Navigating the Cannabis Conversation with Your Family

Ellen Scanlon (00:00):

This podcast discusses cannabis and is intended for audiences 21 and over. Are you curious about a lower alcohol lifestyle? Now in more than 40 states, you can have Cann, the low-dose delicious and sociable cannabis beverages shipped right to your door. Use promo code DOTHEPOT for 20% off when you visit drinkcann.com. That’s Drink C-A-N-N. Try a Cann today and have a fun night without the hangover. Thank you for supporting the brands that support our show.

Dr. Jessica Knox (00:53):

We’ve had a woman in her 70s and she has fibromyalgia, which is notoriously difficult to treat, and so she was on opioids and some of the other antidepressants to try to manage fibromyalgia and was feeling crummy on them. Started using cannabis. She uses a daily tincture just like sort of as a baseline method and then a vaporizer as needed for pain, and she’s eliminated her other medications and she’s out there doing marathons.

Ellen Scanlon (01:26):

Welcome to How To Do The Pot, a podcast helping you feel confident about cannabis. I’m your host, Ellen Scanlon. You just heard from Dr. Jessica Knox, a Harvard-trained physician and the co-founder of life sciences company, Pivotal Holdings. Today’s episode is about a group of people we all care a lot about, our aging parents and grandparents. Did you know that seniors are the fastest growing group of cannabis consumers?

(02:04):

Older Americans are trying cannabis for a lot of health related reasons, to manage pain, support sleep, improve sex, the things we all like it for. And while the numbers are growing quickly, there are probably seniors in your life who have not tried it yet. Stay tuned for expert tips about how to start the cannabis conversation with your parents or your grandparents. A barrier for many Americans, regardless of their age, is the persistent stigma and fear surrounding cannabis.

(02:43):

I, along with many advocates for legalization, believe that meaningful federal policy change will be the most effective way to overcome these challenges. And there was an exciting development in 2023 that I want to be sure you know about. President Biden asked the Department of Health and Human Services or HHS to review the scheduling of cannabis.

(03:09):

In August 2023, the HHS recommended moving cannabis from its current status as a schedule one substance, along with things like cocaine or heroin to a schedule three substance, more like cough medicine with codeine. Then in January of 2024, the FDA released a document that gives us insight into the health questions that the government’s top regulators are asking about cannabis.

(03:41):

There are dozens of medical conditions people consume cannabis for, and the FDA chose to focus on seven of them, anorexia, anxiety, epilepsy, inflammatory bowel disease, nausea and vomiting, pain, and post-traumatic stress disorder. Of these seven, so far, they have found the most evidence for cannabis to be effective when it comes to pain, particularly nerve pain.

(04:14):

If you listened to our episode 227, you heard me talk with journalist Lauren Yoshiko about a phrase called the Silver Tsunami. It describes Americans over the age of 65 who will account for half of the US population by 2030. And many older Americans are in pain. There are currently a million people over the age of 65 living with an opioid use disorder.

(04:45):

These disorders can be particularly problematic in this age group due to what are called comorbidities, which are the presence of two or more diseases or medical conditions in a patient. These comorbidities can increase the risk of side effects, overdose and even death. The Drug Enforcement Agency, the DEA, is the federal agency responsible for making the final decision on rescheduling cannabis.

(05:17):

They’re expected to rule in the coming months. Changing cannabis from a schedule one to a schedule three substance would have wide-ranging effects for the industry and be a real step forward for research, education and safe access. I’ll keep you posted. As we celebrate the fourth year of How To Do The Pot, I am so grateful for your support and excited to create new episodes that help you feel confident about cannabis for health, wellbeing, and for fun.

(05:57):

We have created our first ever listener survey so that your opinions can directly influence our upcoming shows. As a thank you, everyone who completes the survey will be entered to win a 12 pack of Cann’s cannabis infused sparkling beverages. The link to the listener survey is in the show notes, and thank you so much for taking the time to share your thoughts with us.

(06:32):

Have you talked to your parents or grandparents about cannabis yet? My best advice is to keep it basic. Questions I hear a lot are, “Is it legal? Is CBD the same as weed? And do you need to get high to feel better?” California-based Sandra Guynes, also known as The Kush Nurse is an RN who works with a lot of seniors interested in trying cannabis.

Sandra Guynes (07:02):

So I’ll start with seniors, which I love. And so I live in a retirement community, so when we were looking for houses, we ended up here. There’s literally everybody in my neighborhood is retired and I am now the joint lady. Everyone comes over to me for their joints, and when I say joints, it’s not the ones you smoke, it’s the ones on your body.

