Does Marijuana Have A Place In Hospice?

A new study found that 87% of Americans support the use of medical marijuana as a treatment option for terminally ill patients.

By Kate-Madonna Hindes

As Americans continue to age, hospices are exploring new ways to bring peace and calm to the often slow and painful process of end-of-life care. According to the CDC, in 2015, an estimated 1.4 million individuals on Medicare were patients in a hospice setting.

Quadrupling in size in the last twenty years, hospices are investing in creating a patient-centric approach that dismantles beliefs that hospices are cold, and unfeeling institutions. From massage to aromatherapy, some hospices are offering new additions to their programs including music and integrating family into meaningful experiences. While many hospices are focused on offering a thoughtful quality of care, many end-of-life-care specialists are also advocating for marijuana.

MorseLife recently unveiled a 2019 study focused on advances in hospice care and found changing attitudes on medical marijuana. They cited that, “87% of Americans support the use of medical marijuana as a treatment option for terminally ill patients, with nearly three in five Americans (58%) expressing strong support.”

The American Academy of Hospice and Palliative Medicine recently shared a video on how hospices can integrate medical marijuana into care, heralding more change in the market to accepting marijuana as a part of a patient’s care plan.

Pathways Home Health advocates for marijuana in hospice care, stating:

“Marijuana is used in the hospice care setting to ease spiritual and existential suffering, with some studies showing an important therapeutic role for patients faced with the despair of a terminal illness, as well as the loss of function that accompanies it. A mild euphoria or sense of well-being can ease a patient’s mind, body and spirit as they come to terms with their fate.”

Stuck in political limbo

While some hospice programs are embracing medical cannabis, some are facing uncertainty about whether or not to allow medical marijuana, even when it’s legal inside their particular state. With an ever-expanding list of states that allow marijuana both medically and recreationally, hospices are taking an evidence-based, risk-management-forward approach to ensure they comply legally and ethically.

Changing attitudes are allowing for researchers to gain more insight and information regarding the role cannabis and CBD can both play in hospice and palliative care settings. Published in the Journal of Palliative Medicine, an October 2019 study focused on the responses of over 300 palliative care professionals from over 40 states on the use of medical cannabis. The study found “overwhelming support” for the use of medical cannabis in a hospice setting:

Regardless of legal status, hospice staff members were overwhelmingly in agreement that MC (medical cannabis) is appropriate for hospice patients to have access to and use.

Citing barriers such as legal status, clinical safety, and societal influence, the study believes opportunities exist to better support hospice providers and patients with education, research and policies that elevate the use of medical cannabis.

With new patients entering hospice every day and both clinicians and doctors looking to supplement old pain medicines with newer more effective treatments, marijuana will remain a top topic for years to come.

Complete Article HERE!

Cannabis in Palliative Care

Dying with dignity is a human right, and cannabis could help

By Mary Biles

End-of-life care is one of the less frequently discussed uses of medical cannabis. After all, most of us who turn to cannabis, want to continue living, right? And yet, thanks to the ability of cannabis to ameliorate the heavy symptom burden experienced by patients with minimal side effects, palliative care is perhaps the area of medicine that would most benefit from its clinical use.

Dying is a journey all of us will inevitably take, however how to ‘die well’ is something we tend not to consider. Dignity with dying is only possible, I believe, when there is a certain amount of consciousness and acceptance of the process. Something that a skinful of morphine doesn’t allow. But cannabis does, and I experienced this for the first time with a friend’s mother.

As Jose neared the end of her life after battling pancreatic cancer, morphine failed to control her pain, leaving her confused and unable to connect with loved ones. Thanks to an open-minded doctor who recommended cannabis oil, the last few weeks of her life became the gift her family longed for. The pain no longer troubled her, the anxiety lessened, sleep returned, as did her appetite. Not only that, Jose remained fully lucid until moments before she died.

This changed me forever and it’s why I’m sitting here today writing about cannabis.

Holistic medicine

Sadly, when my mother became terminally ill with advanced cancer, this option was not available in the UK. Sure, I had a few offers from my cannabis contacts. But for an 82-year-old Irish ex-nurse, trusting a funky tasting oil (that I couldn’t say for sure how much to take) over the pharmaceutical meds prescribed in precise dosages was never going to happen.

Instead, I found myself administering a list of medications that just kept growing and growing as the disease progressed. This included morphine for the pain (which incidentally my mum couldn’t tolerate), antiemetics for nausea, laxatives for the constipation caused by both the cancer and the pain medication, as well as Lorazepam for the middle-of-the-night agitation.

The frustration was overwhelming. I knew that instead of the sledgehammer approach to her symptom control, a far more holistic, person-centred alternative existed that could not only ease her pain, take the edge off her anxiety and agitation, stimulate her appetite and help with the nausea, but also allow her to be present for the time that remained.

What is Palliative Care?

According to the World Health Organization, palliative care is “an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.”

In other words, palliative care encompasses end-of-life care, but a patient receiving palliative care is not necessarily approaching death.

