With a growing number of states recently enacting medical cannabis legislation, many patients entering palliative care may already be using cannabis for symptom management. Does cannabis have a place in palliative care? Can it be used as a tool to help patients cope with suffering and improve quality of life?
A Growing Field
There is a growing field of research into the use of medical cannabis in hospice and palliative settings. Cannabis medicines have been shown to relieve many symptoms, including pain, nausea, and vomiting, specifically in cancer patients. Cannabis can also help increase appetite, relieve constipation caused by pain killers, diminish pain, and ease anxiety. In a Harvard-led review of 28 studies looking into the effectiveness of cannabis for pain, almost all found significant improvements in pain management.
Opinions Regarding the Use of Medical Cannabis in Hospice
Most of the public now favors the legalization of medical cannabis, and healthcare professionals support its availability for the hospice setting. One study published in the Journal of Palliative Care, “A Survey of Hospice Professionals Regarding Medical Cannabis Practices,” revealed that hospice professionals support using medical cannabis for hospice patients in elder-care and palliative settings.1
Conflicting Federal Laws
Conflicting federal laws and limited research on cannabis safety present an ongoing challenge for hospice and palliative care programs whose patients are interested in medical cannabis or are already using it to manage pain and other systems. More than 5.4 million state-legal patients use medical cannabis in the United States, according to data from the Medical Marijuana Policy Project.
The situation is challenging for hospices, which are primarily funded by Medicare. Many hospices claim they cannot legally prescribe cannabis because it remains a Schedule 1 controlled substance under federal law. A recent report indicates that 38 states, three territories, and the District of Columbia allow use of medical cannabis products according to the National Conference of State Legislatures. However, lawmakers are working to reform cannabis laws as the majority of the United States have legalized recreational or medical cannabis to some extent.
Cannabis is a rapidly growing area in medicine. Due to the numerous symptom-relief benefits associated with cannabis, it has been increasingly proposed for patients in palliative care. However, further studies are needed to determine the best possible prescriptions.
- Costantino RC, Felten N, Todd M, Maxwell T, McPherson ML. A survey of hospice professionals regarding medical cannabis practices. Journal of Palliative Medicine. 2019 Oct 1;22(10):1208-12.