Ellen Scanlon (07:24):

A big part of talking to your parents or grandparents about weed is knowing what health challenges they might be facing.

Sandra Guynes (07:32):

Some 65 year olds, yeah, they’re managing their conditions well. Some 65 year olds are not. So it just really depends. If I get a child referring their parent, I always ask them, “What are they able to do for themselves and how are they managing their condition?” But I definitely will say that topicals is definitely like that. That’s the doorway to access. I feel like the 65 and older would rather apply it or smoke it. It’s the weirdest thing, right?

(08:02):

Because smoking is so familiar to them because remember, this is The Marble Man era. It is surprising to me because I have clients who are literally on their social security check. First of the month, they’re like, “I’m ordering flour,” and I’m like, “Get it girl.” But weirdly enough, I do like inhaled medicine for seniors because the timeframe is short and if they’re forgetful or if they have any kind of side effects, it will be short-lived because it’s inhaled. So it’ll be like two hours or something like that as opposed to edibles or tincture.

Ellen Scanlon (08:43):

Dr. Jessica Knox has seen a lot of seniors in her practice over the years, and I asked her why they come in.

Dr. Jessica Knox (08:51):

For seniors, I think the reason that they come to us and the reason they’re seeking cannabis is often the same as non seniors I guess. Most commonly they’re trying to address pain. They’re also trying to address mental health concerns, whether that’s anxiety or depression. Right? A lot of times they might be lonely, their own friends or family might have passed away.

(09:15):

They have sometimes neurocognitive decline. Cancer is more common amongst our seniors. So these are all reasons that senior patients will come to us seeking the use of cannabis. And we often see really great effects. And what is a great effect? It’s improvement in their symptoms, reduction in pain, improved sleep, reduction in their feelings of anxiety or depression.

Ellen Scanlon (09:40):

Questions about current prescriptions and drug interactions will probably come up when you talk with the seniors in your life.

Dr. Jessica Knox (09:48):

We have had many patients who have a laundry list of medications. It’s an unfortunate phenomenon, at least in our country, that it seems like the older you get, the longer your list of medications gets. And often those medications interact with one another. Many of the medications that older folks get can make them feel tired or fatigued or flattened, and they just don’t feel like themselves.

(10:15):

And so we’ve had a lot of patients who have successfully reduced their other medication burden using cannabis, which that in itself is fantastic, right? Just reducing the number of meds you have to take on a physical level. I don’t have to take as many pills. But also on a mental level because you’re cutting out stuff and reducing the possibility for interactions.

(10:37):

The primary drug interactions that we are concerned with as it relates to cannabis are due to CBD. So CBD along with many, many, many of the pharmaceutical drugs that are out there are metabolized through the Cytochrome P450 system in the liver. And what we know that CBD can do is it can sort of bind up that enzyme that is responsible for breaking down other medicines.

(11:02):

And what that means is if CBD is in the system and blocking up this enzyme, other medicines in the system can start to sort of build up and theoretically, depending on the medicine, can cause toxicity because the drug levels are building up and up and up. Clinically, we haven’t seen a lot of this, right? When we’re taking care of patients in the clinic we haven’t seen a lot of drug interaction issues.

Sandra Guynes (11:26):

With seniors, lifestyle is everything. If you have a senior that’s going to the casino and going over here and walking their dog and active, they may get CBD during the day and they may wear themselves out to the point they can go to sleep because their lifestyle has improved.

(11:43):

But if you have somebody who’s sedentary and they’re not getting out as much and then they’re struggling to sleep, for whatever reason they’re struggling to sleep, they might need to add that THC at night. Some people will take a small dose and it does everything for them, and some need a higher dose. I always say, your move may vary and we kind of play around with it until you find your happy place.

Ellen Scanlon (12:05):

Getting a good night’s rest can get harder as you get older. Not sleeping is not fun and it can feel isolating and lead to more serious mental and physical health issues. We have a very popular series all about sleep that I recommend listening to, and please share it with anyone who has sleep and weed questions.

(12:30):

The key point is that cannabis can help replace the prescription or over-the-counter sleep aids that can be habit-forming. THC will help you fall asleep and CBD will keep you asleep all night. Check out episodes 192 through 195 to learn more. Rosie Mattio, the founder of PR firm, Mattio Communications, found that for her mom, sleep was way back to cannabis after many, many years.

Rosie Mattio (13:09):

She’s a child of the 60s, so would stop. So she consumed back in the day, but even not that much. But now she has hip pain, she also has trouble sleeping, and it’s funny that she’ll come over, “What do you have?” And so she had not had any cannabis probably in 40 years probably. And then a few weeks ago she was over complaining. I just got into the macaroons and I was like, “Take these home, mom.”

