Opinion: Your grandparents are using cannabis. Doctors can help them do it safely

OpinionFirst Opinion Your grandparents are using cannabis. Doctors can help them do it safely Older patients are turning to medical marijuana more rapidly than any other group Manage alerts for this article Email this article Share this article By Peter GrinspoonJuly 9, 2026 Grinspoon is an addiction specialist at Massachusetts General Hospital and the author of “Aging Well with Cannabis: Feel Better, Sleep Better and Live Better with Marijuana and CBD.” In 2016, about six weeks after cannabis was legalized for adults in Massachusetts, I was at a bustling New Year’s Eve party. It was a fun crowd, and I was having a good time. Suddenly, a friend shouted, “Peter, come quickly, you’re the only doctor here who isn’t high. We have an emergency.” I ran into the next room to find a 70-ish woman, an acquaintance, looking incredibly disoriented. She kept repeating, “I’m going to die. I’m going to die,” and seemed unsteady. I did my best to calm and comfort her, but within a few minutes, she collapsed. I checked her pulse but she didn’t need CPR. She came to in a few minutes, anxious and confused.Advertisement I sat by her and reassured her for several hours. The host called an ambulance so she could get checked out in the hospital. In the end, she was fine, although I missed the ball drop and she had slobbered all over my nice outfit. What went wrong? Senior patients are embracing medical cannabis more rapidly than any other demographic group. Among medical cannabis patients at a dispensary in New York state, 25.8% are ages 65 or older, and 34.5% are ages 50-64. They are using it to help alleviate — with great effect — a variety of ailments, most commonly chronic pain, anxiety, and insomnia. It is helping them decrease their dependence on traditional pharmaceuticals, which can be less safe and often have more noxious side effects. It is reliably improving their health-related quality of life. Most medical cannabis users consume cannabis with great benefit and minimal harm.Advertisement The problem is that cannabis is roughly 10 times stronger than it was 50 years ago, when this poor woman had last smoked. If she took about three puffs from the joint circulating at the party, that would be equivalent to about 30 puffs when she last used cannabis. It is incredibly uncomfortable to take too large a dose of cannabis, and it can be medically dangerous. Seniors are more susceptible to all drugs because of their less robust livers and kidneys and because they’re more likely to have medical conditions. Fortunately, overconsumption of cannabis, unlike overdosing on many drugs, is not lethal and leaves no lasting damage. Why is cannabis so strong these days? The pressures of cracking down on cannabis and the war on drugs paradoxically worked to make marijuana much more potent. The economics of smuggling meant that higher THC — the main psychoactive ingredient — led to higher profits. As THC increased, the more medicinal components, such as CBD and other minor cannabinoids, were bred down. Segments of the cannabis industry have also contributed. This industry is bifurcated into two camps. About 10,000 small businesses tend to be ethical and work to redress the vast social justice abuses of the war on drugs. Unfortunately, large, multistate operators increasingly act like alcohol and tobacco companies. They are leading the way in producing these profoundly high-THC products as part of corporate strategies to maximize profit. Their advertising practices are concerning, because of the belief that some of these ads might reach and appeal to adolescents. While teenage usage has not risen with cannabis legalization, there is concern that these super-potent products are filtering their way down to teenagers. Here I should mention that I have always been strongly in favor of cannabis legalization. The war on drugs caused more harm than many of the drugs themselves. Just as it did with alcohol in the 1920s, prohibition makes everything more dangerous. Drug use is driven underground. People are less likely to ask for help. The supply of drugs becomes far more dangerous. We have arrested more than 20 million people, mostly with Black and brown skin, for simple cannabis possession, shattering their employment, educational, and housing options. Despite the well-documented harms, the overwhelming majority of cannabis users consume cannabis without harm and with great medical benefit. Advertisement Yet, legalization must be done safely. We urgently need to educate physicians and nurses so that they can helpfully advise patients. Doctors are far behind patients in their practical knowledge of the uses of medical marijuana, and often caught flat-footed when patients bring it up. Doctors need to know enough to have sensible, guiding conversations with their patients about dosage and consumption, among other things. We need to educate patients on how to get started on medical cannabis. The key to this is to “start low and go slow” so that people don’t overshoot, and so that we keep the doses as low as possible. Over the past 25 years, I have treated thousands of medical cannabis patients with extremely few ill effects. I start them on extremely low doses and creep upward. I often also use CBD, which is nonintoxicating. Cannabis doesn’t work for everyone. Some people can’t stand the feeling it gives them or have other, almost always mild, side effects. It would really help if the cannabis industry bred down the THC and bred up other, more medicinal cannabinoids. We need to focus less on the recreational market and do much more to support the tens of millions of medical cannabis patients in this country. Cannabis, like all other medications, can be used in a generally safe way. This is why we need educated practitioners and educated patients. It would be inhumane to deny our seniors the vast relief they are receiving from medical cannabis. There is no question that cannabis should be legalized by the federal government. Doing so would improve product quality and labeling. We can make the entire enterprise safer. Peter Grinspoon, M.D., is an addiction specialist at Massachusetts General Hospital and the author of the recent book, “Aging Well with Cannabis: Feel Better, Sleep Better and Live Better with Marijuana and CBD.” Letter to the editor Have an opinion on this essay? Submit a letter to the editor. marijuana, Policy, public health Submit a correction requestReprints Peter Grinspoon Newsletter The smartest thinkers in life sciences on what's happening — and what's to come Recommended First Opinion July 9, 2026 Who benefits from classifying obesity as a disease? 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