Senior Guide to CBD and Medical Marijuana
By Colleen McGuire
This article appeared in [MedicareGuide] and has been published here with permission.
Chances are good that you’ve heard a lot in recent years about medical marijuana and cannabidiol, or CBD, as it’s usually known. But even if you’ve seen the news, it can be hard to figure out whether either might be right for you, as well as what’s legal where you live.
The first thing to know is that even if marijuana is legal in your state, it is still illegal from the point of view of the federal government. In 2013, the U.S. Department of Justice updated its policy on marijuana to allow states to govern themselves when it comes to legalization, whether for medical or recreational use or both.
What You Need to Know
- Marijuana comes from the Cannabis Sativa and Cannabis Indica plants and contains THC, the compound that gives you a “high” feeling. CBD is found in marijuana and hemp, but is more abundant in hemp, which does not get you high.1
- The amount of marijuana you can have depends on your state’s law (if it’s legal at all).
- Studies find that many seniors get relief from pain and other symptoms with medical marijuana and CBD, but if the THC content level is too high for your body, you may experience side effects.
What’s the Difference Between Medical Marijuana & CBD?
The marijuana plant contains more than 500 different chemicals, of which 60 are cannabinoids, a group of substances found in the cannabis plant. Delta-9-tetrahydrocannabinol (THC) is responsible for the “high” feeling that marijuana is best known for.
Medical marijuana products may have less THC than recreational marijuana; it’s called medical marijuana because these products are designed to relieve health problems such as pain, anxiety, glaucoma and other issues.2
Cannabidiol (CBD) is another active compound in cannabis, but it doesn’t bring on a high. There are three types of CBD: isolate, full-spectrum and broad-spectrum. Full-spectrum is the only kind that contains small traces of THC, but it’s not enough to get you high. Broad-spectrum CBD contains no THC and isolate CBD is the purest product; up to 99% all CBD is this type.3 Oils, tinctures, lotions and gummies are just a few of the ways you can use CBD.
How Can Medical Marijuana and CBD Help Seniors?
Between 2015 and 2018, medical marijuana use among older Americans nearly doubled, from 2.4% to 4.2%.4 It’s not hard to see why: More states have legalized marijuana not just for medical use but recreationally, making it easier to buy the products and reducing the stigma.
Here are some of the most common conditions for which seniors use marijuana:5
- Cancer: Medical marijuana increases appetite, relieves nausea from chemotherapy and curbs pain and anxiety.6
- Severe/chronic pain: Marijuana reduces pain without increasing the risk of overdose that comes with taking opioids.7
- Glaucoma: One of the most frequently cited reasons for using marijuana, studies have found marijuana reduces the intraocular pressure in glaucoma patients.8
- Alzheimer’s disease and dementia: Research shows that taking a combination of CBD and THC increases brain cell survival, reduces lipid function and stimulates the hippocampus.9
- Crohn’s disease: Decreases pain, improves appetite and relieves nausea and inflammatory bowel disease.10
- Epilepsy and seizures: Can reduce the number of seizures.11
- Multiple sclerosis and muscle spasms: Treats pain and spasms and relieves muscle stiffness.12
- HIV/AIDS: Stimulates appetite and relieves nausea brought on by medication.13
- Amyotrophic lateral sclerosis (ALS): While still being studied, early indicators point to some relief for muscle stiffness when a combination of CBD and THC is used with ALS medication.14
How Do You Choose Between Medical Marijuana and CBD?
If you don’t want the high feeling that comes from the THC in marijuana, you’ll naturally want to avoid any medical marijuana products and perhaps choose a product with CBD instead.
Though the Food & Drug Administration hasn’t approved the cannabis plant for any medical use, it has approved a few drugs that have cannabinoids in them. Depending on what health issues you’re dealing with, these may be useful. The drugs Marinol and Syndros treat nausea and vomiting caused by chemotherapy to treat cancer, and Epidiolex can help treat seizures in people with epilepsy.
How you take medical marijuana also affects how potent each dose is:15
Smoking: Paper rolling, pipes (traditional or vape) and water pipes deliver marijuana through inhalation and work quickly. Smoking vaporizes the marijuana, allowing users to inhale the medicine purely. However, this form isn’t recommended if you have a breathing problem.
Edibles: If smoking isn’t an option, you can eat cannabinoids, though you may only need a small portion compared to what you would smoke. Keep in mind that edibles — which come as brownies, candy, cookies, drinks and snacks — can take up to 60 minutes to work.
Concentrated oils and extracts: Highly concentrated cannabis can be found in vape oil, hash, pills, tinctures, dab oils, CBD oil and many other products. Oils have been separated from the marijuana bud, making them extremely efficient in how they work in the body.
Topical creams: Creams and lotions can be very effective for pain relief, and, because they don’t enter the bloodstream, there’s no risk of side effects you might experience with a product that has THC. Topical CBD also has anti-inflammatory properties, which gives arthritis sufferers relief.
