#75 Strong Clinical Relevance
High-quality evidence with meaningful patient or clinical significance.
“What the COSMOS trial demonstrates is that cannabis use in older adults is far more prevalent than most physicians realize, and our clinical training hasn’t kept pace with our patients’ actual behavior. If we’re not asking about it, assessing it, and understanding potential drug interactions, we’re missing a critical piece of their medical history that could affect everything from fall risk to medication efficacy.”
💊 The COSMOS trial’s finding that over 75% of older adults have used cannabis highlights a significant gap between patient behavior and clinical conversation, particularly since many seniors may not spontaneously disclose cannabis use due to lingering stigma or assumptions that their providers lack interest. This high prevalence underscores the importance of routine, non-judgmental screening for cannabis use in geriatric populations, as older adults may use cannabis for legitimate symptom management (pain, insomnia, anxiety) but face unique pharmacokinetic considerations, drug-drug interactions with polypharmacy, and increased fall risk compared to younger users. However, the evidence base for cannabis efficacy and safety in older adults remains limited, with most trials conducted in younger populations, making it difficult to provide evidence-based counseling specific to this demographic. Clinicians should incorporate cannabis use screening into standard geriatric assessments, discuss potential risks and benefits in the context of individual patient
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