However, when a patient enters the end-of-life stage in a hospice setting, the emphasis on quality of life means rules often get bent in a bid to fulfil a dying patient’s wishes and beliefs. Dogs and family pets are welcome guests in a patient’s room, and a glass of wine is not unheard of, if that’s what the patient wants. So why not allow access to medical cannabis if that will help ease the suffering of a dying patient?

In some countries and states in the US, palliative and end-of-life care is considered a qualifying condition for the prescription of medical cannabis.

Using Cannabis in Palliative Care

Since 2007, the Israeli Ministry of Health has approved medical cannabis for palliative care in patients with cancer. This led to a prospective study analysing the safety and efficacy of cannabis in 2970 patients and the responses were overwhelmingly positive.

Ninety-six percent of patients who responded in the 6 month follow-up reported an improvement in their condition, 3.7% reported no change and 0.3% reported deterioration in their medical condition. Furthermore, while only 18.7% of patients described themselves as having good quality of life prior to cannabis treatment, 69.5% did six months later. Tellingly, just over a third of patients stopped using opioid pain medication.

While observational studies such as these suggest cannabis can improve symptoms commonly found in advanced cancer, as well as improving quality of life, in practice physicians often feel insufficiently informed to prescribe cannabis to their patients.

A 2018 survey found that of the 237 US oncologists interviewed, 80% conducted discussions with their patients about cannabis, while only 30% actually felt they had enough information.

 

However, an encouraging 67% viewed cannabis as a helpful additional way to manage pain, and 65% said that it was equally or more effective than the standard treatments for the rapid weight loss often found in advanced cancer. And yet, only 45% of them actually prescribed cannabis to their patients.

These discrepancies mean that even in countries where cannabis can legally be prescribed for palliative care, many physicians prefer to stick to the usual methods of symptom control.

A Physician’s View

Claude Cyr, MD, a Canadian family physician and author of “Cannabis in palliative care: current challenges and practical recommendations,” believes palliative care is uniquely suited to cannabis.

 

“If we’re going to integrate cannabis products in medicine,” he told Project CBD, “palliative care is the best port of entry because of the fact that doctors have more time, and patients also have the time to deal with possible issues of the medication.”

However, in order for cannabis to fulfil its potential in palliative care, Dr. Cyr believes a shift in how physicians view symptom control is needed.

“What seems to be coming through with the research for symptom control,” says Cyr, “is that cannabis is mildly effective for pain, mildly effective for nausea, mildly effective for insomnia and anxiety. It doesn’t treat any one of these conditions dramatically better than the other medications that we have. So, many physicians are like ‘why would we take a medication that is mildly effective when I can take a much more incisive approach with specific symptoms.’ Instead of saying ‘Do you have a bit of pain, a bit of anxiety, a bit of insomnia, a lack of appetite and a bit of nausea? So why don’t we start with something that’s mildly effective for all that and then we’ll be able to work on more specific symptoms in the long run’.”

Cyr is also critical of fellow physicians’ tendencies to rely on clinical evidence while dismissing the validity of their patients’ positive experiences.

“Palliative care is a specific situation where we can actually put into question the core philosophy of medicine which is the evidence based paradigm. I think physicians need to stop obsessing over the evidence when their patients are dying and clearly telling them, ‘I’m really enjoying this, I’m getting huge benefits from this, I’m sleeping better, I’m eating better.’ But the physicians are nodding their heads and saying, ‘I hear you, but I can’t accept this because I’m still lacking evidence.’

“But I think there is enough data out there to convince physicians that it’s safe for palliative care patients, and it’s predictable.” 

Psychoactivity in palliative care

Cyr urges doctors to find peace with the idea that cannabis is psychoactive, which he believes could actually help patients process the existential anxiety often experienced at the end of their lives.

“When you look at the studies of psychedelics in depression and existential anxiety in cancer patients, some of these results have been dramatic,” says Cyr. “Although cannabis isn’t a true psychedelic, there are some similar experiences that patients tell us about.

At smaller doses patients experience a psycholytic effect, a lowering of the defenses allowing people to explore other aspects of their psyche, and that’s when they start making connections between different aspects of their reality.”

THC’s ability to reduce activation of the default mode network, the area of the brain involved in cognitive processing and where our ego or sense of self is thought to reside, could also potentially bring a sense of peace to dying patients.

Cyr explains: “Existential anxiety is rooted in the loss of the self, but when you can dissolve the ego temporarily and you realize it’s not all about me, that can be liberating.”

For the last fifty years, activists have been campaigning for the right to use cannabis to treat their health conditions in order to be well. This must also be extended to using cannabis to maintain quality of life in life-threatening illnesses, and when this no longer becomes possible, to die well and with dignity.

In memory of Jose and Agnes.

Complete Article HERE!

End-of-life hospital care in California could soon include cannabis

By

Updated 10/24: On October 12th, Governor Newsome unexpectedly vetoed SB 305, citing conflicts between state and federal laws as well as potential loss of federal funding. He did so “begrudgingly,” calling the federal government’s position on cannabis “ludicrous.” 


 

 

 

The awkward legal-ish status of cannabis is something that affects many. And out of those, perhaps terminal patients are the most in need. When someone is painfully dying in a hospital, they are generally pumped full of drugs that often leave them barely conscious, or fully asleep.

