High Hopes medical cannabis for palliative care

Studies suggest that cannabis and prescription cannabinoids, such as dronabinol, nabilone, or nabiximols, may help alleviate symptoms associated with palliative care. These symptoms can include intractable nausea and vomiting, anorexia/cachexia, severe pain, depressed mood, anxiety, and insomnia.

Limited observational studies suggest that cannabinoids may potentially reduce the number of medications used by palliative care patients. Palliative care aims to relieve pain and distressing symptoms and enhance quality of life. While the use of cannabis in mainstream medicine is cautious, it appears to be gaining some acceptance in palliative care settings, where patient choice, autonomy, empowerment, comfort, and quality of life are prioritized. However, the effectiveness of cannabis in palliative care requires further research, particularly in establishing its effects in a wide range of conditions. Some patient populations, such as the elderly or those with pre-existing psychiatric disease, may be more susceptible to experiencing adverse effects.

One observational study found that patients prescribed nabilone had a lower rate of starting pain and anti-nausea medication and a greater tendency to discontinue these drugs. Treated patients reported significant reduction in pain and opioid use compared to untreated patients. Side effects mainly included dizziness, confusion, drowsiness, and dry mouth. Another study on self-reported cannabis use found that patients experienced significant improvement in a variety of cancer and treatment-related symptoms, with 43% of patients using pain medication reporting a reduction in dose. While 20-40% of patients reported a reduction in memory, no significant adverse effects were reported. The study had limitations in terms of its observational nature, lack of appropriate control group, and self-reporting.

Another study found that the most common indication for which cannabis was prescribed was pain, with patients also reporting improvements in appetite, nausea and vomiting, anxiety, and overall well-being. While the majority of responders reported no adverse effects, some reported fatigue, dizziness, delusions, and mood changes.

In conclusion, while limited evidence suggests that cannabis and prescription cannabinoids may help alleviate symptoms associated with palliative care, more research is required to establish their effectiveness in a wide range of conditions. Patients, particularly the elderly and those with pre-existing psychiatric disease, may be more susceptible to experiencing adverse effects. However, cannabis is gaining acceptance in palliative care settings where patient choice, comfort, empowerment, and quality of life are prioritized.

Reference information: https://www.canada.ca/en/health-canada/services/drugs-medication/cannabis/information-medical-practitioners/information-health-care-professionals-cannabis-cannabinoids.html#a4.1

Disclaimer: Views expressed here are those of the author and are not a substitute for professional medical advice, diagnosis, or treatment. If you have any medical questions or concerns, please talk to your healthcare practitioner.