Balancing Analgesic Effects and Abuse Liability in Older Adults: A Randomized, Placebo-Controlled Trial of Oral and Vaporized Δ9-Tetrahydrocannabinol

In adults aged 65+ in a randomized, double-blind trial, oral 5 mg Δ9-THC reduced thermal pain sensitivity versus placebo (p=.040), while other doses and routes did not.

• Why it matters: Older adults use cannabis for pain, but no trial has quantified how Δ9-THC’s analgesic effects trade off against abuse-related effects in this age group.
• What they did: Twenty participants received oral placebo or 5/10 mg and vaporized placebo or 2/4 mg across three 8-hour, counterbalanced sessions; pain sensitivity was tested repeatedly, and abuse liability was assessed via subjective drug effects and reinforcement value.
• The result: Subjective effects rose with dose and were greatest after vaporization, reinforcement value increased only after vaporized 4 mg, and analgesia showed no significant association with exposure; adverse events occurred at vaporized 4 mg.

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