{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T17:09:16Z","timestamp":1787072956888,"version":"build-2736575974"},"reference-count":57,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2020,1,13]],"date-time":"2020-01-13T00:00:00Z","timestamp":1578873600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geriatrics"],"abstract":"<jats:p>Introduction: Medical cannabinoids have received significant mainstream media attention in recent times due to an evolving political and clinical landscape. Whilst the efficacy of cannabinoids in the treatment of some childhood epilepsy syndromes is increasingly recognized, medical cannabinoids may also have potential clinical roles in the treatment of older adults. Prescribing restrictions for medical cannabinoids in certain jurisdictions (including the UK) has recently been relaxed. However, few geriatricians have the detailed knowledge or awareness of the potential risks or rewards of utilizing cannabinoids in the older person; even fewer geriatricians have direct experience of using these drugs in their own clinical practice. Older persons are more likely to suffer from medical illness representing potential indications for medical cannabinoids (e.g., pain); equally they may be more vulnerable to any adverse effects. Aim: This narrative literature review aims to provide a brief introduction for the geriatrician to the potential indications, evidence-base, contra-indications and side effects of medical cannabinoids in older people. Methods: A search was conducted of CENTRAL, Medline, Embase, CINAHL and psycINFO, Cochrane and Web of Science databases. Reference lists were hand searched. Abstracts and titles were screened, followed by a full text reading of relevant articles. Results: 35 studies were identified as relevant for this narrative review. Conclusions: Cannabinoids demonstrate some efficacy in the treatment of pain and chemotherapy-related nausea; limited data suggest potential benefits in the treatment of spasticity and anxiety. Risks of cannabinoids in older patients appear to be moderate, and their frequency comparable to other analgesic drug classes. However, the quality of research is weak, and few older patients have been enrolled in cannabinoid studies. Dedicated research is needed to determine the efficiency and safety of cannabinoids in older patients.<\/jats:p>","DOI":"10.3390\/geriatrics5010002","type":"journal-article","created":{"date-parts":[[2020,1,15]],"date-time":"2020-01-15T03:20:22Z","timestamp":1579058422000},"page":"2","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Cannabinoids in the Older Person: A Literature Review"],"prefix":"10.3390","volume":"5","author":[{"given":"William","family":"Beedham","sequence":"first","affiliation":[{"name":"Medical Student, University of Birmingham Medical School, Birmingham B15 2SG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5978-4573","authenticated-orcid":false,"given":"Magda","family":"Sbai","sequence":"additional","affiliation":[{"name":"Consultant Physician and Perioperative Geriatrician, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London SE1 9RT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Allison","sequence":"additional","affiliation":[{"name":"Medical Student, University of Birmingham Medical School, Birmingham B15 2SG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roisin","family":"Coary","sequence":"additional","affiliation":[{"name":"Specialist Registrar in Geriatric and General Medicine, St James\u2019s Hospital, P.O. Box 580 Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9771-5878","authenticated-orcid":false,"given":"David","family":"Shipway","sequence":"additional","affiliation":[{"name":"Consultant Physician and Perioperative Geriatrician, North Bristol NHS Trust, BS10 5NB&amp; Honorary Senior Clinical Lecturer, University of Bristol, Bristol BS8 2PL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,1,13]]},"reference":[{"key":"ref_1","unstructured":"Department of Health (2019, June 06). An Introduction to the Biochemistry & Pharmacology of Medical Cannabis, Available online: https:\/\/doh.dc.gov\/sites\/default\/files\/dc\/sites\/doh\/publication\/attachments\/Medical%20Cannabis%20An%20Introduction%20to%20the%20Biochemistry%20and%20Pharmacology.pdf."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1016\/j.bmc.2015.01.059","article-title":"Cannabidiol (CBD) and its analogues: A review of their effects on inflammation","volume":"23","author":"Burstein","year":"2015","journal-title":"Bioorg. Med. Chem."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"966","DOI":"10.3732\/ajb.91.6.966","article-title":"A chemotaxonomic analysis of cannabinoid variation in Cannabis (Cannabaceae)","volume":"91","author":"Hillig","year":"2004","journal-title":"Am. J. Bot."