Ryan had stage 4 pancreatic cancer that had reached the point where he needed professional care, but his only option to treat the intense pain was morphine, and even fentanyl—which is up to 100 times stronger than already-potent morphine⁠—leaving him barely conscious, or asleep. The last days of his life were being stolen, and he wanted all the coherent time he could gather to spend with his 9-year-old son

So Ryan asked his father, Jim Bartell, to get him off the pharmaceuticals so he could function in some capacity during his last days. Jim located a hospital that would allow cannabis, and Ryan was promptly transferred to it. On the first day that Ryan was allowed cannabis, they had to spray a tincture under his tongue because he couldn’t even swallow.

But by the next morning, he was reportedly alert, talkative, and pain-free. Ryan was able to spend his last two and a half weeks of life chatting on the phone and taking visitors—connecting, laughing, and taking the precious time to say goodbye.

But Jim Bartell’s mission had just begun

Ryan Bartell passed away on April 21, 2018, but Jim wasn’t done with this issue. He drafted a bill that would allow terminally ill patients to use medical cannabis in hospitals.

In an interview with Leafly, he shared that as President of a San Diego firm that handles things like government PR, he’d been prepared for this mission—he’d already reviewed hundreds of government bills over the years.

After three long months of research and another three weeks of drafting, he took SB305 to Senator Ben Hueso at the end of 2018. Sen. Hueso agreed to sponsor it, and Jim and his staff continued to work together near daily until SB305 was submitted in February. Much of the pushback came from the California Hospital Association, who feared that they would lose federal funding as cannabis is still federally classified as a Schedule I drug.

But they worked through the opposition, drafting the bill so if the government were to change position and enforce federal prohibition against cannabis—then that hospital would be suspended from compliance.

And on September 11th, 2019, the California State Legislature unanimously approved their Senate Bill No. 305, which was aptly, and powerfully, titled “Ryan’s Law.” It’s now on its way to California’s pro-cannabis Governor Newsom, who is expected to sign it in the coming weeks. If all goes as predicted, it will come into effect on January 1st, 2020.

This means that starting next year, terminal medical cannabis patients with a prescription will be able to use cannabis in forms other than smoking/vaporization in hospital care. Cannabis will be procured by the patients, not the hospital. Hospitals will not be allowed to interfere with its administration, but will be allowed to help if needed.

Next steps for Ryan’s Law

Jim doesn’t plan to stop there. He says that this issue is affecting people like Ryan, and the people who love them, all over the country—so he’s doing something about it. First steps are to take on the geographically (and politically) close states of Oregon and Washington. And now they’ll only have to amend the bill with state-specific health codes instead of starting from scratch. Hopefully these states align quickly, and others as well.

Medical cannabis may be legal in many places, but patients in need of this medicine still face obstacles in terms of using it when and where they need it. While the chronically ill and those still in the fighting stages of diseases aren’t yet protected, this is an encouraging step in the right direction.

While some other states have on the books that they allow cannabis in hospitals, this will be the very first law that requires allowing it. Finally.

Even with such strict laws in place, a massive library of studies supporting the power of medical cannabis have amassed over the decades. It’s beyond time that medical cannabis became more accessible.

Complete Article HERE!

How Cannabis Helped Me Cope With Grief

By Emma Stone

My father passed away from cancer six weeks ago. The days after his death were characterized by the expected: disbelief, morbid Hallmark cards extending condolences, and dishes of limp lasagna left at the door. But the period following his passing was also colored by the unexpected.

I wasn’t expecting panic or anxiety. Nor was I expecting derailing flashbacks to the last week in the hospital, night after night of insomnia, or the decimation of my formerly robust immune system. In short, I wasn’t expecting grief.

Theoretically, I knew grief happened after a significant loss. I’d just somehow made it to 34 years of age without ever really experiencing it firsthand. In essence, grief is a common emotional response to a distressing situation. But although it’s normal, it can be utterly annihilating. Grief gathers up feelings and experiences—that are challenging enough to deal with on their own—into one giant, messy package that spills out over everything.

A Small Piece of Cannabis-Infused Fudge

Deep down, I knew the grief and pain I was experiencing was something I had to work through. “The cure for the pain is in the pain,” says the poet Rumi. I wasn’t looking for benzodiazepines, antidepressants, or anti-anxiety meds to numb the feelings. But I did feel like I’d benefit from something that would allow me to elevate myself from the depths of the grief swamp, make sense of it, and muddle through the funeral and weeks that followed.

I found it in my refrigerator. One small piece of cannabis-infused fudge forged a small window of space in my head, allowing me to observe what was going on both inside and outside. A sense of peace descended, and I slept four hours that night.

Any grief-stricken person will tell you that grief can place you at the behest of your emotions, causing you to swing wildly between panic, sadness, regret, and anger. Compound this with sleep deprivation, and your ability to reflect and retain a sense of perspective is severely compromised. Ironically, a functioning reflective faculty is one of the things a grieving person misses most.

