Medical Marijuana for Non-Smoking Older Patients

By Cheryl K. Smith
Bill*, a former Sheriff’s detective in his late 70s, had suffered from Parkinson’s disease for a
decade. He had tried a variety of pain medications, most of which caused unacceptable side
effects. His back pain was relieved by a morphine pump, but he still had unmanageable
neuropathic (nerve) pain. He wouldn’t even have considered marijuana until I broached the
subject with his wife—who was desperate to get him help. They were surprised and relieved
when his pain specialist willingly signed the OMMP paperwork.
Bill was opposed to smoking and was used to taking pills, so we decided his best option would
be cannabis oil capsules. We helped him get a supply and within a day of starting them, he got a
good night’s sleep for the first time in months. He didn’t notice any side effects and continued to
take the capsules regularly. Over time, he found that he needed more and increased the dose, but
otherwise is still doing well. (At one point he encountered a problem with the potency of
capsules made from another source of marijuana.)
Tips for oil capsule medication:
  • Make a large batch each time. This allows you to provide a consistent dose over
    time.
  • Use only high quality butter or olive oil.
  • Use 1-4 oz cannabis trim to 16 oz oil, depending on potency desired.
  • Use the same size capsule each time (I use 00 capsules).
  • Keep capsules in the freezer until use.
  • Start with just 1-2 capsules until you determine the appropriate dose. Wait at
    least 45 minutes before taking more, as the effects may increase for up to 3
    hours
Sharon* was a retired 65-year old-woman whose career was spent in a paramedical profession.
After retirement, she developed back pain and idiopathic (unknown cause) neuropathic pain in
her hands and feet. Morphine relieved her back pain but, despite evaluation by numerous doctors
and drug trials at a large academic medical center, her neuropathic pain worsened until it was so
unmanageable that she was in a wheelchair and was severely depressed.
Sharon’s husband heard about Compassion Center’s medical clinic from a friend, so they
decided to try it in a last-ditch effort to relieve her pain. Neither Sharon nor her husband had
used marijuana previously. Sharon obtained a medical marijuana card, naming her husband as
her caregiver. Then the couple enrolled in our Medicine Preparation class and learned how to
make cannabis butter. They experimented with using the butter in preparation of various foods,
such as brownies and cookies. Sharon’s life gradually improved as they determined an
appropriate dosage and the best way to ingest it.
She’s now out of the wheelchair and her mood has greatly improved. Every morning she eats
cannabis butter on a rice cracker and, when her pain is particularly bad, she also uses a teaspoon
of cannabis tincture in a cup of tea.
We regularly receive inquiries from (mostly) older people who have gotten a medical marijuana
card, or want to get one, but have never smoked and don’t wish to do so. Their question is “What
do I do now?” As cannabis has become more accepted as a medicine, the options for using it
have increased.
While smoking or vaporizing provides the fastest effect, ingesting cannabis orally is also
effective and has the added benefit of not harming the lungs. When made into oil capsules it’s
just like taking any other medication. The same is true of tinctures, which can be made with
glycerine or alcohol and have the added benefit of quick delivery. Most tinctures are taken
sublingually (under the tongue).
Cannabis butter or oil can be substituted for plain butter or oil in any recipe, which disguises the
flavor and makes it more palatable. Patients using this method need to begin with a low dose and
wait at least 45 minutes to one hour before taking more.
An overdose from oral ingestion of cannabis isn’t lethal, but it can be unpleasant and frightening.
Ingesting too much too soon can cause accelerated heart rate, panic, weakness, dizziness and
sweating. The cure for an overdose is time—as the effects of the cannabis slowly end.
Other patients have found cannabis salves—made with cannabis oil—to be an effective pain
relief method. The cannabis is absorbed at a lower level through the skin when applied topically
on the painful area. You can also create a salve using other essential oils that help muscle pain,
such as eucalyptus, cinnamon, or cajuput.
Cannabis is a versatile medication that is effective for pain and other ailments, in combination
with pharmaceutical methods or alone. While many people choose to smoke marijuana, those
who need an alternative and effective pain reliever and don’t want to smoke have a variety of
choices available to them.
*Not his/her real name
Cheryl K. Smith is the Executive Director of Compassion Center, a nonprofit medical marijuana
clinic and educational organization. This article was originally published in the
Cannabis
Connection.