Where Are Medical Marijuana and CBD Legal?
To date, 36 states and four U.S. territories have legalized the use of medical marijuana and 15 states and three territories allow recreational marijuana use.16 All 50 states have legalized CBD on varying levels.17.18 19
| Alabama | Marijuana is illegal. CBD can be sold by a licensed vendor and must contain no more than 0.3% THC by weight. |
| Alaska | Fully legal. |
| Arizona | Fully legal. |
| Arkansas | Medical marijuana is legal. Qualified use is defined as “intractable pain that has not responded to ordinary medical or surgical measures for more than six months.” CBD is available. |
| California | Fully legal. |
| Colorado | Fully legal. |
| Connecticut | Medical marijuana is legal. Qualified use is defined as “chronic pain of at least 6 months’ duration associated with a specified underlying chronic condition refractory [resistant to] to other treatment intervention.” CBD is available. |
| Delaware | Medical marijuana is legal. Qualified use is defined as “severe, debilitating pain that has not responded to previously prescribed medication or surgical measures for more than 3 months or for which other treatment options produced serious side effects.” CBD is available. |
| District of Columbia | Fully legal. |
| Florida | Medical marijuana is legal. Qualified use is defined as “any debilitating medical condition that the physician believes cannabis may alleviate qualifies if it is of the same kind or class as or comparable to those enumerated (which are serious conditions such as HIV/AIDS and cancer).” CBD is available. |
| Georgia | Medical marijuana is legal, however, it is limited to low-THC medical cannabis oil only. CBD can be sold by a licensed vendor and must contain no more than 0.3% THC by weight. |
| Hawaii | Medical marijuana is legal. Qualified use is defined as “a chronic or debilitating disease or medical condition, or treatment [for such conditions, which produces] … severe pain.” CBD is available. |
| Idaho | Marijuana is illegal. CBD products are legal only if they contain zero THC and are derived from one of five parts of the cannabis plant. |
| Illinois | Fully legal. |
| Indiana | Marijuana is illegal. The law allows any person to buy and possess CBD oil as long as it meets certain labeling requirements and contains no more than 0.3 percent THC. |
| Iowa | Medical marijuana is legal in CBD oil form only. The law allows a registered patient the ability to buy and possess CBD oil as long as it meets certain labeling requirements and they receive no more than 4.5 grams of THC every 90 days. |
| Kansas | Marijuana is illegal. CBD can be sold by a licensed vendor if it contains no THC. |
| Kentucky | Medical marijuana has passed the state legislature but has yet to be enacted. Currently, the law allows any person to buy CBD oil as long as it meets certain labeling requirements and contains no more than 0.3 percent THC. |
| Louisiana | Medical marijuana is legal but extremely restricted. Doctors can recommend medical cannabis for any medical condition the physician “considers debilitating to an individual patient” that the physician is qualified to treat. CBD is available. |
| Maine | Fully legal. |
| Maryland | Medical marijuana is legal. Qualified use is defined as “a chronic or debilitating disease or medical condition, or treatment [for such conditions, which produces] … severe pain.” CBD is available as long as it meets certain labeling requirements and contains no more than 0.3 percent THC. |
| Massachusetts | Fully legal. |
| Michigan | Fully legal. |
| Minnesota | Medical marijuana is legal but extremely restricted. Qualified use is defined as “intractable pain – a pain state in which the cause of the pain cannot be removed or otherwise treated with the consent of the patient and which, in the generally accepted course of medical practice, no relief or cure of the cause of the pain is possible, or none has been found after reasonable efforts.” CBD is available. |
| Mississippi | Medical marijuana is legal but a program is not in place yet. Currently, CBD can be sold by a licensed vendor and contain no more than 0.5% THC by weight. |
| Missouri | Medical marijuana is legal. Qualified use is defined as “a chronic medical condition that causes severe, persistent pain” or “a chronic medical condition that is normally treated with a prescription medication that could lead to physical or psychological dependence, when a physician determines that medical use of marijuana could be effective in treating that condition and would serve as a safer alternative |
| Montana | Fully legal. |
| Nebraska | Marijuana is illegal. CBD can be sold by a licensed vendor and contain no more than 0.3% THC by weight. |
| Nevada | Fully legal. |
| New Hampshire | Medical marijuana is legal. Qualified use is defined as “moderate to severe chronic pain.” CBD is available. |
| New Jersey | Fully legal. |
| New Mexico | Medical marijuana is legal. Qualified use is defined as “painful peripheral neuropathy and severe chronic pain with objective proof and two physician certifications.” CBD is available. |
| New York | Medical marijuana is legal. Qualified use is defined as “a condition for which an opioid could be prescribed or any severe debilitating pain that the practitioner determines degrades health and functional capability; where the patient has contraindications, has experienced intolerable side effects, or has experienced failure of one or more previously tried therapeutic options; and where there is documented |
| North Carolina | Marijuana is illegal. CBD oil is available. |
