#78 Strong Clinical Relevance
High-quality evidence with meaningful patient or clinical significance.
Clinicians are missing critical opportunities to identify drug interactions and adverse effects in older adults who use cannabis, since most patients don’t disclose this use during medical visits. This communication gap increases risks of polypharmacy complications and falls in a vulnerable population already taking multiple medications. Implementing routine, non-judgmental cannabis screening as standard clinical practice could improve medication safety and enable evidence-based counseling about age-related cannabis vulnerabilities.
A recent study demonstrates that cannabis use among older adults remains largely undisclosed to healthcare providers, with fewer than 20% of this population reporting such discussions with their clinicians. This communication gap is particularly concerning given that older adults are increasingly using cannabis for chronic pain, sleep disturbances, and other age-related conditions, yet lack adequate clinical guidance on safety, drug interactions, and appropriate dosing. The lack of disclosure may stem from stigma, assumptions about clinician disapproval, or patient uncertainty about whether cannabis use is relevant to medical care, creating a situation where providers cannot accurately assess medication lists or identify potential cannabinoid-related adverse effects or contraindications. For clinicians, this finding underscores the need to proactively ask about cannabis use during medication reviews and to create a non-judgmental environment that encourages older patients to disclose all substances they are consuming. Addressing this communication barrier is essential for safe prescribing, accurate drug interaction screening, and appropriate monitoring of older adults in clinical practice.
“The communication gap we’re seeing in older adult populations isn’t primarily a knowledge problem on either side, it’s a trust and framing problem, and until we normalize these conversations in the clinical encounter the same way we do with alcohol or medications, we’ll keep missing critical drug interactions and underlying pain syndromes that cannabis might actually address.”
💊 The significant communication gap between older adults and their clinicians regarding cannabis use represents a critical clinical oversight, particularly given the growing prevalence of cannabis consumption in this population and potential drug interactions with common medications like anticoagulants and antiarrhythmics. This underreporting likely reflects multiple intersecting factors including patient embarrassment, clinician discomfort or limited knowledge about cannabis in aging populations, and historical stigma rather than a true absence of use. Healthcare providers should recognize that low disclosure rates may mask substantial cannabis exposure that could complicate medication management, contribute to falls or cognitive symptoms, or worsen existing conditions, while also potentially representing an unaddressed therapeutic interest in patients seeking symptom relief. Initiating routine, nonjudgmental screening for cannabis use during medication reconciliation and comprehensive geriatric assessments, similar to alcohol screening practices, could help clinicians identify drug interactions and better understand their older patients’ symptom management strategies.
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