Shin Yoo Mee, Moussa Mohamad, Akwe Joyce
Division of Hospital Medicine Emory University School of Medicine.
Atlanta VAHCS/ VISN 7 Clinical Resource Hub.
J Brown Hosp Med. 2024 Jul 1;3(3):120951. doi: 10.56305/001c.120951. eCollection 2024.
Cannabis has been employed medicinally throughout history, with recent renewed interest for use due to media awareness and medical marijuana legislation. The geriatric population, identified as those 65 years of age and older, is increasingly using cannabis-derived products, has a higher likelihood of having multiple comorbidities, and is subject to polypharmacy. These individuals are at increased risk of psychiatric and other medical adverse events due to their decreased physical and cognitive reserve and changes in their physicality. Recreational use of cannabis in this population has not been well studied, but medical marijuana use has been investigated more frequently. Increased nonmedical use increases the risk of adverse health consequences. Heavy regular use can lead to cannabis use disorder (CUD), which is formerly known as cannabis abuse and dependence, and may also lead to impaired social functioning and psychiatric comorbidity. The pattern of patients admitted to hospitals has dramatically changed recently, with an increased number of elderly patients being frequently admitted. As such, due to the ease of accessing CBD, this vulnerable cohort is seen more frequently in the hospital, and we need to be more vigilant and inquire about cannabis use as we do, asking about routine medications and over-the-counter supplements. In the U.S., marijuana laws have been changing rapidly, and Americans increasingly favor legalizing cannabis for medical and recreational uses. Policymakers should ensure that training on cannabis screening and interventions for CUD are provided to clinicians to equip them better to monitor and treat patients with cannabis-related problems.
纵观历史,大麻一直被用于医学领域,由于媒体的关注和医用大麻立法,近期人们对其使用的兴趣再度燃起。老年人群体指65岁及以上的人群,他们越来越多地使用大麻衍生产品,患多种合并症的可能性更高,且常服用多种药物。由于身体和认知储备下降以及身体机能变化,这些人出现精神和其他医疗不良事件的风险增加。该人群中大麻的娱乐性使用尚未得到充分研究,但医用大麻的使用已得到更频繁的调查。非医疗用途的增加会增加不良健康后果的风险。长期大量使用大麻会导致大麻使用障碍(CUD),该障碍以前被称为大麻滥用和依赖,还可能导致社会功能受损和精神共病。最近,入院患者的模式发生了巨大变化,老年患者入院的数量不断增加。因此,由于获取大麻二酚(CBD)较为容易,在医院中更容易见到这个脆弱的群体,我们需要更加警惕,像询问常规药物和非处方补充剂一样询问大麻的使用情况。在美国,大麻法律一直在迅速变化,美国人越来越倾向于将大麻用于医疗和娱乐用途合法化。政策制定者应确保为临床医生提供有关大麻筛查和大麻使用障碍干预措施的培训,以使他们能更好地监测和治疗有大麻相关问题的患者。