| North Dakota | Medical marijuana is legal. Qualified use is defined as “severe, debilitating pain that has not responded to previously prescribed medication or surgical measures for more than 3 months or for which other treatment options produced serious side effects.” CBD is available. |
| Ohio | Medical marijuana is legal. Qualified use is defined as “pain that is either… chronic and severe or intractable.” CBD is available as long as it meets certain labeling requirements and contains no more than 0.3 percent THC. |
| Oklahoma | Medical marijuana is legal. Qualified use is defined as ”any condition qualifies if a physician believes cannabis may alleviate it.” CBD is widely available. |
| Oregon | Fully legal. |
| Pennsylvania | Medical marijuana is legal. Qualified use is defined as “severe chronic or intractable pain of neuropathic origin or severe chronic or intractable pain.” CBD is available. |
| Rhode Island | Medical marijuana is legal. Qualified use is defined as “a chronic or debilitating disease or medical condition, or its treatment, that produces debilitating, chronic pain.” CBD is available. |
| South Carolina | Marijuana is illegal. CBD can be sold by a licensed vendor and must contain no more than 0.3% THC by weight. |
| South Dakota | Fully legal. |
| Tennessee | Marijuana is illegal. CBD can be sold by a licensed vendor and must contain no more than 0.3% THC by weight. |
| Texas | Medical marijuana is legal in CBD oil form only. The law allows medical patients who qualify to buy CBD oil as long as it meets certain labeling requirements and contains low amounts of THC. |
| Utah | Medical marijuana is legal. Qualified use is defined as “pain lasting longer than two weeks that is not adequately managed, in the qualified medical provider’s opinion, despite treatment attempts using |
| Vermont | Fully legal. |
| Virginia | Medical marijuana is legal in CBD oil form only.The law allows patients to buy CBD oil as long as it meets certain labeling requirements and contains no more than 10 milligrams of THC per dose. |
| Washington | Fully legal. |
| West Virginia | Medical marijuana is legal. Qualified use is defined as “severe chronic or intractable pain in which conventional therapeutic intervention and opiate therapy is contraindicated or ineffective.” CBD is available. |
| Wisconsin | Marijuana is illegal. The law allows anyone to buy CBD in oil form only, as long as it contains low amounts of THC. |
| Wyoming | Fully legal. |
What Are the Effects of Medical Marijuana on Your Health and Your Brain?
An American Geriatric Society survey showed that most seniors were able to partially or fully curb their use of prescriptions by using medical marijuana. Another study found Medicare Part D prescriptions filled for opioids decreased in states with medical marijuana laws.20 Though this research isn’t conclusive, it may indicate that older Americans find medical marijuana effective in managing pain and perhaps other health conditions.
If you choose to take medical marijuana, it’s essential to work with a physician who knows you and your health history and also understands how the plant might interact with any prescription medication you’re taking. While medical marijuana can be useful in some patients with Alzheimer’s disease and dementia, higher doses of THC could cause cognitive and physical impairment, including a worsening of dementia. Thinning blood is also a concern, and using marijuana can cause a sedative effect if you’re also taking antidepressants.21
How Do You Get a Medical Marijuana Prescription?
Even if you live in a state where recreational marijuana is legal, it pays to apply for an official medical marijuana card. It can give you preferred pricing, help avoid taxes and enable you to purchase products across state lines, if the state allows it. In addition, you can get access to stronger potencies if you need them. Here are the typical steps for getting an ongoing prescription for medical marijuana:22
- Determine if your condition qualifies you for a medical marijuana card. If your state has legalized marijuana, you should be able to find this information through your state’s department of health.
- Get treatment advice from a physician with experience prescribing medical marijuana for your condition(s) and can write a legal prescription.
- Through your state health department’s website, find out how to apply for a medical card in your state and pay the application fee, if there is one.
- Once accepted, talk to someone at a dispensary who can direct you to the best type of marijuana and the best product(s) for your condition(s).
- Listen to your body. You may need to adjust your dosage over time if your prescription doesn’t relieve your symptoms or your body adjusts to the dosage over time and you no longer see any benefit.
- Renew your medical card every year.
Does Medicare Cover Medical Marijuana?
Because marijuana is considered illegal by the federal government and Medicare is a federal program, it does not cover this type of treatment.
Next Steps
Many seniors who use marijuana, whether in a low-level CBD form or through medical marijuana, praise medical marijuana and CBD products for their benefits in easing pain, nausea, seizures and other health problems.
If you’re ready to explore how these products might help you, start by talking to a healthcare provider who knows your health history and understands how to use cannabis-derived products. He or she can be an important advocate while keeping you safe.
If your state hasn’t legalized marijuana for medical or recreational use, you can still advocate for legalization at the local level. Contact organizations like NORML ( the National Organization for the Reform of Marijuana Laws) to find a chapter near you and learn how you can help push legalization where you live.