Gray hair fills Jason Mitchell’s office. When he peers into his waiting room, he sees grandparents with walkers, canes and other indicators of chronic pain.
Mitchell isn’t a geriatrician—he’s not even a physician. He’s the general manager of Keystone Shops’ medical marijuana dispensaries in Devon and King of Prussia, where more than half the patients are over 55.
And that surprises Mitchell, who’s no stranger to the marijuana business. He spent almost a decade in Colorado canna-businesses, working his way from bud tender to management positions. But his Pennsylvania patient population is different. “I’m shocked at the volume of really sick people,” says Mitchell. “They’re in so much pain, and everything they’ve tried over many years hasn’t provided relief. There’s an enormous need for pain solutions, and we’re just beginning to address that with medical marijuana.”
Mitchell says that spinal stenosis, arthritic knees and bad hips are the most common complaints among people over 55. Dr. John Peacock, who practices at Main Line HealthCare Adult Medicine at Shannondell, sees patients with the same sort of pain—and a growing reluctance to use opioids. Many of Peacock’s patients inquired about medical marijuana when it was legalized in 2016. Dispensaries didn’t open until this year, but given the strong demand among his patients, Peacock did his own research and went through the state’s certification process so he could legally write recommendations for medical marijuana.
Peacock, however, isn’t the kind of “green” doctor who writes recommendations for everyone who walks into his office. “I got into this for my current patients with conditions who’ve tried other treatments—surgery, opioids, physical therapy—and are still in pain,” he says. “The research is promising, but I’m not using marijuana as a first-line treatment.”
Neither is Dr. Jeffrey Friedman, a physiatrist with Rehab Associates of the Main Line. “I’ll give patients a broad spectrum of treatment options,” he says. “Medical marijuana may fit into that, but I feel that it’s only an adjunct to use if other things have failed.”
Peacock and Friedman may be open-minded about marijuana’s medicinal potential, but neither have enough patients using it to judge its efficacy. “A few feel like it’s helping; a few feel that it’s not,” Friedman says. “It’s a mixed response, which is what I expected.”
Those expectations are based on Friedman’s extracurricular research—though that research doesn’t address medical concerns involving contraindications, long-term use and comorbidities. While the risk of marijuana overdose is as low as the risk of harmful side effects, Friedman and others aren’t convinced that marijuana provides any measurable medical benefits. There just isn’t enough clinical data. Marijuana is still not legal on a federal level, making research so convoluted that it’s almost impossible to conduct.
Ilera Healthcare aims to change that. The grower-processor, which also runs a dispensary in Plymouth Meeting, is working on ailment strain alignment, a term for cultivating marijuana plants to treat specific symptoms. “We don’t just grow cannabis—we formulate medicines,” says Oludare Odumosu, the COO of Ilera Healthcare. “And we didn’t just enter the cannabis business—we entered the pharmaceutical space.”
Ilera grows its own strains, along with a few from the Israeli company Tikun Olam, which means “repair the world” in Hebrew. “Tikun Olam published peer-reviewed, scientific articles—and that, for me as a scientist, was a big draw,” Odumosu says. “Clinical trials would be ideal, but we can generate some data. We’re starting to dial in very specifically for unique indications.”
A Tikun Olam study published in the European Journal of Internal Medicine touted the efficacy of marijuana among patients over age 65. After six months of treatment, 93.7 percent of the 2,736 respondents reported that their pain levels were reduced by half. Those patients used Tikun Olam’s proprietary strains, some of which may become available in Pennsylvania through Ilera.
Meanwhile, Mitchell continues to tell seniors about currently available marijuana pain-relief options—and the over-60 crowd does have a learning curve. “They grew up being told that anything related to marijuana is just wrong,” he says.
Via education, though, the stigma is dissipating, Mitchell insists. The answer, he says, is more education.