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Medical Cannabis – cannabinoids for symptom management in seniors

Chronic pain affects 1 in every 5 Canadians, but it is more common in older persons, with ¼ to ¾ of older adults suffering from chronic pain, which limits their movement and dexterity. Chronic pain is significantly more common among elderly people who live in long-term care settings.

The Invisible Epidemic: Senior’s over-index for chronic pain

The most used medications to treat chronic pain are opioids. However, there is no evidence of the benefit of opioids in long-term chronic pain management. In fact, observational studies show how prescribed long-term opioids for chronic pain is associated with increased risk of abuse, overdose, fractures, and heart attacks.

Considering 66% of seniors take at least five medications, there is rising concern about the risks associated with polypharmacy. Polypharmacy increases the risk of adverse events such as falls, fractures, and hospitalizations. And among seniors in long-term care, >60% take ten or more medications, some of which may be used to manage symptoms associated with the ‘Pain Triad,’ such as opioids, benzodiazepines, anti-depressants, and anti-psychotics. Most of these medicines are sedating, increasing the risk of delirium, falls, fractures, pulmonary embolisms, and cerebrovascular accidents (CVA).

The Potential for Cannabis-based Medicines

Medical cannabis is a promising alternative to opioids for the treatment of chronic pain, which is the most common reason for its use. Areas where cannabis has shown promise to date, are in fact covered by drug classes corresponding to the three pillars of the pain triad. More importantly, cannabis is likely to spare patients the side effects associated with opioid use.

In addition to chronic pain, many seniors suffer from poor appetite and cachexia. Cannabis has the ability to be a potent anti-nauseant and appetite stimulant.

The fastest-growing demographic is those aged 65 and up, which will account for 23% of the population by 2031. They are also the fastest-growing demographic of cannabis users, with a strong desire to learn more about the medication’s use.

Know someone who might need the access to medical cannabis? Contact our Client Care Team for more information at 1-844-756-7333 or

1. Schopflocher, D., Taenzer, P. & Jovey, R. The prevalence of chronic pain in Canada. Pain Res Manag 16, 445–450 (2011).
2. Matsuno, R., Wallace, L., Glanzman, R., Martell, B. & Coplan, P. Long-term efficacy and safety of opioid therapy for chronic non-cancer pain: evidence from randomized and open-label studies. The Journal of Pain 14, S77 (2013). Due to FDA regulatory guidelines, most contemporary phase III RCTs of opioid analgesics for chronic non-cancer pain (CNCP) are 3 months long. Furthermore, conducting placebo-controlled, double-blind RCTs ≥3 months presents ethical and operational challenges. (Purdue Pharma)
3. Chou, R. et al. The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop. Ann. Intern. Med. 162, 276–286 (2015)
4. Vogel, L. Two-Thirds of Seniors in Long-term Care Take 10 or More Drugs: CIHI. CMAJ June 10, 2014 186 (9) E309.
5. Abrams, DI. Integrating Cannabis into Clinic Cancer Care. Curr Oncol. 23 (2): S8-S14, 2016