During the week leading up to the funeral and for a few days after, nuggets of fudge provided not an escape, but elevated respite. Throughout the constant coming-and-going of family, friends, funeral directors, and total randoms who stayed lingering long after they’d worn out their welcome, cannabis was my grief aid, helping me find presence in the moment. Those little nibbles of fudge enabled me to appraise the more challenging events with a sense of equilibrium and calm.

Openness to Insight and Meaning

Mickey Nulf, a cannabis educator and patient consultant, leaned into cannabis after he lost his mother to a drug overdose. For Nulf, cannabis helped him to confront his grief in a healthy way.

“Cannabis kept my mind level as I was being rushed with emotions from the feelings of grief and sadness that I had. It allowed me to feel the feelings, but understand them at the same time,” explains Nulf. “It kept my anxiety down while the grief hit, and encouraged me to actually deal with the grief instead of just burying it.”

Grief is often tinged with moments of profound insight and meaning, and openness to these moments can make testing times easier to weather. Nulf recalls the most impactful moment he experienced was seeing his mom lying in the funeral home. “I hadn’t cried before then but cannabis allowed me to experience those feelings again. I dropped to my knees and cried for my mom. I was sad she was gone; sad that I didn’t get the chance to say ‘I love you,’” he reflects.

Nulf believes cannabis enabled him to access his feelings fully, which was essential to making sense of his mother’s death. “I was able to process the loss, and understand that the picture was greater than the loss,” he recalls. “I could see the tragedy but find happiness through it. It was a first for me in my lifetime.”

An Expert’s Opinion

But what do the experts think? While there are no clinical studies exploring cannabis use and grief, there is plenty of interest. “Currently, there is promising preliminary evidence about the efficacy of medical cannabis in the treatment of these conditions, all of which are hallmark features that characterize the constellation of grief symptoms,” observes Dr. Rahul Khare, MD, an expert on the medical applications of cannabis.

Large-scale clinical trials, however, are needed to draw firmer conclusions. It’s also vital to acknowledge that studies indicate that a grieving individual is more vulnerable to substance abuse, dependency, and addiction. A recent study also suggests that cannabis use among individuals with depression can be problematic and prevent them from seeking proper psychiatric care. Cannabis may straddle a fine line between helpful aid and problematic crutch.

Dr. Khare suggests that the key may be to combine cannabis with appropriate mental healthcare. “Although it is controversial, the current evidence suggests an overall promising relationship in the treatment of grief with medical cannabis, if such treatment is paired with proper psychiatric and mental healthcare by licensed professionals,” he reflects.

Khare is optimistic that cannabis could represent a powerful tool for helping with grief in the future. “In my personal experience treating patients with medical cannabis, I have found a marked decrease in the use of antidepressant medication as well as a reduction in opioid and benzodiazepine use as well,” he states. “I believe with further research, a more definitive link between the efficacious uses of cannabis for grief will be unveiled.”

Complete Article HERE!

People in western China smoked marijuana to bury their dead 2,500 years ago

— the oldest evidence of weed smoking in human history

In a tomb in western China, scientists discovered human remains and evidence of marijuana use from 2,500 years ago.

By

It appears people have been smoking weed for more than two millennia.

Researchers reported on Wednesday that they’ve found some of the earliest evidence of ritual cannabis smoking in the archaeological record.

The evidence comes from stone-filled braziers — a device used to burn a plant and fill the air with its vapors — that were unearthed in eight tombs at the Jirzankal Cemetery in the Pamir Mountains of western China.

Preserved in the 2,500-year-old braziers were traces of cannabinol (CBN), the compound that forms after tetrahydrocannabinol (THC) comes in contact with the air. THC is the most potent psychoactive agent in marijuana.

This wooden brazier with burnt stones in the center provides some of earliest evidence of ritual cannabis smoking.

The authors published their findings in the journal Scientific Advances. The chemical signature of THC residue in the tomb, they said, indicates that people in this region of China likely smoked marijuana during burial ceremonies, perhaps as a way to communicate with the dead.

“It’s the earliest strong evidence of people getting high” on marijuana, Mark Merlin, a botanist at the University of Hawaii, told USA Today.

This marijuana was potent

Marijuana is one of the most widely used psychoactive drugs in the world today, but the legacy of its use and cultivation spans millennia. The earliest known cultivation of cannabis plants occurred in Eurasia roughly 6,000 years ago, but it was used as a food crop and for hemp material — not smoked for psychoactive effects.

Previous evidence of ancient cannabis smoking came mostly from historical anecdotes, not archaeological evidence. Greek historian Herodotus wrote about ritual and recreational pot use around the same time that these braziers were buried in distant China.

Scientists also found cannabis seeds in a different 2,500-year-old Chinese tomb in 2006, but there was no evidence of smoking

Usually, wild cannabis ( Cannabis sativa) has lower levels of THC than its cultivated counterparts. But the residue in these Chinese braziers indicates that the type of cannabis smoked in them had higher THC levels than wild plants. It also had higher amounts of THC than the cannabis grown in ancient Eurasia, the authors of the new study noted in a press release

The authors aren’t sure whether the cannabis used in this region was intentionally cultivated to have higher amounts of THC (as it is today), or whether the people who conducted this burial had some other way of seeking out more potent plants.

