Not Your Mama's Cannabis - Understanding the Risks of Modern-Day Cannabis-November Webinar Recording

Video Transcription

Video Summary

In the webinar "Not Your Mama's Cannabis: Understanding the Risk of Modern Day Cannabis," Dr. Keri Hempel-Sandroff, a hospice physician and cannabis expert, discusses the evolving landscape of cannabis use, particularly among older adults and hospice patients. Cannabis access has expanded significantly across over 40 U.S. states, with varying laws, potencies, and products available, creating challenges for patients and clinicians alike. Many older adults are turning to cannabis for chronic pain, sleep disorders, anxiety, and neurological symptoms, with use increasing from less than 1% to nearly 10% over the past 15 years. Commonly used forms include smoking or vaping flower cannabis, edibles, tinctures, and topicals; however, the potency of modern cannabis has dramatically increased from 1-3% THC historically to over 30%, along with highly concentrated extracts (e.g., wax, dabs) that pose greater risks.<br /><br />Dr. Sandroff emphasizes the importance of understanding cannabis pharmacology, particularly the variable onset and duration of effects between inhaled and edible forms, which affects dosing and potential for unintentional overdose or prolonged intoxication. She warns about synthetic cannabinoids (e.g., K2, Spice) and hemp-derived products like Delta-8 THC, which are unregulated and carry unknown risks. Potential adverse effects include neurological symptoms (dizziness, delirium, falls), cardiovascular issues (arrhythmia, stroke), respiratory exacerbations in lung disease, gastrointestinal problems (dry mouth, cannabinoid hyperemesis), increased emergency visits, and drug interactions, particularly with opioids, benzodiazepines, SSRIs, and warfarin.<br /><br />Screening for cannabis use, counseling on safer use (start low, go slow), monitoring for complications, and collaborating across care teams are crucial. While cannabis carries risks, there is recognition of potential therapeutic benefits when properly dosed and monitored. Dr. Sandroff advocates for clinicians to stay informed about local laws, dispensary offerings, and to maintain open, nonjudgmental dialogues with patients to promote risk reduction and safe use.

Keywords

Cannabis use

Older adults

Hospice patients

THC potency

Cannabis pharmacology

Synthetic cannabinoids

Adverse effects

Drug interactions

Safer cannabis use

Therapeutic benefits