• Research suggested that CBD use in seniors may have purported benefits, including pain relief, reduced anxiety, and improved dementia symptoms(1-3).
• Generally, CBD use in older adults is safe(4). However, side effects include dizziness, disorientation, confusion, and sedation(5-6).
• According to a 2019 study on cannabis use in the elderly, a 5mg increase in dosing every seven days until the desired effects are achieved may have optimal results (7).
• Seniors and their caregivers are encouraged to speak with a doctor before purchasing any CBD product.

The World Health Organization says that there are medical conditions that individuals may develop as they age, including diabetes, dementia, depression, osteoarthritis, and chronic obstructive pulmonary disease (COPD)(8).

The agency adds that as people grow older, these individuals’ likelihood of experiencing several conditions also increases.

Multimorbidity (the presence of multiple conditions, often at least two or more simultaneously) was observed to have a negative effect on older adults’ quality of life(9).

According to a review in the journal Pharmacognosy Reviews, older adults may turn to complementary and alternative medicine to search for more effective therapies or ones with a lower cost(10).

They may also consider these approaches to improve the quality of their life and for pain relief.

Health Report Live discusses another alternative— cannabidiol (CBD) oil use— and how its purported benefits may help seniors with back pain like sciatica and psychological issues, such as depression and anxiety. 

The article covers CBD use safety by age and the risks and benefits of CBD, so seniors can decide whether CBD oil is right for them.

Other concerns on CBD that the elderly may have, such as its legality and difference from marijuana, are also discussed.

 

Benefits of Using CBD

CBD for Pain Relief

Research suggests that CBD, the nonpsychoactive component of the Cannabis sativa plant, may have analgesic (pain-relieving) properties that may help improve an individual’s quality of life(11). 

Cannabis sativa has many naturally occurring compounds (phytocannabinoids), and two of the plant’s most researched active ingredients are CBD and delta-9-tetrahydrocannabinol (THC).

It is believed that the cannabis plant has the potential to help with serious and chronic symptoms (12). However, the THC component of the plant has psychoactive effects and is highly addictive.

Through the 2018 Farm Bill, the United States of America (USA) federal government prohibited the use of substances with over 0.3% THC in dry weight(13). The agency classifies these substances as marijuana. 

To date, marijuana is classified as a Schedule I drug under the Controlled Substance Act(14). These substances are defined as drugs with no accepted medical use and a high potential for abuse.

Meanwhile, substances with less than 0.3% THC are classified by the US Food and Drug Administration (FDA) as industrial hemp(15).

  However, some states allow the use of medical marijuana (also known as medical cannabis) to help with certain health conditions specified by state laws.

To regulate medical marijuana use, states have a patient registry form that also functions as a protection from arrest for possession of medical marijuana with high levels of THC(16).

In states where the use of medical cannabis is legal, pain relief is cited as one of the primary reasons seniors turn to medical cannabis(17).

Researchers of a 2019 study stated that 89.7% of the older patients in the Colorado medical cannabis registry listed pain as their primary or secondary condition(18).

A 2019 survey from Consumer Reports shared that of 1,018 people who tried CBD for the first time, more than a quarter of the sample said that the compound was at least moderately effective for their intended purposes(19).

The same survey shared that older respondents used CBD primarily for joint pain.

In another survey conducted on 800 people ages 50 to 70, over 80% reported chronic pain(20). Meanwhile, one in four respondents said they had tried six or more treatments to manage their pain.

The participants also shared that there were no significant differences in outcomes for patients that used products with high THC and those that used CBD-rich products.

According to these respondents, both CBD and THC were effective in managing their pain.

Still, further research needs to be conducted on the use of CBD for pain in seniors. 

CBD for Anxiety and Depression

According to the National Institute on Aging (NIA), depression is a serious mood disorder(21). Despite being a common condition in adults, depression is not a normal part of aging.

A 2019 study in the journal Neurology stated that medical cannabis had purported benefits on anxiety disorders, sleep, chronic pain, and neuropathy in a sample with an average age of 81 years old(22). 

To achieve these results, the authors used a balanced 1:1 THC to CBD oil tincture (dropper). 32% of the respondents reported reduced opioid pain medication upon the use of the CBD-THC tincture.

It is believed that CBD’s anxiolytic (anti-anxiety) effects may help improve libido, particularly anxiety about an individual’s sexual performance.

However, no clinical research proves that cannabis has any direct influence on sexual experience(23).

CBD for Cancer Symptoms

Among cancer patients and survivors, pain is a common symptom that affects 30% to 90% of individuals. 

Cancer pain may be caused by the condition itself, the treatments individuals undergo (post-surgical pain, chemotherapy, radiotherapy), or factors not related to the disease(24).

A 2018 study in the European Journal of Internal Medicine conducted on 901 participants ages 65 to 74 years old showed that 67% of the participants received medical cannabis (including CBD) for pain while 61% received cannabis treatment for cancer(25).

In the research, the cannabis strains had THC and CBD. Among the participants who used CBD-rich strains, 23.3% said that they used CBD for pain. Meanwhile, 30.9% used it for chemotherapy side effects, and 45.7% used it for Parkinson’s disease.

