Should Cannabis be introduced to the palliative care program?

Palliative care is a multidisciplinary system of care that is provided by a range of doctors and health professionals, with a range of specialisms, to make a patient suffering from a serious illness more comfortable. The main aims of palliative care are to manage pain and other discomforting symptoms. Normally this type of care includes physical, mental, social and spiritual support. Though it is not always the case, palliative care is most frequently used for patients with irrecoverable illnesses and is therefore often associated with ‘end of life’ care.

While palliative and end of life care are things that are never easy to discuss, often conjuring up sad memories and evoking emotions, they clearly hold significant importance to us and our families as we think about the future. This means that we are constantly looking for new ways to ensure that our relatives and loved ones have the best care and are given drugs that make them feel at ease, in often very uneasy times.

In recent years, with the decriminalisation of cannabis for medical use in many places across the world, experts have begun to examine and research the possible advantages of introducing the drug to the palliative care program. So does the plant have the required health giving properties to warrant administering it to patients in hospices and hospitals? And is it any better than the drugs that are already available?

It is now a well documented fact that certain strains of cannabis can help with a wide range of medical issues. It is prescribed to cancer sufferers, people with epilepsy, motor neurone disease, Parkinson’s, and a whole host of other illnesses. The drug has the ability to ease pain, nausea and vomiting, increase one’s appetite and reduce the severity of seizures. These are all things that would clearly be beneficial to those receiving palliative or end of life care.

The most common drugs that are currently used to ease patients suffering in their final weeks, months or years, are opiates such as morphine. Morphine is one of the best known painkillers available today, however it does come with its downfalls. The high doses that are needed to provide relief from the severe pain that many people suffer due to their illnesses, will virtually incapacitate the patient. This leaves many families sharing their final moments with loved ones who are unable to speak, or even know that they are there.

This is a side effect that many suggest could be dramatically reduced with the use of medical marijuana, but would cannabis be strong enough to have the same pain killing results while allowing the patient to remain cognitive?

American doctor, Joseph Morgan, believes it can. At a discussion held by the College of Physicians of Philadelphia, he stated that “People who use cannabis medically can reduce their opioid use by, perhaps, up to fifty percent.” This dramatic change could enable many patients to spend more of their final moments with their families in a way that would be more fitting and, arguably, more comfortable. This would of course be in an ideal situation and realistically it may not always be
possible. Doctors would have to examine each case as they come, but the fact that medical cannabis has the ability to make this wish a reality, even if only for a small number of people, is refreshing and gives hope to many.

Medical marijuana really is on the up at the moment as scientists discover new uses for it by the day, but it is important at this time to remember that while they are discovering the benefits of the drug, they are also discovering marijuana’s own downfalls. One such issue has reared its rather ugly head during the ongoing discussion on whether to introduce it into palliative care or not. The problem it seems, with introducing the drug to a critically ill population, is that many of them are immunocompromised by their treatment, meaning that their immune system is significantly weaker than it should be. Smoking marijuana when in a condition such as this can cause a whole host of problems, with the most documented being Aspergillosis infections of the lung. This shows the fine line that is bring tread when prescribing medical marijuana to critically ill patients.

One option that is currently being worked on to avoid this possible side effect is cannabis edibles. There are many different forms of these being produced by pharmaceutical companies today, including tinctures, oils and balms, however many of them still lack the strength to be able to produce the same results as smoking the drug when it comes to pain relief.

It is clear that there is a lot that patients suffering from a variety of illnesses can gain from the cannabis plant. It is also obvious that scientists and doctors alike believe that the drug would be useful in palliative care, but perhaps most importantly we must realise that there are some risks that come with this, and in a bid to make patients more comfortable, we must first be sure not to do them any further damage.

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