Conservatives aren’t known for supporting legalization or even decriminalization of marijuana, as evidenced by former Attorney General Jeff Session’s determination to prosecute marijuana-related crimes. So what happens when Republican voters, specifically older individuals, support a change of policy? The fact is, aging Americans, particularly those with serious health issues, are pursuing medical marijuana (MMJ) as a means of managing pain, nausea, and other symptoms, and it’s forcing conservative politicians to reconsider their stance.

Public Opinion’s Transformation

At present, MMJ is legal in 33 states, while recreational marijuana is legal in significantly fewer, but according to research into media portrayals of the drug, medical framing is likely played a significant role in changing people’s opinions. This includes the use of marijuana to ease cancer pain, as part of weaning chronic pain patients off of opioids, and even as a tool for treating intractable seizures in children. Regardless of their prior opinions, it is apparently difficult for individuals to condemn marijuana use outright, despite its classification as a Schedule I drug, because of its medical benefits -- and this phenomenon is particularly marked among seniors, whose political stances are less likely to change.

End of Life Care Conundrums

End of life care plays a significant role in why older, more conservative individuals are changing their opinions about MMJ, regardless of their stance on recreational use. For example, in conditions that disproportionately impact older patients, such as ALS, neuropathy, glaucoma, and dementia, MMJ has shown significant benefits as a form of pain relief, and can be used as a replacement for opioid pain relievers. It’s also regularly used to manage cancer pain and even muscle wasting in terminal patients. Unfortunately, because it’s illegal at a federal level, interest in MMJ for among seniors puts care providers, such as nursing homes and hospitals, in a difficult position, though some states are finding ways around this.

What does a senior-friendly MMJ policy look like? In Arizona, where marijuana’s use in medical treatment is legal, designated caregivers -- who may be almost anyone over age 21, including home health aides or children of the patient -- are given leeway in accessing the drug. These caregivers can transport patients to the dispensary or make the purchases themselves, grow a limited amount of marijuana for use by the patient if they live at a distance, and prepare the substance for use. Caregivers need to be licensed by the Arizona Department of Health Services, and the policy is designed to accommodate seniors and the seriously ill who otherwise may not be able to access MMJ.

Implications for Politicians

MMJ represents a key element in our culture war, which raises questions about whether politicians are especially likely to change their stance on legalization -- but the fact is, it’s already happening. Last June, the Republican Party of Texas approved platform planks supporting decriminalization, MMJ, and industrial hemp cultivation. Many Republican politicians have also spoken out, encouraging the DEA to deschedule marijuana entirely, and this is in large part because current MMJ regulations overlook a sizable population of patients who could benefit from it.

As a prominently conservative state, Texas Republicans could change the terms of the conversation around marijuana, which means that now is the time to watch other states. Additionally, since Republicans have lost control of the House of Representatives, it’s an important moment for considering what platform changes could be most beneficial in regaining that status. Support for MMJ could be key.

Demographic Demands

Ultimately, conservative politicians must consider how changing national demographics, widespread recreational use of marijuana, and increased state-level legalization all shape changing opinions of the drug. Furthermore, supporting patients in their pursuit of the drug reflects broader support for patient advocacy. As some patients and their supporters explain, seniors are uniquely vulnerable to dangerous polypharmacy. Their doctors prescribe a series of drugs which never quite resolve all their health problems and may exacerbate other ones or result in unacceptable side effects.

Additionally, patients describe a healthcare system in which doctors don’t seem concerned that this kind of polypharmacy may be harming patients and shortening their lifespans; they see seniors and assume they are already on death’s door. Conservative politicians support for patients’ rights means supporting MMJ legislation to make it more accessible. Currently, the majority of patients can’t reside in nursing homes or other skilled care facilities because these facilities aren’t allowed to store MMJ. Changing its legal status would allow patients to take advantage of the most appropriate healthcare environment for their needs, rather than an environment of last resort.

Whether or not changing marijuana policy is actually popular among conservative politicians, doing so could be among the most beneficial approaches going into the next election cycle -- and could be a negotiating chip when dealing with liberals in Congress. As with many other political positions, the goal is to meet the needs of your base while also promoting other key party aims. If MMJ policy can be combined with regionally beneficial hemp farming subsidies and help conservatives curry favor with older voters and their families, it could be just what they need to execute a power play.