Development and Implementation of a Medical Cannabis Clinic Within a Geriatrics Primary Care Clinic: Preliminary Data

Cannabis use is rising among adults, yet few users receive structured medical supervision. Older users face unique risks necessitating specialized oversight. Given their longitudinal relationships and detailed understanding of patients' health and goals, primary care providers are well-positioned to guide decisions and education about medical cannabis (MC). Further, because of their expertise in managing complex considerations of aging, geriatricians in particular are uniquely qualified to offer safe, evidence-informed guidance to older adults using MC. This led us to develop and implement a physician-led MC clinic embedded in a geriatric primary care practice.

A monthly, physician-led MC certification clinic was established to provide individualized evaluation, safety assessment, medication review, and counseling, with support from pharmacy and nursing. The clinic was shaped by the legal, regulatory, and clinical context. The demographic characteristics, medical and qualifying conditions, and medication profiles of patients with a MC clinic visit between Jan 1, 2022, and July 1, 2024, were evaluated retrospectively. Data was analyzed descriptively.

In 30 months, 144 visits were completed. The population had a mean age of 65 years (SD 13.8), was 59.7% female, and diverse. There was high clinical complexity (mean 20.9 comorbid conditions, 14.7 medications). Pain was the predominant qualifying condition (88.9%), with anxiety (13.9%) and insomnia (11.8%) also common. Drug utilization reviews revealed a mean of 4.6 interactions per patient. Common medications included CNS depressants (66.0%), pain medications (59.0%), and psychiatric medications (56.9%).

This model demonstrates a feasible approach to integrating MC care into primary care for medically complex older adults. This integration prevents MC care fragmentation, provides thorough drug interaction screening, and supports informed MC risk-benefit assessment.