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1007\/s11481-013-9445-9","article-title":"Cannabinoid Receptor 2: Potential Role in Immunomodulation and Neuroinflammation","volume":"8","author":"Rom","year":"2013","journal-title":"J. Neuroimmune Pharmacol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1385\/NMM:7:1-2:037","article-title":"Cannabinoid Receptors and Their Role in Neuroprotection","volume":"7","year":"2005","journal-title":"Neuromol. Med."},{"key":"ref_6","unstructured":"(2019, May 11). High-Strength Skunk \u2018Now Dominates\u2019 UK Cannabis Market [Internet]. Available online: https:\/\/www.nhs.uk\/news\/mental-health\/high-strength-skunk-now-dominates-uk-cannabis-market\/."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1007\/s40266-018-0616-5","article-title":"Medical Cannabis for Older Patients","volume":"36","author":"Minerbi","year":"2019","journal-title":"Drugs Aging"},{"key":"ref_8","unstructured":"Adili, A., Busse, J., and Ashoorion, V. (2020, January 02). Cannabinoids vs. Placebo on Persistent Post-surgical Pain Following TKA: A Pilot RCT, Available online: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03825965."},{"key":"ref_9","first-page":"2338","article-title":"OldeTetrahydrocannabinol for neuropsychiatric symptoms in dementia: A randomised controlled trial","volume":"84","author":"Ahmed","year":"2019","journal-title":"Neurology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.maturitas.2018.10.010","article-title":"Medical cannabis use in older patients: Update on medical knowledge","volume":"118","author":"Beauchet","year":"2018","journal-title":"Maturitas"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.ejim.2018.01.019","article-title":"Epidemiological characteristics, safety and efficacy of medical cannabis in the elderly","volume":"49","author":"Abuhasira","year":"2018","journal-title":"Eur. J. Intern. Med."},{"key":"ref_12","unstructured":"Agornyo, P. (2018, January 3\u20135). Older adults\u2019 use of medical marijuana for chronic pain: A multi-site community-based survey. Proceedings of the American Geriatrics Society Annual Meeting, Orlando, FL, USA."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1111\/jgs.15346","article-title":"Medical Marijuana Use in Older Adults","volume":"66","author":"Briscoe","year":"2018","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"M\u00fccke, M., Phillips, T., Radbruch, L., Petzke, F., and H\u00e4user, W. (2018). Cannabis-based medicines for chronic neuropathic pain in adults. Cochrane Database Syst. Rev.","DOI":"10.1002\/14651858.CD012182.pub2"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e183485","DOI":"10.1001\/jamanetworkopen.2018.3485","article-title":"Assessment of Efficacy and Tolerability of Medicinal Cannabinoids in Patients with Multiple Sclerosis","volume":"1","author":"Papaseit","year":"2018","journal-title":"JAMA Netw. Open"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.ebcr.2017.10.001","article-title":"An interaction between warfarin and cannabidiol, a case report","volume":"9","author":"Grayson","year":"2018","journal-title":"Epilepsy Behav. Case Rep."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1932","DOI":"10.1097\/j.pain.0000000000001293","article-title":"Cannabis and cannabinoids for the treatment of people with chronic noncancer pain conditions","volume":"159","author":"Stockings","year":"2018","journal-title":"Pain"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"341","DOI":"10.4140\/TCP.n.2017.341","article-title":"Marijuana Use in the Elderly: Implications and Considerations","volume":"32","author":"Mahvan","year":"2017","journal-title":"Consult. Pharm."},{"key":"ref_19","first-page":"71","article-title":"Clinical Evidence for Utilizing Cannabinoids in the Elderly","volume":"19","author":"Katz","year":"2017","journal-title":"Isr. Med. Assoc. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"110","DOI":"10.9740\/mhc.2018.05.110","article-title":"Preliminary evaluation of the efficacy, safety, and costs associated with the treatment of chronic pain with medical cannabis","volume":"8","author":"Bellnier","year":"2017","journal-title":"Ment. Health Clin."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e21671","DOI":"10.1200\/JCO.2017.35.15_suppl.e21671","article-title":"Evaluation of safety, efficacy, and other clinical endpoints of delta-9-tetrahydrocannabinol in older patients with hem\/onc malignancies","volume":"35","author":"Hansra","year":"2017","journal-title":"J. Clin. Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1159\/000481089","article-title":"Dronabinol Is a Safe Long-Term Treatment Option for Neuropathic Pain Patients","volume":"78","author":"Schimrigk","year":"2017","journal-title":"Eur. Neurol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"301","DOI":"10.9758\/cpn.2017.15.4.301","article-title":"A Systematic Review of the Effectiveness of Medical Cannabis for Psychiatric, Movement and Neurodegenerative Disorders","volume":"15","author":"Lim","year":"2017","journal-title":"Clin. Psychopharmacol. Neurosci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1089\/can.2017.0002","article-title":"Cannabinoids in Parkinson\u2019s Disease","volume":"2","author":"Sancesario","year":"2017","journal-title":"Cannabis Cannabinoid Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1007\/s00482-015-0092-3","article-title":"Efficacy, tolerability, and safety of cannabinoids for chemotherapy-induced nausea and vomiting\u2014A systematic review of systematic reviews","volume":"30","author":"Tafelski","year":"2016","journal-title":"Der Schmerz."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2587","DOI":"10.1007\/s00213-015-3889-y","article-title":"Safety, pharmacodynamics, and pharmacokinetics of multiple oral doses of delta-9-tetrahydrocannabinol in older persons with dementia","volume":"232","author":"Ahmed","year":"2015","journal-title":"Psychopharmacology"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Smith, L.A., Azariah, F., Lavender, V.T.C., Stoner, N.S., and Bettiol, S. (2015). Cannabinoids for nausea and vomiting in adults with cancer receiving chemotherapy. Cochrane Database Syst. Rev.","DOI":"10.1002\/14651858.CD009464.pub2"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1007\/s40263-015-0270-y","article-title":"Cannabinoids for the Treatment of Agitation and Aggression in Alzheimer\u2019s Disease","volume":"29","author":"Liu","year":"2015","journal-title":"CNS Drugs"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.arr.2014.01.007","article-title":"Efficacy and safety of medical cannabinoids in older subjects: A systematic review","volume":"14","author":"Ahmed","year":"2014","journal-title":"Ageing Res. Rev."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1016\/j.euroneuro.2014.06.007","article-title":"Safety and pharmacokinetics of oral delta-9-tetrahydrocannabinol in healthy older subjects: A randomized controlled trial","volume":"24","author":"Ahmed","year":"2014","journal-title":"Eur. Neuropsychopharmacol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1097\/WNF.0000000000000016","article-title":"Cannabis (Medical Marijuana) Treatment for Motor and Non\u2013Motor Symptoms of Parkinson Disease","volume":"37","author":"Lotan","year":"2014","journal-title":"Clin. Neuropharmacol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1177\/0269881114550355","article-title":"Effects of cannabidiol in the treatment of patients with Parkinson\u2019s disease: An exploratory double-blind trial","volume":"28","author":"Chagas","year":"2014","journal-title":"J. Psychopharmacol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1111\/jgs.12661","article-title":"Medicinal Use of Cannabis and Cannabinoids in Older Adults: Where Is the Evidence?","volume":"62","author":"Ahmed","year":"2014","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1161\/STROKEAHA.112.671347","article-title":"Cannabis-related Stroke","volume":"44","author":"Wolff","year":"2013","journal-title":"Stroke"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"294","DOI":"10.2133\/dmpk.DMPK-11-RG-107","article-title":"Comparison in the In Vitro Inhibitory Effects of Major Phytocannabinoids and Polycyclic Aromatic Hydrocarbons Contained in Marijuana Smoke on Cytochrome P450 2C9 Activity","volume":"27","author":"Yamaori","year":"2012","journal-title":"Drug Metab. Pharmacokinet."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1038\/npp.2011.6","article-title":"Cannabidiol Reduces the Anxiety Induced by Simulated Public Speaking in Treatment-Na\u00efve Social Phobia Patients","volume":"36","author":"Bergamaschi","year":"2011","journal-title":"Neuropsychopharmacology"},{"key":"ref_37","first-page":"5","article-title":"The management of chronic pruritus in the elderly","volume":"15","author":"Patel","year":"2020","journal-title":"Skin Ther. Lett."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1001\/archgenpsychiatry.2008.519","article-title":"Distinct Effects of \u03949-Tetrahydrocannabinol and Cannabidiol on Neural Activation During Emotional Processing","volume":"66","author":"Crippa","year":"2009","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/j.jpain.2007.10.018","article-title":"Efficacy of Dronabinol as an Adjuvant Treatment for Chronic Pain Patients on Opioid Therapy","volume":"9","author":"Narang","year":"2008","journal-title":"J. Pain"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"3394","DOI":"10.1200\/JCO.2005.05.1847","article-title":"Comparison of Orally Administered Cannabis Extract and Delta-9-Tetrahydrocannabinol in Treating Patients With Cancer-Related Anorexia-Cachexia Syndrome: A Multicenter, Phase III, Randomized, Double-Blind, Placebo-Controlled Clinical Trial from the Cannabis-In-Cachexia-Study-Group","volume":"24","author":"Strasser","year":"2006","journal-title":"J. Clin. Oncol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/S1470-2045(03)01019-2","article-title":"Management