A growing wave of scientific research is sounding the alarm on the increasing health risks linked to cannabis use among older adults, as usage climbs to record levels amidst expanded legalization and shifting social attitudes. The latest analysis, published in the Journal of the American Medical Association (JAMA), reveals a sharp uptick in cannabis consumption by individuals aged 65 and older, igniting urgent debate among health experts about the safety, efficacy, and regulation of cannabis use in Thailand’s rapidly aging society.
The spotlight on senior cannabis use comes after a cautionary case: a 76-year-old woman seeking relief for insomnia consumed several THC-laced gummies in one evening, far exceeding recommended doses. Her subsequent anxiety and heart palpitations led to an emergency hospital visit. Thankfully, she was ultimately sent home safe, but her story highlights vulnerabilities in the elderly population that are often overlooked in public discourse about cannabis. As a geriatrician at the University of California San Diego cautioned, “Our brains are more sensitive to psychoactive substances as we age.” For Thai seniors with common conditions like hypertension or arrhythmia, such episodes could easily spiral into dangerous territory, especially if falls or drug interactions occur (nytimes.com).
This issue is increasingly relevant in Thailand, which legalized cannabis for medical and culinary use in 2022 before tightening restrictions amid public health concerns (bbc.com). Thai authorities continue to debate safe access within a country whose demographic shift is among the fastest in Southeast Asia. By 2040, one in five Thais will be 65 or older (worldbank.org). How the Land of Smiles handles the rise of cannabis use among seniors could serve as a model or warning for neighboring nations.
Recent data from Dr. Han and colleagues shows the share of Americans over 65 using cannabis in the past month nearly doubled from 4.8 percent in 2021 to 7 percent in 2023—a dramatic rise from less than 1 percent in 2005. Thai studies are less comprehensive but suggest a similar pattern as cannabis dispensaries proliferate and stigma declines, especially in urban centers like Bangkok and Chiang Mai (bangkokpost.com).
Motivations for cannabis use in older populations diverge from recreational motives seen in younger groups. Surveys indicate that seniors often turn to cannabis seeking relief from chronic pain, insomnia, and anxiety—a trend mirrored in Thailand’s elderly who may be dissatisfied with conventional pharmaceuticals or eager to try traditional remedies rebranded in modern forms. However, robust clinical evidence for cannabis’s effectiveness remains thin, and new findings are increasingly drawing attention to acute health risks. These include heightened rates of emergency room visits, hospital admissions, and potentially an increased risk of cognitive decline (jamanetwork.com).
For example, a Canadian study found that cannabis-related emergency or hospital visits among Ontarians over 65 soared more than 26-fold between 2008 and 2021. California, a pioneer in cannabis reform, saw emergency visits for cannabis issues in this age group grow from 21 per 100,000 in 2005 to 395 per 100,000 by 2019. Thai clinicians report a gradual emergence of similar cases, often linked to tourists or returning nationals experimenting with edibles, oils, or high-potency strains (pubmed.ncbi.nlm.nih.gov).
Expert voices in the latest research urge caution. Specialists note that seniors are more likely to be on multiple prescription medications, raising the risk of unpredictable or hazardous interactions with cannabinoids. Dr. Myran, lead author of the Ontario study and investigator at Ottawa’s Bruyère Health Research Institute, explained, “There’s a number of warning signals… this isn’t reflective of everyone, but it’s capturing people with more severe patterns.” Dr. Pravosud, a cannabis researcher at the Northern California Institute for Research and Education, flagged the high rates of cannabis use disorder among older veterans—including physical dependency and withdrawal, echoing concerns about substance misuse in vulnerable groups.
Underlying these personal health stories are sweeping demographic and marketing shifts. Cannabis companies are targeting seniors directly: dispensary chains in the United States offer discounts and senior education programmes, seeking to cultivate so-called “wisdom customers.” Thai dispensaries have taken note, with some offering “senior wellness” products prominently displayed next to herbal balms and traditional medicines (thairath.co.th). The blending of ancient Thai traditions—such as the use of cannabis in temple medicine with contemporary global marketing—complicates regulatory oversight and public education efforts.
