Increased Rates of Cannabis Poisoning Seen in Elderly Canadians Since Legalization

If you thought those videos of Grandma’s toking up were one of a kind among older generations, you might be surprised to know that cannabis use among senior citizens is on the rise. This is especially true in Canada, where the plant was legalized nationwide for adults over 18. However, it also seems this has led to an increase in cannabis poisoning among elderly Canadians, according to a new study published in the JAMA Internal Medicine journal¹.

Study Finds Spike in Cannabis-Related ER Trips in Elderly Canadians

As it turns out, once legalized, seniors are far more likely to try cannabis – and many of them opt for edibles over smokable cannabis products.

“There’s a bit of an age-related bias that many health care practitioners, and frankly society, hold that older adults are not using drugs. And that’s not true,” said author of the study Dr. Nathan Stall.

The problem lies in the fact that edibles are considerably stronger than smokable cannabis. Also, the effects have a slower onset while lasting much longer, making it easier for inexperienced consumers to “overdose” or experience symptoms of cannabis poisoning.

The study broke up the time frame into three sections:

• pre-legalization (Jan 2015 – September 2018)
• post-legalization of cannabis flower (October 2018 – December 2019)
• post-legalization, including recreational sales of edibles and other high-THC products (January 2020 – December 2022)

During this eight-year period, researchers found a total of 2,322 visits to emergency departments for cannabis poisoning in adults older than age 65. However, it’s important to note that the study does not differentiate between intentional and accidental ingestion.

“We found that the largest increases in emergency department visits for cannabis poisoning among seniors occurred after edible cannabis became legal for retail sale in January 2020.”

Seniors Are More Likely to Try Edibles (Yes, On Purpose!)

“More than half (52 per cent) of seniors aged 65 and older reported using cannabis exclusively for medical reasons, while the remaining seniors were evenly split between non-medical only (24%) and both medical and non-medical reasons (24 per cent),” the survey said.

According to the study, the largest increase in ER visits for seniors reporting cannabis poisoning happened after edibles hit retail dispensaries – around the same time as a slight increase in similar visits for Canadian children. Though some of these visits are clear-cut when the individual comes in and is aware that they ate too much of an edible – that’s not always the case.

Edibles Have a Higher Risk of Cannabis Poisoning Over Smokable Products

Dr. Stall shared a story of an 80-year-old patient who came into the ER presenting with decreased consciousness, elevated blood pressure and heart rate, nausea, vomiting, and even hallucinating at times. All the normal tests came up empty, but a toxicology screening came back positive for THC.

A very embarrassed family member realized at that moment the older gentleman had unknowingly eaten cannabis edibles. While cannabis poisoning or overdose isn’t deadly like some other drugs, it’s certainly not a comfortable experience, especially in the case of accidental ingestion.

“Edible cannabis products may be particularly dangerous because they are often indistinguishable from non-cannabis containing foods and may contain high amounts of THC (delta-9-tetrahydrocannabinol), the major active ingredient in both medical and recreational cannabis,” Dr. Lona Mody and Dr. Sharon K. Inouye stated in a commentary on the research, (though they had no direct involvement in the study).

Education Beyond Dispensary Associates Can Reduce Risks

“This study provides a cautionary tale of legalization of substances without adequate research, education, and counseling of users regarding adverse effects and safe usage, particularly in older adults,” Drs. Mody and Inouye continued in their commentary.

On a personal level, I agree entirely with Dr. Mody and Dr. Inouye – this is a clear case of needing better education about cannabis, ensuring consumers know what they’re getting into. Plus, finally researching the ways the effects of the plant may differ as we age could provide better dosing suggestions for seniors. Right now, new consumers are looking to the internet and their budtender at the dispensary to guide them in the right direction, but that’s just not enough, and the increase in cannabis poisoning in elderly Canadians is just more proof of that fact.

Once legalization happens, it’s important to follow-up these changes with consumer education – because people who are unfamiliar with it will want to try it and need to know how to do so safely so they can have as pleasant of an experience as possible.

Study Reference:

^{1. Stall, N. M., Shi, S., Malikov, K., et al. (2024). Edible cannabis legalization and cannabis poisonings in older adults. JAMA Internal Medicine, 184(7), 840–842. https://doi.org/10.1001/jamainternmed.2024.1331}