Medical cannabis in older patients: protocol and initial results

Introduction and clinical context

Population aging brings with it an increase in chronic conditions — persistent pain, insomnia, anxiety and neurodegenerative disorders — that often coexist in the same patient. In this scenario, medical cannabis attracts growing interest as a complementary therapeutic option for the older population, precisely for its ability to act on multiple symptoms simultaneously. This prospective study followed geriatric patients using medical cannabis in order to evaluate, in real clinical practice, both the perceived benefits and the tolerability of the treatment in this age group, in which safety is a central concern.

Methodology and findings

This is an observational study, with a defined protocol and follow-up of patients over six months. The most notable outcome was striking: 84.8% of the older adults reported an overall improvement in their condition after the follow-up period. The adverse events recorded were mostly mild — predominantly dizziness and drowsiness —, which reinforces a favorable tolerability profile when the treatment is conducted carefully. These initial results suggest that, under medical supervision, medical cannabis can contribute to the older person's quality of life, although controlled studies are needed to confirm the magnitude of the benefit.

Mechanism of action and safety

Phytocannabinoids — especially cannabidiol (CBD) and tetrahydrocannabinol (THC) — act on the endocannabinoid system, a network of receptors (CB1 and CB2) involved in the modulation of pain, mood, sleep and inflammation. In the older patient, however, prescribing requires redoubled caution: polypharmacy (the simultaneous use of several medications) raises the risk of drug interactions, and effects such as dizziness and drowsiness increase the risk of falls. For this reason, it is recommended to start with low doses and titrate slowly (the "start low, go slow" principle), keeping close follow-up and attention to cardiovascular comorbidities.

Regulation in Brazil (Anvisa)

In Brazil, access to cannabis products for older adults is regulated by Anvisa. RDC 660/2022 allows import by the patient themselves with a medical prescription, while RDC 1,015/2026 establishes the new manufacturing and import framework. Any treatment must start from an individualized medical assessment. This content is informative and scientific and does not replace the guidance of a healthcare professional.