What Role Does Cannabis Play in Hospice and End of Life Care in Ohio?
Medical marijuana is being used by millions of people across the United States, many of which are in the later stages of life. Because of this, many people are asking if marijuana should be used by people living in hospice or assisted living situations, and if it could benefit them.
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What is Hospice Care?
Hospice is medical care focused on helping those with a terminal illness. This can be to increase their quality of life and help address any problems they or their family might have, on top of fighting the illness itself. For most, hospice is usually started when the patient is expected to live for less than a year or their health is rapidly degenerating.
In most cases, hospice care is done in a patient’s home, be it their own or in a caring facility. Hospice care includes services such as; diet counseling, medication to help symptoms, physical therapy, and even counseling for loved ones. It does not include treatment intended to cure the illness, however. Since hospice care started, it has evolved from its main original purpose of helping those with cancer to helping care for those with heart conditions, dementia, stroke, and other conditions. In fact, as of 2018, less than half of all patients in hospice care are being treated for cancer .
Hospice and palliative care are becoming more and more important due to an aging population where the majority of deaths are caused by chronic or progressive conditions. For many people undergoing end of life care, mental disorders such as depression and anxiety are also common.
How Does Medical Marijuana Help Patients in Hospice?
Medical marijuana has a huge range of uses that can help increase the quality of life of those in hospice. Before we get into those, though, it is important to acknowledge the recent increase in support for medical marijuana in hospice care. Both patients and physicians are calling for its use, with a recent survey showing overwhelming support regardless of their state’s legal status . This pairs with a previous study of patients in Washington state, which found high rates of cannabis use and an increased rate of marijuana requests by patients .
One of the reasons for this support is marijuana’s use in cancer treatment. In fact, there are already several marijuana-based drugs in use to combat some of the side effects of both the condition itself and its treatment. Studies have shown that THC, one of the main cannabinoids found in marijuana, may lower nausea in some users . On top of this, CBD has also been found to be a potent antiemetic, itself coming with several other beneficial effects.
Chronic pain is another common problem many patients face while in hospice care, and one that is notoriously hard to help with traditional pharmaceuticals. This form of pain is especially common in those with degenerative conditions such as Parkinson’s, Alzheimer’s, and fibromyalgia. In this area, both CBD and THC have been found effective. Other studies have suggested adding medical marijuana to an already established analgesic drug routine. It is suggested that addition, rather than outright substitution may lead to the strongest results in some people. It has been further hypothesized that by adding marijuana to the patient’s opioid intake, the rates of tolerance and withdrawal may decrease, and once-ineffective dosages may once again become useful . This may be particularly useful in hospice care, where patients are more likely to have an established drug regimen.
Marijuana may also be able to help with other common problems associated with hospice care as well. A 2018 survey found improvements in fatigue, sleep problems, and anxiety and depression . The same survey found over a fifty percent increase in patients reporting their quality of life as “good” after using marijuana as well, and the added benefit of some users ending their use of opioids. This shows that the use of marijuana may not be limited to pain reduction as some believe.
Are There Any Dangers?
While marijuana can be an extremely useful tool for physicians and patients in hospice (with some studies showing no increase in the risk of adverse effects when properly administered ), there are some potential dangers. For example, if a patient were to be given a dose of THC that was too high, they are at an increased risk of injury to due decreased reaction time and memory and balance problems. Marijuana may also interact with certain medications, including popular heart medications, and cause serious and unexpected effects.
Those with heart conditions should also be treated with extra care, due to possible risk of hypertension when consuming marijuana in some patients, especially with THC-rich strains. Some researchers also believe that use of marijuana with certain sedatives and opioids may also lead to problems with the central nervous system. Patients with a family history of psychotic disorders may also require higher CBD and lower THC content than others.
Hospice care is a growing branch of medicine focused on increasing the quality of life of those with chronic and terminal conditions. Patients may enter hospice care for a variety of reasons, many of which marijuana may help relieve. Chronic pain, insomnia, depression and anxiety are all common problems of those living in hospice care that marijuana has been found to help treat. Marijuana may also fit into and already established drug regimen for some users, increasing its usefulness further. It has been found that patients who use marijuana during hospice report not only a higher quality of life, but lessened dependence on other medicines as well. If the patient is prone to heart problems, uses certain medications, or has a family history of mental disorder, though, special care must be taken when administering marijuana.