Either way, they appeared to be aware that not all cannabis is created equal when it comes to its psychoactive qualities.

These tombs had evidence of human sacrifice

In the Jirzankal Cemetery, the archaeologists also found skulls and other bones with signs of fatal cuts and breaks, which they interpreted as signs of human sacrifice. They found a harp as well — an important musical instrument in ancient funerals and sacrificial ceremonies.

These clues from the past indicate that the burials had a ritual quality to them, and that smoking marijuana played a role in commemorating the dead.

The excavation of the tomb M12, in which evidence of the oldest ritual smoking of cannabis was found. In the photo, the cannabis brazier can be seen at the middle bottom edge of the central circle.

“We can start to piece together an image of funerary rites that included flames, rhythmic music, and hallucinogen smoke, all intended to guide people into an altered state of mind,” the study authors wrote.

Merlin told The Atlantic that this discovery does not suggest ancient Chinese people were into recreational drug use. Instead, he said, it was likely a spiritual practice — part of ushering the dead into the afterlife and helping the living commune with deities or the deceased.

Complete Article HERE!

Herb & Hospice:

How Medical Marijuana Is Helping End-Of-Life Care

by Emily Berkey

While terminal patients are finding that medical cannabis offers relief with fewer side effects, health professionals must navigate legal challenges to offer aid.

While medical and recreational cannabis are currently legal in 33 U.S. states and the nation’s capital, it still remains illegal at the federal level, fostering fears of punishment for professionals within the medical establishment who may want to prescribe cannabis as a medication. Cannabis’ federal illegality not only deters discussions between doctors and patients seeking relief for various ailments, but it also greatly limits scientific research that could help assist medical experts seeking to determine cannabis’ efficacy as a treatment for certain disorders. Hospice patients and those receiving end-of-life care — a group who could arguably greatly benefit from medicinal cannabis use — are often times uninformed about the plant’s therapeutic properties, because their doctors, nurses, and other medical staffers are often hesitant to speak with patients about the advantages and risks of consuming cannabis.

“As an administrator, I can tell you it’s not that we’re not allowed to talk about the use of cannabis, but there’s a fear that the federal funding [Medicare and Social Security] could be pulled, so we just don’t know what we can and can’t talk about. But as a nurse, I feel it’s our duty to advocate for any healing measure for the patient,” says Lance Pool, the main Registered Nurse at Stoneybrook Assisted Living in Corvallis, Oregon. “I’d fear losing my job if I spoke about it… many places I’ve worked would terminate you on the spot if you spoke about cannabis use.”

Lance and Cydney Pool of Treewise Holistic Nursing Services

Armed with a desire to create change in their fields, Lance and his wife Cydney, who is a death doula (someone who assists individuals and their families in the dying process by offering physical, mental, and emotional support, similar to a birth doula), created Treewise Holistic Nursing Services, a company designed to meet the needs of elderly patients and those seeking end-of-life care with the help of cannabis as medicine. “Some of my friends who are administrators in nursing homes and assisted living [facilities] said what they really needed was an outside consultant who they could refer people who have questions about cannabis to… so that’s how Treewise got started,” says Pool. “There are a lot of elderly folks who have questions, and we’re there to answer them as an outside source.”

Treewise offers private consultation to senior citizens who are curious about or need help using cannabis for various ailments. “State regulation requires that the facilities provide for the ‘holistic’ needs of their residents… There are several ways that facilities can [do that with cannabis medications]: they can assign a “caregiver” to visit the dispensary for their residents, [or] the dispensary can “deliver” to the facility. We are licensed as a patient and [a] grower, so we can provide any of these services,” explains Pool. Although they do not sell cannabis to patients, they assist in administering it, advising, and coordinating care and communication between patients and their caregivers. “We are new to Oregon, so we are building a client base and growing our own medicine,” says Pool. “It is nice to be in a legal state where our professional licenses are relatively safe. Federal prohibition has never held us back — we are doing exactly what we want to do and always have, but federal prohibition is holding our elders back from the ‘holistic’ benefits of nature’s medicine.”

Jennifer Rosenthal Iverson, an attorney specializing in medical marijuana in Monterey, California, explains why assisted living facilities may be apprehensive to get on board with medical marijuana despite it being legal at the state level since 1996: “In California, any entity receiving federal funding is concerned because [cannabis] it’s still a Schedule I narcotic. The fear or notion that the federal government will come after an assisted living place is very far off, but if someone is receiving federal subsidies, it would be a concern.” Many hospice companies run into the same dilemmas as nursing facilities — patients who are anxious, in pain, and lacking an appetite who could potentially benefit from cannabis as medicine — and an inability to speak about cannabis for fear of reprimand or loss of federal Medicare and Social Security funding. 

