Use of synthetic cannabinoids increasing dramatically among older adults in Ontario
Synthetic cannabinoids are approved for the treatment of chemotherapy-induced nausea and vomiting, yet they are commonly prescribed off-label to older adults for a variety of conditions. A recent study, published in Annals of Internal Medicine, examined 20-year trends in synthetic cannabinoid prescriptions to older adults in Ontario, who have increased susceptibility to the adverse effects of these drugs.
Dr. Paula Rochon
Led by Dr. Nathan Stall, geriatrician and postdoctoral fellow at Women’s College Research Institute (WCRI), and Dr. Paula Rochon, vice-president of research at Women’s College Hospital (WCH) and senior scientist at WCRI, the study showed a nearly 4-fold increase in the use of synthetic cannabinoids among older adults between 2012 and 2017. Overall, 92 per cent of prescriptions were off-label and given to older adults with a median of four chronic conditions who were concurrently receiving an average of seven drugs.
Dr. Nathan Stall
“While synthetic cannabinoids have been available in Ontario for more than 20 years, our study showed there was a recent dramatic increase in their use among older adults,” explains Dr. Stall, lead author. “Despite limited evidence for benefit and largely unknown harms, most cannabinoids are prescribed off-label and given to older adults with multimorbidity and who are on multiple medications.”
Providers may be prescribing synthetic cannabinoids to older adults because of the lack of safe and effective treatment options for chronic pain, sleep disturbances and the behavioural and psychological symptoms of dementia. The authors also suggest that the increasing use of synthetic cannabinoids may also reflect a broader societal acceptance of cannabis, particularly in Canada where recreational use was recently legalized.