CBD for the Skin

A study sought to explore the potential therapeutic effects of CBD ointment on severe skin conditions(26). 

The authors observed that topical treatment with CBD significantly improved the skin parameters and symptoms of participants with atopic dermatitis, psoriasis, and resulting outcome scars.

The researchers suggested that CBD ointment without THC is a safe and effective non-invasive treatment that may help with wellness and the quality of life of individuals with inflammatory skin disorders.

Another study stated that cannabidiol had sebostatic (skin oil-reducing) and anti-inflammatory properties promising in acne treatment(27).

However, further research on CBD’s effects on skin conditions plaguing seniors is warranted.

CBD for the Nervous System

Dementia refers to symptoms affecting memory and other abilities related to thinking and socializing(28). It is caused by the loss of or damages to nerve cells and their connections in the brain.

Research in 2019 indicated that a combination of CBD and THC given to 10 female patients with dementia improved the participants’ behavioral problems(29). The average age of the sample was 79.5 years old.

The authors also observed that CBD and THC improved rigidity and daily care in patients with severe dementia. The combination was also well tolerated, and half of the patients decreased or stopped their other psychotropic medications.

In another study, 64 patients with an average age of 79 were given CBD-rich oil for Alzheimer’s disease-related agitation(30).

The most common dementia cause is Alzheimer’s(31).

The researchers did not observe adverse effects in the participants. The authors also shared that 72% of those treated with high-quality, CBD-rich oil experienced relief from agitation induced by dementia. 

Upon evaluating the participants after treatment, the authors also noted reduced adverse behavioral symptoms common to those with the disease.

Another disorder related to the nervous system is schizophrenia. 

Research published in the journal Translational Psychiatry indicated that CBD may be promising in alleviating psychotic symptoms of schizophrenia(32).

The hemp plant extract was also observed to enhance anandamide signaling. 

Anandamide is a cannabinoid involved in reward, motivation, and pleasure functions.

Results reported that the inhibition of anandamide deactivation may contribute to the antipsychotic effects of cannabidiol.

CBD for Heart Health

Research found in the British Journal of Clinical Pharmacology suggested that CBD’s anti-inflammatory and antioxidant properties are factors that make the hemp extract promising for cardiovascular health(33).

Through its interaction with the endocannabinoid system’s (ECS) cannabinoid receptors, CBD is suggested to reduce infarct (tissue death) size and increase blood flow in stroke models, as seen in animal studies.

The research also cited CBD’s promise in reducing the cardiovascular response to stressful situations through the substance’s interaction with 5-HT1A (serotonin) receptors.

Serotonin is a hormone involved in mood stabilization and feelings of happiness and well-being.

However, research on cannabis’ effects on seniors’ heart health is limited and requires further studying.

According to the American Heart Association, despite cannabis’ purported benefits, older adults have to be careful when taking THC for their heart-related conditions(34).

Cannabis may interact with other medications, like blood thinners, antipsychotics, antidepressants, antiarrhythmics for heart rhythm abnormalities, and cholesterol-reducing statin drugs.

The article also cited research indicating that THC may induce heart rhythm abnormalities upon one hour of being consumed. 

The report also cautioned seniors of THC’s possible stimulating effects on the sympathetic nervous system, which could result in the following:

• A higher heart rate 
• More demand for oxygen in the heart
• Higher blood pressure when lying down
• Arterial wall dysfunction

Meanwhile, the American Heart Association article maintained that CBD may have more positive effects on the heart, including lowered blood pressure, reduced heart rate, and an increased opening of the arteries.

CBD for Epilepsy

After several human studies and clinical trials on CBD use for epilepsy, the US FDA has approved Epidiolex for the treatment of seizures associated with Dravet syndrome or Lennox-Gastaut syndrome in individuals one year of age and older(35).

Epidiolex, a purified form of the drug substance CBD, is also FDA-approved for seizures associated with tuberous sclerosis complex in patients one year of age and older.

This approval implies that the FDA deems Epidiolex effective and safe for its intended use.

However, the FDA stated that CBD and THC, which may be active ingredients in a drug product, are not dietary supplements(36).

A 2019 study in the journal Epilepsy and Behavior Reports acknowledged other research that suggested CBD’s promise in improving seizure frequency and severity in patients with treatment-resistant epilepsy(37).

Eight participants ages 16 to 73 years old underwent data collection procedures consisting of a clinical and neuroimaging component before and after 10 to 12 weeks of CBD treatment.

The authors observed that CBD was safe and effective in a limited sample of patients. Preliminary findings also showed that the participants’ daily treatment with purified CBD did not change the cortical thickness in patients with treatment-resistant epilepsy.

CBD Use in Seniors: Is It Safe?

CBD’s purported health benefits, such as its positive effects on post-traumatic stress disorder, neuropathic pain, and the immune system, have led to the substance’s popularity in the US(38-41).

With the proliferation of over-the-counter CBD products, seniors are advised to take caution when purchasing CBD products. 

According to the World Health Organization, generally, CBD is well tolerated and has a good safety profile(42).