T Ngu, a hospice volunteer

T Ngu, the owner of Project Object in Portland, Oregon, has been volunteering for a hospice organization for five years. “One of the families was very involved in the medication process. They really wanted to know what the medication was doing, how it was affecting them, and what the side effects are,” says T.  “It was very apparent that many of the medications made [the patient] feel anxious, have hallucinations, or made them feel worse, so they needed other medications to help with those side effects. Then they started giving their loved one cannabis-based products. They tried tinctures and she didn’t like the taste, so they started giving her marijuana chocolates. It was really apparent that when she had the chocolates, she was happier, would laugh, make jokes, was a little more present, and had less pain. When she wasn’t on them, she would scream and be more anxious and uneasy.” T is aware of the benefits of cannabis-based products, but doesn’t speak about the medication with hospice patients and their families because it’s against the hospice company’s policy. 

With staffers at assisted living, nursing home, and hospice facilities uneasy about discussing medicinal cannabis use, families with loved ones receiving end of life care are left to their own devices — often times led by a younger member of their family who discovered the benefits of such products on their own.

James Lumis, a Portland resident whose mother recently passed away, was reminded of the possible benefits of giving his mother cannabis during her time in hospice by his nephew. “He had some [edibles, which he’d made himself with recreational marijuana], so I asked my mom if she was open to trying it so she could eat, and she was,” explained Lumis. Not only did the cannabis products help his mother’s appetite, but they seemed to relieve painful constipation caused by her prescription painkillers, while easing her anxiety and diminishing her pain. Due to a lack of research and resources to consult regarding proper dosages and strain types, James tested the products on himself before giving them to his mother. “I didn’t give her anything until I tried it. I was her guinea pig,” he adds.

James Lumis of Portland, Oregon

“If cannabis was federally legal, I feel like I would have had more information when I needed it,” says Lumis. Cannabis’ federal illegality not only deters care providers from prescribing cannabis-based products, but it also results in a lack of reliable research, as many U.S. institutions have been dissuaded by the plant’s controlled legal status. With Canada’s newly adopted cannabis policies, physicians have expressed excitement about the scientific findings expected to come from a country now free of many previous restrictions on marijuana studies

Dr. Allan Frankel, a physician based in Santa Monica, California, recognizes the lack of resources surrounding cannabis dosing recommendations for hospice patients and those in need of end-of-life care. Dr. Frankel, who says he cured himself of a debilitating viral chest infection by using cannabis, offers in-office and phone consultations for patients who are seeking more information on medicinal marijuana — a service that James Lumis and his mother likely could have benefited from. “I think the odds of the federal government stepping in on an 85-year-old lady, who’s on death’s door getting some relief in a legal state from cannabis, are slim,” says Dr. Frankel.  

As far as potential consequences of doctors in California prescribing medical cannabis, attorney Iverson says that if the federal government wanted to get involved, a revocation of medical license would be the worst case scenario; “But that decision is really on a state by state basis… I haven’t heard of any cases in California where there’s been reprimand for this… But then, there aren’t many doctors that will do it.“

Dale Gieringer, the director of California’s branch of NORML (the National Organization for the Reform of Marijuana Laws), has been on the front lines of cannabis legal reform long before the Golden State’s passage of Proposition 215 in 1996 — the nation’s first medical marijuana law. Advocates battling HIV/AIDS (then an often terminal disease), along with senior citizens suffering from cancer, were instrumental in building support for California’s first medical cannabis program. However Gieringer explains to MERRY JANE that originally, “Prop 215 was in no way intended to be limited to terminal illnesses. Our opponents tried to paint it that way so as to limit its application, but we were very definitive about it being for any disorder for which marijuana provides relief.” 

He foresees marijuana being legalized on a federal level in the near future: “Most of the [federal] legislation now is all-out legalization of some sort. I think the bill that has the best chance of approval is a bill called the STATES Act, which basically says that anything that’s legal under state marijuana laws will be considered legal under federal law.” Gieringer believes that after the presidential election in 2020, there’s a good chance the U.S. may see federal reform. “I’ve never been one to predict that legalization was just around the corner, but I can see it now… even the head of the [U.S. Food and Drug Administration], Scott Gottlieb, said that federal reform looks inevitable.”

Until then, medical professionals and caregivers for patients approaching the end of their lives will have to continue using their best judgment on how to navigate the remaining legal challenges around medicinal marijuana. Echoing nurse Lance Pool’s belief of doing what’s best for the patient, Dr. Frankel says, “We have to all be a little braver just to do the right thing. You decide what’s best for that patient in that moment, and you do it. If you do anything short of that, you’re not practicing according to [medical] code.”

Complete Article HERE!

Medical Marijuana and Terminal Illness

People who have been diagnosed with a terminal illness suffer a broad range of physical and emotional symptoms and other overwhelming struggles. Terminal illnesses are devastating diagnoses, and patients must learn to cope with the news that their disease cannot be cured.

When it comes to terminal illnesses, conventional medicine focuses on palliative treatment goals. This means doctors aim to make their patients feel as comfortable as possible in their last remaining weeks or months. Unfortunately, most of the drugs prescribed to terminally ill patients cause a host of unpleasant side effects, and some people flat out stop responding to conventional treatments. That’s where natural therapies come into play.

