How to Talk to Senior Parents About Medical Marijuana

When you notice a change in your health or new symptoms, how quickly do you schedule an appointment with your primary care provider? The out-of-pocket cost of doctor’s visits and diagnostic testing (even for people with good health insurance) can be a delaying factor.  In 2020, the average annual deductible for a single individual is $4,364 and $8,439 for family coverage. 

But seniors who are over the age of sixty-five years are covered by Medicare.  The standard monthly premium in 2021 for Medicare Part B will be $148.50.  The annual deductible for seniors will be $200.00 in out of pocket costs before full health insurance coverage.  Medicare for most seniors remains very affordable. Cost is not usually the deterrent to seeking medical care. 

Parents may not be forthcoming about their symptoms.  This may be more true for senior men, who statistically are less likely to talk about pain or other chronic conditions.  Men are also less likely to report symptoms or seek medical advice. Until they can no longer ignore signs, for that reason, the window for early intervention on life-threatening diseases is often missed.  

Substance Use Disorders Rising for American Seniors

Male seniors are also less likely to explore alternatives when it comes to symptom management. Could your parent be self-medicating by other methods to cope with chronic pain?  More than one million older adults in the United States live with a Substance Use Disorder (SUD).  

According to the National Institute on Drug Abuse, older adults are more prone to using addictive substances.  There are many reasons for this. First, retired individuals do not have a routine that requires them to remain alert and active.  They can imbibe anytime they feel like it because they make their schedule. 

Alcohol is the most commonly abused drug.  The Nation Institute on Drug Abuse reported that approximately 65% of seniors aged sixty-five or older report high-risk drinking.  That is defined as exceeding the daily alcohol consumption guidelines at least once per week in the past year.  And 1 out of every 10 American seniors reports that they binge drink. For men, that rate is five or more drinks on the same occasion. For women, that rate is four or more drinks on the same occasion. 

Additional research published in 2020 shows a startling increase in seniors’ alcohol consumption in the United States in recent years.  Alcohol use among Americans who are over the age of fifty is outpacing any other age group. 

The Question Not Being Asked: Why Are Seniors More Prone to Alcohol Abuse?

The opioid crisis and increasing overdose fatalities from prescription pain medications have created a reverberating problem.  While it is agreed that the rate of opioid prescriptions needed to go down for public safety, it has also left patients with chronic pain in the lurch.  Patients accustomed to receiving opioids or prescription NSAIDs now feel they are not given enough medication to manage their symptoms adequately. 

If you have ever endured a period where you had to cope with excruciating pain daily, you inherently understand what it is like. However, many people can’t visuals the impact of unmanaged chronic pain.  On independence and activities of daily living.  On overall mental health, mood, energy, ability to exercise, and more. 

Alcohol is the easiest way to moderate symptoms. It is legal to purchase. There are no limits as to how much you can buy.  And many seniors are using alcohol daily to help moderate their chronic health symptoms.  It is a dangerous alternative.  Alcohol abuse places seniors at greater risk of developing esophageal and liver cancer.  And it can worsen symptoms for seniors with diabetes, osteoporosis, and hypertension.

One of the other critical dangers for seniors who use alcohol to manage pain symptoms is the increased risk of injury from trip and fall incidents. It can also accelerate symptoms of memory loss and dementia and improve cardiovascular health problems. 

Over the Counter Pain and Anti-Inflammatory Medications Are Often Ineffective 

The other option that seniors have to ameliorate their pain are over-the-counter (OTC) anti-inflammatory medications. When an individual has been treated for years with opioid medications, they can develop a resistance to all NSAIDs.  That means that OTC pain relievers available in their local pharmacy may reduce but not resolve pain symptoms. 

Over-the-counter medications can conflict with prescription drugs in three ways:

  1. Alteration

An OTC may affect the way your body metabolizes or absorbs active ingredients in prescription medications. One example of this is Asprin’s use for patients on blood-thinning drugs like Warfarin, Coumadin, Pradaxa, Xarelto, Eliquis, and Heparin. 

  1. Opposition

The active ingredient(s) in an over-the-counter medication may counteract the therapeutic benefits of prescription medication.  Some OTC’s may negate the effectiveness of prescription drugs entirely.  For instance, taking decongestants will work against medications you may take to control your blood pressure (hypertension).

  1. Duplication 

You can take too many pain medications and amplify the effects to a dangerous level where you may be at a high risk of overdose or injury.  For example, if you are already taking a daily prescription anti-inflammatory and over-the-counter ibuprofen, you can sustain damage to your liver or kidneys. 

Because OTC’s are not 100% effective at reducing pain, seniors’ likelihood of using them in conjunction with prescription medications, and alcohol is very high.  And it can be a lethal combination.

Start By Having a Conversation About The Symptoms They Cope With Daily 

Start by having your parent(s) complete a pain inventory.  They may or may not have already completed one with their primary care provider (PCP).  But, if you are trying to gain some insight into your parent’s health condition, they may feel more comfortable evaluating their symptoms with a family member. 

A Brief Pain Inventory will help determine the degree of discomfort your senior parent is experiencing, including:

  • Frequency of pain and inflammation 
  • The severity of pain symptoms
  • The level of disruption that pain symptoms cause with activities of daily living
  • How much of an impact pain symptoms have on sleep (or the presence of a sleep disorder because of discomfort)

Some seniors are highly focused on their health and wellness. Many can feel fatigued and demoralized after years of struggling to manage pain symptoms.  And they may not be forthcoming about how they are coping with it, mainly if they are abusing alcohol or OTCs.

The results of a brief pain inventory may be enough to persuade them to seek medical advice. Often patients who have learned to cope with symptoms for years may not be aware of the severity of their symptoms.  The inventory can also be shared with a physician as a starting point for treatment planning. 

Talking About Medical Marijuana as a Doctor-Supervised Treatment Plan

The irony of having a conversation about marijuana with your parents?  Awkward? Maybe. After all, you may remember having the conversation with your parents in your teen years. And now the roles have reversed somewhat. 

But a lot has changed in social opinion about medical marijuana.  Now that thirty-six states have legalized it, and federal legislation is moving forward. It may be time to have a ‘little talk’ about your parent’s health.  And introduce doctor-supervised medical marijuana as a new and potentially safer treatment strategy. 

Getting a medical card is not difficult for seniors who have one or more qualifying health conditions.  In fact, in many states, mandatory health evaluations can be done online.  Through a telemedicine visit. 

Get ready to deal with the stigma that your parent(s) may have about cannabis.  You may want to show them a medical cannabis dispensary website.  Review some of the intake methods that may suit their needs and preferences. 

 If your parent has a  respiratory issue, tinctures or THC infused drops may be a better approach. Edibles are also a popular choice (where legalized) for pain relief.  The physiological and psychoactive effects of edibles can last 4-8 hours or longer for patients.  Help them to pursue a medical card and try cannabis as a new option for symptom management.