#72
Notable Clinical Interest
Emerging findings or policy developments worth monitoring closely.
Clinicians treating older adults need to recognize that edible cannabis use is increasing in this population, which carries specific risks including delayed onset of effects that may lead to overdosing and higher rates of falls and cognitive impairment compared to other routes of administration. Understanding patients’ cannabis use patterns, particularly edibles, is essential for assessing drug interactions with common geriatric medications and identifying adverse events that may be misattributed to other causes. Patient counseling about appropriate dosing, onset timing, and storage safety becomes a critical clinical responsibility as cannabis use expands among seniors.
A University of Utah study of 169 cannabis-naive adults over age 60 examined patterns of first-time cannabis use among older adults, with a particular focus on edible products. The findings indicate that seniors increasingly view cannabis edibles as an accessible entry point for cannabis use, likely due to their perceived ease of administration and dose control compared to other delivery methods. This trend has important clinical implications, as older adults may face heightened risks from delayed-onset effects of edibles, which can lead to unintended overdosing, falls, and drug interactions with common medications used in this population. Clinicians caring for older patients should proactively screen for cannabis use, including edibles, and provide counseling on product selection, dosing, and potential safety concerns specific to aging physiology. Physicians should be aware that older adults represent a growing market for cannabis products and may encounter patients using edibles without full understanding of pharmacokinetics or cumulative dosing effects.
“What concerns me most about older adults turning to edibles is that they often underestimate the onset time and potency, then redose before the first dose takes effect, which is how we end up seeing preventable falls and cardiac events in this vulnerable population. We need honest conversations in the clinic about dosing, timing, and drug interactions before patients self-experiment with products that lack the standardization they’re accustomed to with their other medications.”
? As cannabis legalization expands across North America, older adults represent a growing segment of new users, and edibles are an increasingly popular route of administration in this population. Clinicians should be aware that older adults often lack prior experience with cannabis and may be unfamiliar with dosing, onset times, and the delayed and prolonged effects characteristic of oral formulations, which differ substantially from inhalation. This knowledge gap creates risk for accidental overdose, drug interactions with polypharmacy common in this age group, and falls or cognitive impairment that could be particularly dangerous given age-related vulnerabilities. When taking a substance use history, providers should specifically ask about cannabis products, including edibles, since older patients may not spontaneously disclose use or may underestimate potency and risks. Discussing appropriate dosing, the importance of “start low and go slow,” potential interactions with medications, and fall risk can help older patients use
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