New cannabinoid use is associated with elevated rates of adverse outcomes among older adults with COPD, according to a study published in Thorax. Researchers used administrative data (2006 to 2016) to identify 185,876 individuals aged 66 and older with COPD. New cannabinoid users (defined as individuals dispensed either nabilone or dronabinol, with no dispensing history for either drug in the year previous) and controls (new users of a non-cannabinoid drug) were matched for 36 factors, and respiratory-related morbidity and mortality were compared between the groups (2,106 in each group). Rates for hospitalization for COPD or pneumonia did not signifi cantly differ between the groups (hazard ratio [HR], 0.87). There were signifi cantly higher rates of all-cause mortality among new cannabinoid users versus controls (HR, 1.64). Compared with controls, individuals receiving higher-dose cannabinoids had both increased rates of hospitalization for COPD and pneumonia (HR, 2.78) and all-cause mortality (HR, 3.31). “Older adults with COPD represent a group that would likely be more susceptible to cannabinoid-related respiratory side effects, since older adults less efficiently break down drugs and hence, drug effects can linger in the body for longer—and since individuals with COPD have pre-existing respiratory troubles and respiratory compromise,” a co-author said in a statement.