(13:35):

And she’s like, “When do I take them?” So she took it at night, texted me being like, “I don’t really feel anything but tastes delicious.” And then the next morning I got a text from her saying, “I had the best sleep of my life,” which is awesome. It’s awesome. She’s like, “I feel amazing today.” She had no trouble getting up in the morning after having the macaroons. The next time she came over, she’s like, “What do you got for me?” I’m like, “Hey, I’m going to have to share with you now?” But it’s great and I love that she’s using it as an option.

Ellen Scanlon (14:01):

When Rosie’s dad was going through cancer treatment, he wasn’t as open to the plant.

Rosie Mattio (14:07):

And my dad, thankfully, he’s in remission. He’s doing great. When he had the nausea and the pain, I tried to get him to try cannabis, but that generation, they really rely on what your doctor says. Doctor said, “Take this medication, this for nausea.” So he was very hesitant to try cannabis and I never got him to do it, and he just never tried it. So I would’ve loved for that to have been an option for him, but everyone makes their own choices.

Ellen Scanlon (14:30):

Dr. Jess does see patients receiving unexpected positive benefits from cannabis.

Dr. Jessica Knox (14:37):

What’s nice about cannabis is an addition to it often improving the symptom you’re trying to treat, whether that’s pain or sleep, it’s often helping people boost their mood or feel a little bit better or feel a little bit more social. And so we like to talk a lot about the side benefits of cannabis. And so all that means is that yeah, you can address your pain, but maybe you can also just have a little bit of a lighter affect while you’re doing that.

Ellen Scanlon (15:04):

A common question you may hear is, “Do I need THC or CBD?” This is where I have to remind you that cannabis requires some experimentation. CBD reduces inflammation, so it will help with muscle aches, arthritis, bursitis, and other pain that’s related to inflammation.

(15:28):

THC helps with acute pain relief by telling the brain, “It’s okay, let’s not process that pain signal with the same pulsing intensity.” Migraines and post-op pain often require higher levels of THC for pain relief. I also get a lot of questions about whether cannabis can help patients with Alzheimer’s. Dr. Jess shares what we know.

Dr. Jessica Knox (15:53):

The information is incomplete, as it is I think probably with most conditions. But we know that cannabis can help reduce neuro-inflammation, which is really important in not only Alzheimer’s, but in other diseases of neurocognitive decline. We still have a lot of work to do as far as understanding the exact effects of cannabis for things like Alzheimer’s, but in general, reducing inflammation is going to be good. It’s going to be helpful for the brain.

(16:22):

Often we’re going to see a lot of mood enhancement for people, whether they have Alzheimer’s or Huntington’s or Parkinson’s or whatever it may be. For a lot of those people, a depressed or flat mood is one of the very distressing components for them. So yes, there’s still a lot of research that needs to be done, but we do see a number of patients that have those sorts of neurological diseases who are seeking cannabis as a form of treatment. There’s no harm that can come about from trying to apply cannabis for those conditions and for any given individual, it might do a lot of good. So I think it’s worth trying.

Ellen Scanlon (17:01):

How many prescriptions do your parents or your grandparents take? Would a topical cream work instead of another pain pill or a cannabis-infused tea instead of an ambient before bed? As we wait and hope for the rescheduling of cannabis to schedule three, I am really looking forward to more studies that help us understand drug interactions and how cannabis affects the prescriptions you or your loved ones are taking. If you haven’t listened to episode 227 yet, don’t miss it.

(17:38):

I talked with journalist Lauren Yoshiko about her dynamic 80-year-old grandmother. A few years ago, Lauren’s Grandma tried a topical cream to help her with arthritis, and now she loves a low-dose edible to help with nerves before public speaking. She sounds amazing. Lauren and I had a fun talk about how cannabis products are making their way to older Americans despite a lack of marketing.

(18:06):

And Lauren has a new book coming out in March that I can’t wait to read. It’s called Green Scenes: A Guide to Legal Cannabis Destinations and Experiences Across the US. Check it out wherever you buy books. Thanks for listening to this episode of How To Do The Pot.

(18:29):

For lots more information and past episodes, visit DoThePot.com. That’s also where you can sign up for How To Do The Pot’s Popular newsletter. If you like How To Do The Pot, please rate and review us on Apple Podcasts. It really helps people find the show. Thank you to writer Joanna Silver and producers Maddie Fair and Nick Petri. I’m Ellen Scanlon and stay tuned for more of How To Do The Pot.