of terminal cancer in elderly patients","volume":"4","author":"Sutton","year":"2003","journal-title":"Lancet Oncol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1200\/JCO.2002.20.2.567","article-title":"Dronabinol versus Megestrol Acetate versus Combination Therapy for Cancer-Associated Anorexia: A North Central Cancer Treatment Group Study","volume":"20","author":"Jatoi","year":"2002","journal-title":"J. Clin. Oncol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2108","DOI":"10.1212\/WNL.57.11.2108","article-title":"Cannabinoids reduce levodopa-induced dyskinesia in Parkinson\u2019s disease: A pilot study","volume":"57","author":"Sieradzan","year":"2001","journal-title":"Neurology"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1093\/ajcn.70.2.183","article-title":"Geriatric cachexia: The role of cytokines","volume":"70","author":"Yeh","year":"1999","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1002\/(SICI)1099-1166(199709)12:9<913::AID-GPS663>3.0.CO;2-D","article-title":"Effects of Dronabinol on anorexia and disturbed behavior in patients with Alzheimer\u2019s disease","volume":"12","author":"Volicer","year":"1997","journal-title":"Int. J. Geriatr. Psychiatry"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"E694","DOI":"10.1503\/cmaj.091414","article-title":"Smoked cannabis for chronic neuropathic pain: A randomized controlled trial","volume":"182","author":"Ware","year":"2010","journal-title":"Can. Med. Assoc. J."},{"key":"ref_47","unstructured":"(2019, May 22). NABILONE [Internet]. Available online: https:\/\/bnf.nice.org.uk\/drug\/nabilone.html#indicationsAndDoses."},{"key":"ref_48","unstructured":"Kim, J., and Grobelna, A. (2019, May 11). Nabilone for Chronic Pain Management: A Review of Clinical Effectiveness and Guidelines. Available online: https:\/\/www.cadth.ca\/sites\/default\/files\/pdf\/htis\/2017\/RC0906%20Nabilone%20for%20Chronic%20Pain%20Management%20Final.pdf."},{"key":"ref_49","unstructured":"(2019, May 11). Cannabinoid Buccal Spray for Chronic Non-Cancer or Neuropathic Pain: A Review of Clinical Effectiveness and Guidelines, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK395789\/pdf\/Bookshelf_NBK395789.pdf."},{"key":"ref_50","unstructured":"(2019, May 11). Cannabis [Internet]. Available online: https:\/\/www.mssociety.org.uk\/about-ms\/treatments-and-therapies\/cannabis."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1016\/j.clnu.2015.09.004","article-title":"ESPEN guidelines on nutrition in dementia","volume":"34","author":"Volkert","year":"2015","journal-title":"Clin. Nutr."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1002\/da.20653","article-title":"Anxiety disorders in older adults: A comprehensive review","volume":"27","author":"Castriotta","year":"2010","journal-title":"Depress. Anxiety"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1080\/00952990.2017.1318891","article-title":"Older adults\u2019 marijuana use, injuries, and emergency department visits","volume":"44","author":"Choi","year":"2017","journal-title":"Am. J. Drug Alcohol Abus."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1093\/jat\/bkv012","article-title":"Smoked Cannabis\u2019 Psychomotor and Neurocognitive Effects in Occasional and Frequent Smokers","volume":"39","author":"Desrosiers","year":"2015","journal-title":"J. Anal. Toxicol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1016\/j.jagp.2019.05.002","article-title":"Randomized Placebo-Controlled Trial of Nabilone for Agitation in Alzheimer\u2019s Disease","volume":"27","author":"Herrmann","year":"2019","journal-title":"Am. J. Geriatr. Psychiatry"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/j.jagp.2012.11.022","article-title":"Dronabinol for the Treatment of Agitation and Aggressive Behavior in Acutely Hospitalized Severely Demented Patients with Noncognitive Behavioral Symptoms","volume":"22","author":"Woodward","year":"2014","journal-title":"Am. J. Geriatr. Psychiatry"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/S1474-4422(18)30406-X","article-title":"Safety and efficacy of nabiximols on spasticity symptoms in patients with motor neuron disease (CANALS): A multicentre, double-blind, randomised, placebo-controlled, phase 2 trial","volume":"18","author":"Riva","year":"2019","journal-title":"Lancet Neurol."}],"container-title":["Geriatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3417\/5\/1\/2\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T14:33:03Z","timestamp":1760365983000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3417\/5\/1\/2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,13]]},"references-count":57,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,3]]}},"alternative-id":["geriatrics5010002"],"URL":"https:\/\/doi.org\/10.3390\/geriatrics5010002","relation":{},"ISSN":["2308-3417"],"issn-type":[{"value":"2308-3417","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,13]]}}}