Department of Health Management and Policy, College of Public Health, University of Iowa.
Gerontologist. 2017 Nov 10;57(6):1166-1172. doi: 10.1093/geront/gnw166.
Cannabis use among older Americans is increasing. Although much of this growth has been attributed to the entry of a more tolerant baby boom cohort into older age, recent evidence suggests the pathways to cannabis are more complex. Some older persons have responded to changing social and legal environments and are increasingly likely to take cannabis recreationally. Other older persons are experiencing age-related health care needs, and some take cannabis for symptom management, as recommended by a medical doctor. Whether these pathways to recreational and medical cannabis are separate or somewhat tangled remains largely unknown. There have been few studies examining cannabis use among the growing population of Americans aged 65 and older. In this essay, we illuminate what is known about the intersection between cannabis and the aging American population. We review trends concerning cannabis use and apply the age-period-cohort paradigm to explicate varied pathways and outcomes. Then, after considering the public health problems posed by those who misuse or abuse cannabis, we turn our attention to how cannabis may be a viable policy alternative in terms of supporting the health and well-being of a substantial number of aging Americans. On the one hand, cannabis may be an effective substitute for prescription opioids and other misused medications; on the other hand, cannabis has emerged as an alternative for the undertreatment of pain at the end of life. As intriguing as these alternatives may be, policy makers must first address the need for empirically driven, representative research to advance the discourse.
美国老年人的大麻使用量正在增加。尽管这种增长在很大程度上归因于更宽容的婴儿潮一代进入老年，但最近的证据表明，大麻的使用途径更加复杂。一些老年人对不断变化的社会和法律环境做出了反应，他们越来越有可能将大麻作为娱乐用途。另一些老年人则出现了与年龄相关的医疗保健需求，一些人根据医生的建议，服用大麻来缓解症状。这些娱乐性和医疗性大麻使用途径是分开的，还是有些交织在一起，目前还知之甚少。很少有研究调查 65 岁及以上的美国人口中使用大麻的情况。在本文中，我们阐述了已知的大麻与美国老年人口之间的交集。我们回顾了大麻使用的趋势，并应用年龄-时期-队列范式来解释不同的途径和结果。然后，在考虑到那些滥用或误用大麻的人所带来的公共卫生问题之后，我们将注意力转向大麻如何在支持大量美国老年人的健康和福祉方面成为一种可行的政策选择。一方面，大麻可能是处方类阿片类药物和其他被滥用药物的有效替代品；另一方面，大麻已经成为临终疼痛治疗不足的替代药物。尽管这些替代方案很有吸引力，但政策制定者首先必须解决对实证驱动、有代表性的研究的需求，以推进这一讨论。