However, a 2020 study on the safety and efficacy of cannabis in older subjects reported that the use of THC:CBD formulations had several side effects on the elderly, including(43):

• Dizziness or drowsiness
• Disorientation or confusion
• Hallucinations

Another study on CBD use in elderly patients suggested that CBD doses of up to 300mg daily for six weeks are well tolerated(44). 

However, adverse effects have been observed, including sedation, orthostatic hypotension, psychomotor slowing, and lightheadedness.

The researchers also observed gastrointestinal adverse effects, like decreased appetite, dry mouth, and weight loss. They added that the side effects worsened with the daily intake of doses above 15 to 20mg of CBD per kg of body weight.

The studies mentioned above highlight that the side effects may increase a senior’s likelihood of falling. Thus, the elderly and their caregivers should take caution when using CBD. 

CBD Dosage 

Researchers from the Soroka University Research institute and Clinic sought to understand the benefits and risks of cannabis treatment on elderly patients(45). The authors recommend that seniors start low and go slow when dosing CBD.

They added that a 5mg increase in dosing every seven days until reaching the desired effects may be optimal in maximizing the purported benefits of CBD.

In the study, the authors administered cannabis (CBD and THC combinations) with this dosing:

• Day 1-3: 5mg THC + 5mg CBD
• Day 4-6: 10mg THC + 10mg CBD
• Day 7-14: 15mg THC + 15mg CBD

Seniors or their caregivers may also calculate the CBD dose ideal for them. Aside from CBD dose calculators online, the elderly or their healthcare providers may refer to this Health Report Live article on CBD dosing for finding the optimal CBD dose. 

Possible Drug Interactions

THC and CBD are metabolized by different isoforms (proteins) of the P450 enzyme system. Thus, these cannabinoids may affect other drugs metabolized by this pathway(46).

Some of the drugs that may have potential interactions with cannabinoids metabolized by the P450 enzyme system include:

• Anticoagulants, like warfarin
• Hypoglycemic drugs, like glimepiride
• Anti-inflammatory drugs, like ibuprofen
• Asthma drugs, like zafirlukast
• Anticonvulsant medications, like phenytoin
• ACE (angiotensin-converting enzyme) inhibitors, like losartan
• Anti-cancer drugs, like cyclophosphamide

Before taking CBD with existing medications, older adults should consult with their doctor.

Purchasing and Using CBD

The elderly and their caregivers should remember the following to ensure that they purchase high-quality CBD:

• • Check if state laws allow CBD use.
  • Find the CBD product type appropriate for the senior:
    • Full-spectrum CBD includes all the phytocompounds of the cannabis plant, including terpenes, CBD, and THC. The synergy of the full-spectrum CBD components produces the entourage effect, which gives the maximum benefits of a CBD product.
    • Broad-spectrum CBD has all the active ingredients of a full-spectrum CBD except for THC. This type is recommended for the elderly who do not want to consume THC to avoid its psychoactive effects.

• CBD isolates contain pure CBD only. This CBD type may work for seniors who have allergies to the other phytocompounds of CBD.

• Look up the CBD company and its credibility and check reviews. Labeling accuracy issues surrounding CBD products sold online have become prevalent(47). Thus due diligence should be taken, especially when buying from e-commerce sites. 
• To purchase products of the highest quality, ensure that the CBD compound was extracted from non-GMO hemp.
• Find out how CBD was extracted from the cannabis plant (examples include CO2 extraction and ethanol extraction).
• Ask for access to a product’s third-party lab test results. These examinations done by organizations outside the CBD company report trace amounts of pesticides, heavy metals, and contaminants that may harm seniors.

There are various ways older adults may take CBD. Sublingual administration is common in seniors(48). Through a dropper, CBD may be applied under the tongue.

 

CBD products use different carrier oils, including hemp oil, MCT oil (medium-chain triglyceride oil) derived from coconut oil or palm oil, and hempseed oil. 

The best CBD oil may vary for every individual. It is recommended to check for ingredient allergies to ensure that the senior is given the right CBD oil.

Seniors who dislike the naturally grassy taste of CBD may mix it with their food and beverages. 

Ingestion is another CBD administration method. CBD may be ingested via gel caps and pills. It also comes in edible forms, such as gummies, cookies, and even chocolate.

A study in 2021 indicated that seniors who used cannabis for the first time as older adults were more likely to be older. They also preferred CBD-only products and used cannabis for medical purposes only(49).

The researchers found that these individuals were less likely to consume cannabis via smoking or edibles.

Seniors new to cannabis use engaged in less risky consumption practices than those who had experience with cannabis in the past. 

Thus, older adults who are new cannabis users tend to consume cannabis through tinctures or topical applications.

For older people who want targeted CBD application, topicals, such as creams, lotions, and muscle balms, may be applied. 

CBD topicals may be helpful in pain management, especially products with soothing ingredients, like peppermint or menthol.

CBD vape is another way of taking CBD. Through vape pens, CBD may be inhaled, and its effects may be felt instantaneously.

However, older adults are discouraged from inhaling the substance. Vaping may cause lung problems in individuals(50).

Before older adults take any CBD product, seniors, their caregivers, or family members should first consult with their doctor.

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