research
The study looked at 2,322 people aged 65 years or older in Ontario who visited emergency rooms due to cannabis intoxication. The visits spanned from 2015 to 2022 and allowed researchers to see what happened before and after Canada legalized the sale of dried cannabis in October 2018, and in January 2020 when edibles became legal.
In 2015, there were 55 emergency room visits due to cannabis intoxication. This figure steadily increased to 462 through 2021, before falling slightly to 404 in 2022.
Dr. Stoll said he was motivated to conduct the research after being called to the emergency room to consult a patient in his 80s who was severely confused. The patient was barely conscious and had stroke-like symptoms. Multiple tests did not reveal a clear cause until Dr. Stall ordered a toxicology test and found cannabis in the patient's urine.
When Dr. Stall revealed the results, one of the patient's family members at the bedside “got red in the face and realized the older man had eaten an edible cannabis product and mistook it for food,” he said..”
Dr. Stoll said the patient was hospitalized and received supportive care, but there was no specific treatment or antidote for this addiction.
Why is it increasing?
Although the study did not examine why older people overdosed, Dr. Stoll said he and other doctors have seen poisonings resulting from intentional use of edibles for recreational or medical purposes, as well as accidental ingestion.
There are many reasons why older people tend to overdose, Dr. Stall said. Many cannabis strains are much more potent than they were in past decades, and older adults who used the drug as children may underestimate the concentration of THC they are inhaling or ingesting. Especially with edibles, it can take about three hours to reach a peak, which can lead users to consume too much, Dr. Stall said.
Older people also metabolize cannabis differently than younger people, with their bodies eliminating the drug more slowly, Dr. Stoll said. Older people are also more likely than younger people to take other medications, including psychotropic drugs for sleep, that may have problems interacting with cannabis. And Dr. Stoll said some older people are already prone to confusion or falls, and cannabis use could make them worse.
“The question is what do we do about it?” Dr. Stoll said.
What you can do
Dr. Stall noted that it is important to store edible foods in a locked location and in clearly identified packaging to prevent unintentional exposure.
He also said policymakers should promote cannabis dosage information for older adults and conduct public education campaigns about conditions and situations that put older adults at risk when using the drug. He added that older adults experimenting with cannabis for the first time may want to refer to the “start low and go slow” mantra used in geriatric medicine.
“This means they start lower and progress slower than younger populations who are trying cannabis for the first time,” Dr. Stall said.