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Shirley Avedon, 90,颅颅 had never been a cannabis user. But carpal tunnel syndrome that sends shooting pains into both of her hands and an aversion to conventional steroid and surgical treatments is prompting her to consider some new options.

鈥淚t鈥檚 very painful, sometimes I can鈥檛 even open my hand,鈥� Avedon said.

So for the second time in two months, she鈥檚 climbed on board a bus that provides seniors at the Laguna Woods Village retirement community in Orange County, Calif., with a free shuttle to a nearby marijuana dispensary.

The retired manager of an oncology office says she鈥檚 seeking the same relief she saw cancer patients get from smoking marijuana 25 years ago.

鈥淎t that time [marijuana] wasn鈥檛 legal, so they used to get it off their children,鈥� she said with a laugh. 鈥淚t was fantastic what it did for them.鈥�

Avedon, who doesn鈥檛 want to get high from anything she uses, picked up a topical cream on her first trip that was sold as a pain reliever. It contained cannabidiol, or CBD, but was formulated without THC, or tetrahydrocannabinol, marijuana鈥檚 psychoactive ingredient.

鈥淚t helped a little,鈥� she said. 鈥淣ow I鈥檓 going back for the second time hoping they have something better.鈥�

As more states legalize marijuana for medical or recreational use 鈥� 30 states plus the District of Columbia to date 鈥� the cannabis industry is booming. Among聽聽of users: people over 50, with especially steep increases among those 65 and older. And some dispensaries are tailoring their pitches to seniors like Avedon who are seeking alternative treatments for their aches, pains and other medical conditions.

On this particular morning, about 35 seniors climb on board the free shuttle 鈥� paid for by Bud and Bloom, a licensed cannabis dispensary in Santa Ana. After about a half-hour drive, the large white bus pulls up to the parking lot of the dispensary.

About half of the seniors on board today are repeat customers; the other half are cannabis newbies who鈥檝e never tried it before, said Kandice Hawes, director of community outreach for Bud and Bloom.

Residents of Laguna Woods Village, a retirement community in Orange County, Calif., ride a free shuttle to a marijuana dispensary in August.(Stephanie O鈥橬eill for KHN)

鈥淣ot everybody is coming to be a customer,鈥� Hawes said. 鈥淎 lot are just coming to be educated.鈥�

Among them, Layla Sabet, 72, a first-timer seeking relief from back pain that keeps her awake at night, she said.

鈥淚鈥檓 taking so much medication to sleep and still I can鈥檛 sleep,鈥� she said. 鈥淪o I鈥檓 trying it for the back pain and the sleep.鈥�

Hawes invited the seniors into a large room with chairs and a table set up with free sandwiches and drinks. As they ate, she gave a presentation focused on the potential benefits of cannabis as a reliever of anxiety, insomnia and chronic pain and the various ways people can consume it.

Several vendors on site took turns speaking to the group about the goods they sell. Then, the seniors entered the dispensary for the chance to buy everything from old-school rolled joints and high-tech vaporizer pens to liquid sublingual tinctures, topical creams and an assortment of sweet, cannabis-infused edibles.

Jim Lebowitz, 75, is a return customer who suffers pain from back surgery two years ago.

He prefers to eat his cannabis, he said.

鈥淚 got chocolate and I got gummies,鈥� he told a visitor. 鈥淣ever had the chocolate before, but I鈥檝e had the gummies and they worked pretty good.鈥�

鈥淕ummies鈥� are cannabis-infused chewy candies. His contain both the CBD and THC, two active ingredients in marijuana.

Derek Tauchman rings up sales at one of several Bud and Bloom registers in the dispensary. Fear of getting high is the biggest concern expressed by senior consumers, who make up the bulk of the dispensary鈥檚 new business, he said.

鈥淲hat they don鈥檛 realize is there鈥檚 so many different ways to medicate now that you don鈥檛 have to actually get high to relieve all your aches and pains,鈥� he said.

But despite such enthusiasm, marijuana isn鈥檛 well researched, said Dr. David Reuben, the Archstone Foundation professor of medicine and geriatrics at UCLA鈥檚 David Geffen School of Medicine.

While cannabis is legal both medically and recreationally in California, it remains a Schedule 1 substance 鈥� meaning it鈥檚 illegal under federal law. And that makes it harder to study.

