majority of people will respond to somewhere between 40 and 100 mgs of CBD/day.
AR: If a 70 year old woman came into your clinic, would you recommend that she take 40 mg of CBD?
DS: No. What I would say is, we don’t know what your dose is going to be. Everyone’s endocannabinoid tone is different, their metabolism is different, you’re on a certain number of medications that will potentially affect the metabolism of CBD and the only way to know if it is going to work and what the dosage is, is by taking a standardized approach, starting low and going slow.
AR: And what would the starting dose be?
DS: In a healthy adults a starting dose would usually be 5 mg of CBD, but in people who are elderly, who are potentially on a number of medications, and who are very sensitive to side-effects of medications, we like to cut that dose in half, and start at 2.5 mgs of CBD. The 40-100 mgs a day of CBD a day that I mentioned previously, that’s usually for people who are using it for pain or for anxiety and wellbeing.
AR: Pain and anxiety are two of the main issues that older adults are facing – so the picture that I’m getting is that, if an older adult comes in and says, I have pain and I’d like to start with CBD – you’d start low but you might theoretically get up to 40-100 mgs of CBD to actually address the effects.
DS: Exactly – so what we usually do is, we encourage people to start at a very low dose – 2.5 mgs – and then increase in 2.5 mg increments – depending on how aggressive they want to be – over anywhere between 2 days and one week. And then wait to see if they feel any kind of response.
Usually, the psychological symptoms will take longer to actually improve or respond to CBD than the physical symptoms. So we would often recommend a slower titration for anxiety or depression, and for the physical symptoms that have a quicker response, we could recommend a quicker titration.
AR: What do you recommend for seniors who want to supplement or replace their medications with CBD?
DS: Whenever we want to start a new medication, one of the very basic principles is that we should really not be playing around with another medication. So you only want to introduce or remove one medication at a time.
If you’ve been on a sleep aid for many years, and you want to stop taking it and use CBD, I would not recommend that you all of a sudden stop taking the sleep aid and start taking CBD, because your insomnia will get worse. Under the guidance of your physician, you would want to taper in the CBD until you reach a stable dose.
AR: Is CBD alone a potent medication?
DS: It can be. But it’s probable that the best benefits – at least what I see in clinical practice – is when we can use a combination of both THC and CBD.
There is idea that exists that THC is bad and CBD is good, when in actuality, both of these molecules have a very important place in clinical practice. And while THC has received a bad rap, because it is associated with getting high, in actuality, it has more immediate benefits than CBD. With THC there’s a huge misconception that people just use it to get high. But in doses that do not cause you to get high, it can be very beneficial for things such as sleep, pain, nausea, appetite stimulation and muscle spasms.
AR: That’s all fine and well in Canada. But in most of the United States, older adults need to get a medical marijuana card to access those products –with all the bureaucracy that entails. And now they can access CBD in almost any drugstore – and that’s what they’re doing!
DS: For someone who wants to access CBD on the open market, that’s absolutely fine – but ideally, they would be doing so under the supervision of their main treating physician.
AR: In your practice, are you seeing older adults who are asking for CBD products?
DS: That’s actually what we’re seeing the most of these days. In Canada, where cannabis has been legalized for recreational use, the greatest increase in our patient population at the clinics are the Baby Boomers and the parents of Baby Boomers who are coming in all the time asking to try that CBD oil.
But the other thing is that, even when they want CBD, once we start examining them, getting their history and understanding what it is they are looking for, we find that very often they would benefit from a low dose of THC in addition to CBD. Here in Canada, you can very easily say, I know you’ve heard about CBD, but you could benefit even more from something with a little THC.
AR: And there’s the beauty of full legalization – that you don’t have to jump through so many hoops to get a little THC in your medicine.