CBD Oil for Older Adults, What is Known and Unknown

J.Adderton, BSN, MSN

This past week, the local pharmacy in my small southern town (population 4,900) placed a large “CBD oil sold here” storefront banner. Small town America is experiencing a surge in CBD product sales, such as tinctures, CBD oil infused bath-bombs, ice cream, water, pet food and even beer. Advertising and marketing strategies rely on the professed wide range of health benefits offered by CBD products. However, there is little scientific evidence available to back up the bold benefit claims of CBD distributors.

What is the Difference between CBD and Marijuana?

Cannabidiol (CBD) is the second most prevalent active ingredient of cannabis (marijuana). CBD is derived from the hemp plant, a cousin of the marijuana plant. CBD oil is a component of medical marijuana, however, it does not cause a “high”. According to the World Health Organization, “CBD exhibits no effects indicative of any abuse or potential abuse”.

Older Adults Willing to Give it a Try

A recent Gallup poll found 1 in 7 Americans use CBD oil with 11% of users age 50-64 and 8% at least 65 years of age. The top 5 medical and therapeutic benefits reported by users include:

Pain
Anxiety
Sleep/insomnia
Arthritis
Migraines/headaches

However, there is very limited scientific evidence on the effects of CBD among older adults with heart disease or other cardiovascular problems. CBD’s drug to drug interactions is lacking data and is a major concern for older adults on polypharmacy.

What is Known

The science behind CBD has not kept up pace with the rapid use in the U.S. However, experts agree there are reasons to be excited about the potential health benefits.

Scientific Backing

Based on strong scientific evidence, the Food and Drug Administration (FDA) approved the first CBD medication, Epidiolex, as a treatment for two severe childhood epilepsies. Approved in 2018, Epidiolex has been successful in reducing the number of seizures in Lennox-Gastaut syndrome and Dravet syndrome. In some cases, seizures in these hard to treat childhood epilepsies were stopped altogether.

Early Research

There is a large gap in research on the benefits of CBD in treating other conditions when compared to the scientific support for treating epilepsy. Early experiments on lab animals, and some human samples, suggest CBD may help with anxiety, schizophrenia symptoms and pain relief.

The Unknown

There are significant “unknowns” regarding the benefits and risks of CBD products. Consumers are exposed to the “proven” health benefits product sellers advertise and largely unaware of a gap in scientific backing.

Unknown Effects on the Cardiovascular System

According to Robert A. Kloner, MD, PhD at Huntington Medical Research Institute, what little is known about CBD in the heart is from preclinical studies and data suggests potential cardiovascular benefits. There are also case reports and a study showing an increase in heart attacks after smoking marijuana. Older adults with cardiac disease may be at increased risk as little is known about CBD interactions with cardiac medications in the body.

With little scientific data, neither the American College of Cardiology nor the American Heart Association have issued position statements on the cardiovascular effects of CBD or medical marijuana.

Unpredictable Bioavailability

Researchers, in a 2017 study published in JAMA, ordered and tested 84 CBD-containing products sold online. The study’s findings are eye opening and show inconsistency across products.

26 products were labeled with inaccurate amounts of CBD
36 products had more CBD than labeled amount
22 products had less CBD than labeled amount

With lacking regulatory oversight, consumers do not know what is actually in the oils, rubs and many other CBD oil infused products.

Research Roadblocks

Researchers have significant obstacles in accessing the CBD compound for study, including navigating complicated FDA and Federal Drug Enforcement Administration regulations. The marijuana plant remains in the restricted Schedule I class with other drugs such as LSD, ecstasy and other highly abused drugs. Therefore, researchers have had limited ability to obtain CBD for research.

The Big Picture

Interest in the health benefits of CBD oil is expected to grow with CBD product sales reaching $20 billion by 2024. A simple internet search will yield a seemingly never ending stream of health benefits and personal testimonies. However, most of the information is coming from product sellers and there is a wide gap in the CBD boom and the availability of supporting scientific data. Older adults experiencing chronic illness and polypharmacy may be at higher risk for potential risks associated with CBD that are not yet understood.

Additional Information

As CBD Finds Small-town America, What Do We Tell Its Graying Users

Gallup- 14% of Americans Say They Use CBD Products