Medical cannabis is an excellent option as a complementary treatment solution alongside prescription opiates or other drugs for symptom management, but it can also be an effective alternate solution when patients suffer from side effects and no longer wish to take conventional medications.

Studies on medical cannabis and terminal illness have proven its effectiveness in treating specific symptoms that are often associated with end-of-life difficulties. Medical cannabis is a safe remedy for maintaining quality of life and providing comfort and relief for patients with terminal illnesses.

What Is a Terminal Illness?

Terminal illness is a broad term used to describe any kind of illness that is incurable or untreatable. Patients with a terminal illness have been told by their medical team that they have a certain remaining life expectancy and their disease will likely result in death. Illnesses like AIDS or cancer can be diagnosed as terminal illnesses when the disease is too advanced to be treated.

One of the primary issues surrounding a terminal illness is the psychological trauma associated with the diagnosis. Many patients fall into a deep depression and may even turn to substance abuse. Additionally, many of these patients have such advanced illnesses that they suffer from chronic pain, which only further amplifies their psychological symptoms.

Sadly, terminal illnesses affect far too many families. In 2006, the Pew Research Center reported that 42% of Americans know a friend or relative who is suffering or has suffered a terminal illness. Though this is a shocking statistic, but it’s made clearer when looking at the rates of terminal illnesses among Americans.

n the United States, cancer is the second leading cause of death. On average, more than 1,500 Americans die each day from cancer. HIV/AIDS is another potentially terminal illness taking far too many lives. In 2014, 6,721 Americans died from HIV or its complications, although the death rate associated with AIDS is steadily declining in the United States.

An under-recognized potentially terminal illness in the United States is kidney disease. According to the National Institutes of Health, advanced kidney failure kills more Americans than breast or prostate cancers. In 2013, 47,000 Americans died of kidney disease.

Terminal illness doesn’t just affect adults and seniors. The National Cancer Institute reported that in 2014, 1,960 children and adolescents under the age of 19 died from cancer.

With these high rates of terminal illness in American society, it’s no wonder many of these patients are turning to medical cannabis as a natural end-of-life therapy.

Terminal Illness History and Outlook

The landscape of illnesses has changed drastically in the past 100 years. Thanks to greater global disease awareness and advanced medical technologies, people are living longer than ever. But illnesses themselves have evolved. A hundred years ago, it was common for people to die from infections and other acute conditions that could not be treated medically.

Today, in the industrialized world, it’s less common for people to die from infections. However, chronic illnesses attributed to our environment, lifestyles and the fact that people are living longer are the new medical challenge our society faces. Generally, our high-fat diets, sedentary lifestyles and increased exposure to synthetic products and chemicals have led to new types of terminal illnesses to combat. Cancer is a potentially fatal disease that is claiming lives at an astonishing rate.

In 2003, the World Health Organization, recognizing the global cancer epidemic, published a report estimating that by 2020, cancer death rates would increase by 50% to 15 million annually.

Thankfully, since those findings were published, medical technology has advanced, and many of these expected deaths are now preventable. There are still far too many cases where cancer results in terminal illness. This is why different therapy approaches, such as medical cannabis, can help address the cases where cancer becomes fatal.

Terminal Illness Causes

There are many different types of terminal illnesses all resulting from different causes and risk factors. Here are some of the terminal illnesses patients are diagnosed with as well as their causes:

  • Cancer: Cancer is a broad term used to describe several different diseases that can affect virtually every part of the body. There are many possible causes of cancer depending on where in the body it first develops. All cancers are characterized by the mutation of normal, healthy cells into abnormal, cancerous cells. By nature, cancer cells divide and spread quickly. As they spread, they form tumors — lumps of cancerous tissue. If left untreated, tumors will begin to shut down nearby organs, as the immune system can no longer fight against the attacking cells.

All cancers are terminal if left untreated. Some cancer types are deadlier than others. Two of the deadliest forms of cancer are brain and ovarian cancers. The National Cancer Institute estimates that 16,700 Americans will die of brain cancer and 14,080 will die from ovarian cancer in 2017.

  • HIV/AIDS: HIV is acronym for the human immunodeficiency virus. It’s caused by a sexually or blood transmitted infection that attacks a person’s immune system. After years of being infected with HIV, a person’s immune system eventually becomes so weakened they develop AIDS — acute immunodeficiency syndrome — which is fatal.
  • Kidney Disease: Kidney disease is a serious, potentially terminal illness that damages a person’s kidneys. Damaged kidneys are unable to filter the blood properly, which causes waste and toxins to build up inside the body. Sadly, initial symptoms of kidney disease often go unnoticed until the condition becomes advanced. If kidney disease reaches the most advanced stage — kidney failure — the patient is no longer eligible for a kidney transplant or dialysis and the condition becomes fatal.

These conditions are some of the many well-known terminal illnesses that exist. Countless other diseases and conditions are considered terminal when patients stop responding to treatments or when the illness becomes too advanced to treat.

Terminal Illness Symptoms

While there are many different conditions that cause terminal illnesses, each having their own unique symptoms, most patients experience a similar set of symptoms during the end stages of life. These common symptoms include both physical and emotional or mental symptoms.