One pervasive problem is misunderstanding cannabis’s risks. Research cited in JAMA Network Open found that nearly 44 percent of American adults believed daily cannabis smoking to be safer than tobacco—a dangerous misconception given mounting evidence of cardiac, respiratory, and cognitive risks, especially for those with preexisting chronic diseases (jamanetwork.com). Thai public health campaigns report similar confusion, particularly among middle-aged groups who recall cannabis’s folk remedy reputation without knowing about the greater potency and scientific uncertainties of modern products (dms.moph.go.th).
Acute health complications among elderly cannabis users typically involve anxiety attacks, cardiovascular symptoms, impaired coordination, and falls—conditions that can quickly escalate due to frailty, bone loss, and comorbidities common in individuals aged 65 and up. Alarmingly, a growing body of evidence suggests a link between cannabis-related medical visits and later dementia diagnoses. The Ontario study found that such patients had a 23 percent higher risk of developing dementia compared to those visiting the emergency room for non-cannabis-related issues, and a 72 percent higher risk than the general population. Dr. Myran stresses that while these are observational findings and cannot prove causality, they point to worrisome trends requiring urgent public health response.
The lack of tailored clinical research on cannabis’s effects in seniors is another major concern. Many studies fail to specify whether cannabis was smoked, vaped, eaten, or applied topically—factors that affect absorption, efficacy, and risk profile. Many clinical trials exclude older participants or those with multiple health conditions, leaving Thai clinicians and patients with little guidance on safe dosages, credible delivery methods, or the real risk of adverse outcomes (pubmed.ncbi.nlm.nih.gov).
In Thailand, the challenge is compounded by a fragmented regulatory landscape. Cannabis remains technically a controlled substance under narcotics law, but a patchwork of new policies and commercial interests muddy the waters. Medical professionals, including those at leading university hospitals, have called for more rigorous training and public information to prevent accidental overdoses, drug interactions, and unsafe driving or home activities among elderly users (thairath.co.th).
From a cultural perspective, cannabis has a long but ambiguous history in Thailand. Long before legalization, it was used in traditional medicine and recipes, though usually in lower doses and less concentrated forms than today’s products. The rapid commercialization and normalization of potent edibles, extracts, and vaping devices have outpaced both folk knowledge and medical research, creating a public health blind spot. For many Thai families, stories like the California grandmother’s—of well-meaning children bringing “sleep aids” home—are increasingly familiar.
Will Thailand face the same spike in cannabis-related ER visits among seniors? If the American and Canadian experience is any indication, the risk is real—especially as local attitudes shift and older adults become more willing to experiment. Thai medical professionals are already seeing a steady drip of accidental overdoses, often complicated by cardio-cerebral events, drug interactions, or distress from unfamiliar psychoactive effects. Emergency physicians at prominent Thai hospitals stress the need for “start low, go slow” education and urge families to discuss new supplements and treatments with clinicians (bangkokpost.com).
Looking forward, public health authorities, community leaders, and the cannabis industry itself face mounting pressure to provide clear, evidence-based guidelines for senior cannabis use. Experts recommend:
- Consulting a physician before starting any cannabis product, especially for those with heart, kidney, or psychiatric conditions.
- Beginning with the lowest possible THC doses and avoiding high-potency edibles.
- Monitoring for side effects, including anxiety, dizziness, and confusion, particularly in the first weeks.
- Cross-checking all prescription medications for possible interactions.
- Avoiding cannabis products when driving or performing tasks that require coordination.
For families, open communication is key. Children and grandchildren should discuss the potential risks and benefits with their senior relatives and help research reliable products and reputable dispensaries—avoiding unregulated markets or “folk” preparations of unknown potency.
At the policy level, Thai authorities must redouble efforts to collect comprehensive data on cannabis-related health visits, track emerging trends among elderly populations, and update patient education as new research becomes available. Medical schools and hospitals should develop targeted training on geriatric cannabis care. Most importantly, all stakeholders—from policymakers to dispensary owners—should prioritize transparent information over marketing hype, ensuring seniors can make informed choices as the green tide surges through Thailand’s golden years.
For Thai readers, the bottom line is caution and communication. As the allure of cannabis grows in an aging society, the risks are real and rising. Follow the experts’ guidance, involve your healthcare provider, and remember that traditional remedies, however familiar, must be balanced with modern science and vigilant oversight.
For more information about cannabis and elderly health, visit the Department of Medical Services at dms.moph.go.th.