The limited research that exists suggests that marijuana may be helpful in treating pain and nausea, according to a聽聽published last year by the National Academies of Sciences, Engineering and Medicine. Less conclusive research points to it helping with sleep problems and anxiety.

Reuben said he sees a growing number of patients interested in using it for things like anxiety, chronic pain and depression.

鈥淚 am, in general, fairly supportive of this because these are conditions [for which] there aren鈥檛 good alternatives,鈥� he said.

But Reuben cautions his patients that products bought at marijuana dispensaries aren鈥檛 FDA-regulated, as are prescription drugs. That means dose and consistency can vary.

鈥淭here鈥檚 still so much left to learn about how to package, how to ensure quality and standards,鈥� he said. 鈥淪o the question is how to make sure the people are getting high-quality product and then testing its effectiveness.鈥�

And there are risks associated with cannabis use too, saidwho directs the Substance Abuse and Mental Health Services Administration.

鈥淲hen you have an industry that does nothing but blanket our society with messages about the medicinal value of marijuana, people get the idea this is a safe substance to use. And that鈥檚 not true,鈥� she said.

Side effects can include increased heart rate, nausea and vomiting, and with long-term use, there鈥檚 a potential for addiction, some studies say.聽聽that between 9 and 30 percent of those who use marijuana may develop some degree of marijuana use disorder.

Still, Reuben said, if it gets patients off more addictive and potentially dangerous prescription drugs 鈥� like opioids 鈥� all the better.

Jim Levy, 71, suffers a pinched nerve that shoots pain down both his legs. He uses a topical cream and ingests cannabis gelatin capsules and lozenges.

鈥淚 have no way to measure, but I鈥檇 say it gets rid of 90 percent of the pain,鈥� said Levy, who 鈥� like other seniors here 鈥� pays for these products out-of-pocket, as Medicare doesn鈥檛 cover cannabis.

鈥淚 got something they say is wonderful and I hope it works,鈥� said Shirley Avedon. 鈥淚t鈥檚 a cream.鈥�

The price tag: $90. Avedon said if it helps ease the carpal tunnel pain she suffers, it鈥檒l be worth it.

鈥淚t鈥檚 better than having surgery,鈥� she said.

Precautions To Keep In Mind

Though marijuana use remains illegal under federal law, it鈥檚 legal in some form in 30 states and the District of Columbia. And a growing number of Americans are considering trying it for health reasons. For people who are, doctors advise the following cautions.

Talk to your doctor.聽Tell your doctor you鈥檙e thinking about trying medical marijuana. Although he or she may have some concerns, most doctors won鈥檛 judge you for seeking out alternative treatments.

Make sure your prescriber is aware of all the medications you take. Marijuana might have dangerous interactions with prescription medications, particularly medicines that can be sedating, said Dr. Benjamin Han, a geriatrician at New York University School of Medicine who studies marijuana use in the elderly.

Watch out for dosing.聽Older adults metabolize drugs differently than young people. If your doctor gives you the go-ahead, try the lowest possible dose first to avoid feeling intoxicated. And be especially careful with edibles. They can have very concentrated doses that don鈥檛 take effect right away.

Elderly people are also more sensitive to side effects. If you start to feel unwell, talk to your doctor right away. 鈥淲hen you鈥檙e older, you鈥檙e more vulnerable to the side effects of everything,鈥� Han said. 鈥淚鈥檓 cautious about everything.鈥�

Look for licensed providers.聽In some states like California, licensed dispensaries must test for contaminants. Be especially careful with marijuana bought illegally. 鈥淚f you鈥檙e just buying marijuana down the street 鈥� you don鈥檛 really know what鈥檚 in that,鈥� said Dr. Joshua Briscoe, a palliative care doctor at Duke University School of Medicine who has studied the use of marijuana for pain and nausea in older patients. 鈥淏uyer, beware.鈥�

Bottom line: The research on medical marijuana is limited. There鈥檚 even less we know about marijuana use in older people. Proceed with caution.

Jenny Gold and Mara Gordon contributed to this report.

This story is part of a partnership that includes and Kaiser Health News.

麻豆女优 Health News鈥� coverage of these topics is supported by and