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British Columbia Exemption from Controlled Drugs and Substances Act
The province of British Columbia (BC) announces that starting January 31, 2023, adults (18 and over) in BC will not be subject to criminal charges for the possession of up to 2.5 grams of certain illegal drugs for personal use. The exemption only covers possession for personal use with no intent to traffic, produce or export. Instead, all individuals found in possession of substances of up to 2.5 grams for personal use will be provided with local health and social services support. Additionally, the Government of Canada announced $11.78M in funding for projects in BC to address and prevent substance related harms and to help save lives. Given BC’s record rates of substance abuse and overdose fatalities, this is a step in the right direction to make out healthcare system more compassionate. We need to rethink how emergency support and mental health resources are made accessible to individuals who need them. Why? British Columbia has been significantly impacted by overdose deaths and related harms, which has worsened with the pandemic. This exemption will ensure that those possessing a small amount of certain illegal drugs for personal use will not be subject to criminal charges, and instead, will be supported with social and health services. According to studies, punishing people with substance use disorders with criminal charges can exacerbate their physical, emotional, psychological, and financial issues, as well as burden them with the criminal justice system's complexities. Substance us is a complex public health issue, many of which can be beyond an individual’s control. This is Canada's first exemption of its sort, and the federal government will monitor whether it achieves its goals of reducing stigma and harms associated with substance abuse while also increasing access to health and social services. Cannabis is a Gateway Exit Drug Is cannabis able to help in the fight against the opioid crisis? One in every five Canadians suffers from chronic pain. Canada is the world's second-largest consumer of opioids per capita (the U.S. is the highest). This, combined with the usage of illegal heroin and fentanyl, has resulted in an opioid epidemic that has resulted in 5,368 deaths between January and September 2021, or around 20 deaths per day. In addition, 4,532 hospitalizations with opioid-related poisoning occurred throughout the same time period, averaging 17 per day. Cannabis was once thought to be a ‘gateway drug’, leading to the use of more dangerous drugs and addiction. This idea has been substantially debunked since we have seen time and time again how cannabis may be used to effectively replace potentially harmful drugs like opioids and benzodiazepines. At the very least, we can replace a medicine that has the potential to kill people (opioids) with one that does not (cannabis). According to data from the United States, medical cannabis laws have lowered opioid prescribing in every state where they have been implemented. Naloxone Naloxone is a fast-acting drug used to temporarily reverse the effects of opioid overdoses. Naloxone can restore breathing within 2 to 5 minutes. When you take an opioid, it affects certain receptors in your brain. Naloxone works by kicking opioids off the receptors in your brain and binding to those receptors instead. This reverses or blocks the effects of opioids on your body. Click here to find out where to get naloxone in your province or territory: • Take-home naloxone kits are available at most pharmacies. • A prescription is not needed. • Ask the pharmacist. 1. 2. 3. Bradford, A. C., Bradford, W. D., Abraham, A. & Adams, G. B. Association Between US State Medical Cannabis Laws and Opioid Prescribing in the Medicare Part D Population. JAMA Intern Med (2018). 4. Wen, H. & Hockenberry, J. M. Association of Medical and Adult-Use Marijuana Laws With Opioid Prescribing for Medicaid Enrollees. JAMA Intern Med (2018). 5. Bradford, A. C., Bradford, W. D. Medical Marijuana Laws Reduce Prescription Medication Use In Medicare Part D. Health Aff (Millwood) 35, 1230–1236 (2016).
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Learn More: Pineapple Express Delivery
We introduced Pineapple Express Same/Next-Day Delivery to our patients because we know that fast, reliable, and safe delivery of your medical cannabis is essential. Starting in October 2022, we're reducing the price for Pineapple Express Delivery to $10.00 and it will be the primary delivery option for qualifying patients. For patients on Direct Billing plans, the $10 shipping fee will be covered by your insurance. How it Works Simply choose Pineapple Express as your shipping method and your order will be fast-tracked to same/next day delivery. Please note, orders that are processed before 12 pm on Monday - Friday qualify for same/next day delivery service. For your convenience, you will receive 2 text messages when packages are 1 hour away and 5 minutes away from being delivered to your address. Tracking Your Order To check the status of your order, enter your tracking number into the Pineapple Express website here. List of Delivery zones Pineapple Express is available to postal codes in the following areas: 1. Greater Toronto Area (same day) 2. London (same day) 3. Ottawa (next day) 4. Kingston (next day) 5. Windsor (next day) 6. Barrie (next day) 7. Durham (next day) 8. Niagara (next day) If you are not available at the time of delivery, please contact the delivery driver to provide them with instructions to leave the package in an area that meets the following criteria (within reason): • The package is sheltered from the weather • The package cannot be seen from the street or by passers-by • The entrance is not shared Direct Billing If your medical cannabis plan allows for direct billing, your order will be shipped once approved by your provider. The $10 shipping fee is now covered by your insurance. Feel free to connect with our Client Care Team at 1-844-756-7333 or if you have any questions about Pineapple Express. We’re here to help!