Research study · Age and Ageing · 2024
Adverse events caused by cannabinoids in middle aged and older adults for all indications: a meta-analysis of incidence rate difference
Verified on PubMed Systematic review or meta-analysis
A 2024 meta-analysis in Age and Ageing tested cannabinoids in adverse events. Limited information on adverse events in older adults using CBMs. This analysis reinforces that while cannabinoid medicines are generally safe for older adults, clinicians must specifically monitor for dose-dependent side effects like dizziness and sedation when prescribing THC-containing products.
In plain language
Study overview
Clinicians should be cautious when prescribing cannabinoid-based medicines to older adults due to the limited data on adverse events. Monitoring for potential adverse effects is essential.
Findings
Limited information on adverse events in older adults using CBMs. Quantified incidence rate difference of AEs in adults aged ≥50. Examined associations with weekly doses of CBMs.
The deeper readScientific analysis
Background: Cannabinoid-based medicines (CBMs) are being used widely in older people. However, information on the incidence of adverse events (AEs) is limited.
Objective: To quantify the incidence rate difference (IRD) of AEs in middle aged and older adults of age ≥50 years receiving CBMs and also examine associations with weekly doses.
Design: Systematic review and meta-analysis.
Data sources: MEDLINE, PubMed, EMBASE, CINAHL, PsychInfo, Cochrane Library and ClinicalTrials.gov (1st Jan 1990–12th June 2023).
Methods: We included randomised clinical trials (RCTs) using CBMs with mean participant age ≥50 years for medicinal purposes for all clinical indications. Paired reviewers independently screened studies, extracted data and appraised risk of bias. We estimated pooled effect-sizes IRD under the random-effects model.
Results: Data from 58 RCTs (37 moderate-high quality studies, pooled n = 6611, mean age range 50–87 years, 50% male, n = 3450 receiving CBMs) showed that compared with controls, the incidence of all-cause and treatment-related AEs attributable to delta-9-tetrahydrocannabinol (THC)-containing CBMs were: THC alone [IRD:18.83(95% Confidence Interval [CI], 1.47–55.79) and 16.35(95% CI, 1.25–48.56)] respectively; THC:cannabidiol (CBD) combination [IRD:19.37(95% CI, 4.24–45.47) and 11.36(95% CI, 2.55–26.48)] respectively. IRDs of serious AEs, withdrawals and deaths were not significantly greater for CBMs containing THC with or without CBD. THC dose-dependently increased the incidence of dry mouth, dizziness/lightheadedness, mobility/balance/coordination difficulties, dissociative/thinking/perception problems and somnolence/drowsiness. The interaction of weekly THC:CBD doses played a role in mostly neurological, psychiatric and cardiac side-effects.
Conclusions: Although CBMs in general are safe and acceptable in middle aged and older adults, one needs to be mindful of certain common dose-dependent side-effects of THC-containing CBMs.
The paper
Citation
Velayudhan L, Pisani S, Dugonjic M, McGoohan K, Bhattacharyya S Adverse events caused by cannabinoids in middle aged and older adults for all indications: a meta-analysis of incidence rate difference. Age and Ageing (2024). PubMed 39602500 · DOI
Limitations the authors noted
Moderate-to-high quality evidence in 64% of studies, with 36% having low to very low quality under GRADE criteria. Potential selective reporting of side effects and relatively short trial exposure durations in underlying RCTs. Heterogeneity across pooled clinical indications, though meta-regressions accounted for disease type and dose moderators.
In practice
Why this matters
This analysis reinforces that while cannabinoid medicines are generally safe for older adults, clinicians must specifically monitor for dose-dependent side effects like dizziness and sedation when prescribing THC-containing products.
Browse related research
Condition: Adverse events Topic: Cannabinoids Topic: THC
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Reviewed by Dr. Caplan on September 23, 2026.
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