Real Talk with Micah Smith, Episode 128: Cannabis update

🧠 While media discussions about cannabis can raise awareness among patients, this episode format lacks the systematic evidence synthesis that clinicians need to counsel patients effectively. The topics of cannabis effects on brain function and aging are particularly important given our aging population, yet podcast conversations—even with credentialed researchers—often emphasize individual perspectives rather than the totality of evidence, including null findings and study limitations that may not translate to clinical populations. Several confounders complicate clinical interpretation: cannabis products vary dramatically in cannabinoid ratios and contamination profiles, patient populations self-select based on symptom severity and comorbidities, and long-term safety data in older adults remain sparse despite growing use in this group. Rather than relying on interview-style content, clinicians should consult systematic reviews and clinical guidelines (such as those from the American Academy of Neurology for specific conditions) when discussing cannabis with aging patients, while remaining transparent about evidence gaps and encouraging shared decision