Increased Synthetic Cannabinoid Use Found in Older Adults With COPD

Older adults above the age of 66 with chronic obstructive pulmonary disease (COPD) were found to be twice as likely to use prescription synthetic oral cannabinoids when compared with adults of the same age without COPD, according to a study published this week in the journal Drugs & Aging.

Research led by Saint Michael’s Hospital in Toronto and the Institute for Clinical Evaluative Sciences (ICES) sought to examine the frequency of synthetic oral cannabinoid use, human-made versions of THC such as nabilone and dronabinol, in patients with COPD. Previous studies by the study group have revealed that other psychoactive drugs such as opioids and benzodiazepines have been frequently used for care related to COPD, which were correlated to a potential increase in mortality risk.

Currently, safety recommendations advise against prescribing cannabinoids in patients with COPD. However, due to the effects of THC in the central nervous system which produce effects such as sedation and pain relief, many patients and physicians are turning to its use to manage symptoms.

Researchers analyzed information obtained from a retrospective, population-based, cohort study on 172,282 adults with COPD and 1,068,256 older adults without COPD all aged 66 or older:

• Physician-diagnosed COPD identified using previously validated, highly specific algorithm
• Incident off-label oral cannabinoid use examined between April 1, 2005 and March 31, 2015
• Descriptive statistics used to describe drug use patterns and multiple logistic regression used to identify characteristics correlated to incident drug use

Data from the study unveiled a significantly greater frequency in incident synthetic oral cannabinoid use for patients with COPD versus without (0.6% vs 0.3%; P < .001). When compared to older adults without COPD who use synthetic cannabinoids, patients with COPD exhibited increased high dosage frequency and significantly longer usage duration. Study results additionally found that cannabinoids were used more frequently in subgroups of older adults with COPD at a heightened risk for adverse events, such as patients receiving other sedating psychiatric medications and those with psychiatric disease.

Lead study author Nicholas Vozoris, MD, a respirologist at Saint Michael’s and an associate scientist at Li Ka Shing Knowledge Institute and ICES, highlighted the study’s findings while also stressing for precaution. “Our study showed that patients and clinicians are turning to cannabinoids more frequently to manage the symptoms associated with COPD, but little is known about the potential dangers associated with this medication class,” said Vozoris.

The management of prescribed doses, especially in patients with COPD is vital considering the study’s indication of their high dosage and longer duration use. “Though the use of these drugs isn’t too frequent today, without careful monitoring of the way they’re being prescribed and used now, we could end up with larger problems in the future,” said Vozoris.

The study authors noted that further research into the respiratory safety of cannabinoid use is warranted among individuals with COPD. “We’d like [clinicians] to reflect on their own prescribing practices and ensure cannabinoid drugs are used and prescribed with vigilance,” said Vozoris.

Reference

Vozoris NT, Yao Z, Li P, et al. Prescription synthetic oral cannabinoid use among older adults with chronic obstructive pulmonary disease. [published online September 24, 2019]. Drugs Aging. doi: 10.1007/s40266-019-00707-3.