Here are the common symptoms experienced by people with terminal illness:

Physical Symptoms. When patients suffer advanced stages of diseases, there are common physical symptoms that occur. These symptoms include chronic pain and general weakness. Chronic pain affects more than 60% of cancer and AIDS patients. Other physical symptoms of terminal illness include:

  • Chronic weight loss
  • Anorexia
  • Loss of appetite
  • Fatigue and insomnia
  • Nausea
  • Vomiting
  • Constipation
  • Difficulty breathing

Emotional Symptoms: A terminal illness diagnosis is tragic and earth-shattering for patients and their families. Because of this, there is a range of different reactions among patients. Patients can experience emotions such as:

  • Anger
  • Fear
  • Shock
  • Denial
  • Blame
  • Depression
  • Helplessness

Many patients diagnosed with terminal illness go on to develop depression and anxiety. The Baylor University Medical Center found up to 77% of terminally ill patients suffer depression symptoms. Other reports indicate up to 20% of terminally ill patients are diagnosed with major depression — a serious and chronic grade of depression. In many cases, anxiety and delirium also accompany feelings of depression.

Conventional Terminal Illness Treatments

Treatments for terminal illness are focused on improving a patient’s comfort and quality of life in their remaining time. Terminal illnesses, however, are untreatable in the sense that they cannot be cured. Terminal illness treatments are referred to as palliative, meaning they reduce pain without an attempt to cure the disease.

Treatments focus on alleviating pain, improving strength and appetite and managing any symptoms of depression, anxiety and grief.

Here are the types of conventional treatments and care given to patients with terminal illness:

  • Opiates. Opiates are a class of drug that suppress the central nervous system and provide pain relief and a sense of euphoria. Morphine and hydromorphone are two of the most commonly prescribed opiates to relieve pain during end-of-life. Fentanyl, oxycodone and methadone are other opiates used to alleviate chronic pain for patients with terminal illness.
  • Anti-nausea medications. Nausea and vomiting are common terminal illness symptoms that can be managed effectively. Haloperidol is an anti-nausea medication that doctors prescribe to control these symptoms. Haloperidol can be taken orally or via injection.
  • Antidepressants. In many cases, doctors may prescribe terminally ill patients with antidepressants (SSRIs). Quite understandably, stress and depression arise with a patient’s knowledge of terminal illness. The physical and emotional suffering coupled with knowledge of impending death make some patients want to commit suicide, become overly stressed or too depressed to respond well to care-giving methods. Unless antidepressants are already part of the medical regimen, the patient may not respond to them in time to have any benefits before death.
  • Psychological/spiritual counseling. Doctors and experts advise patients to seek psychological or spiritual counseling to help cope with a terminal illness. Counseling helps patients better understand their condition, be better equipped to deal with it and address symptoms of depression and anxiety. Often, psychological and spiritual counseling for terminally ill patients will include the person’s family members.

Medical Cannabis for Terminal Illness

Unfortunately, many patients with terminal illnesses struggle with the types of palliative treatments they’re prescribed. Opiates and antidepressants both come with a host of side effects that can aggravate many of the end-stage struggles people experience. Medical cannabis is an alternative or complementary treatment option that many people with terminal illnesses have had success with.

The cannabis plant contains two organic compounds that provide medical benefits: tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the compound responsible for the psychoactive effect associated with cannabis. It’s also shown to possibly reduce pain, relieve nausea and boost appetite.

CDB is the other compound that doesn’t produce psychoactive effects. However, it does treat symptoms like pain, nausea, depression and anxiety, which are all associated with terminal illness.

Legal medical marijuana such as Marinol is approved by the FDA. In some states, smoked marijuana is also legal under state law but still illegal under federal law. Both forms of medical marijuana have been shown to help with pain. They are not pain relievers, but can work with opiates to make them more effective.

According to UCSF, they conducted a study using cannabinoids with opiates and found that patients showed up to 95% decrease in chronic pain when using inhaled marijuana vapor with opiates such as morphine. It also showed that the dosages of opiates could be decreased when opiates are used in conjunction with cannabinoids.

Medical Cannabis for Alleviating Symptoms

One of the strongest arguments for medical marijuana and terminal illness is for the treatment of nausea, vomiting and loss of appetite. Cancer patients that are undergoing chemotherapy have benefited greatly from the availability of FDA approved medical marijuana. It is known to reduce nausea and vomiting, often when more traditional medical treatments for the symptoms fail to produce significant results. Nausea and Vomiting can occur with several terminal illnesses such as cancer and AIDS – related illness.

Cancer and AIDS can also result in loss of appetite. It is expected at the very end of life that appetite decreases until it is nonexistent in many cases. However, it is often good for patients to eat as much as possible until it becomes impossible. Medical marijuana can help with that and is prescribed for just such occasions. In fact, the hunger-inducing effects of medical marijuana are so well known that they are even known colloquially as “the munchies” in the recreational marijuana use community.

Medical marijuana’s effects are felt soon after ingestion and virtually immediately after inhalation. There is no waiting period as there is for antidepressants. There is no guarantee that it will alleviate depression, stress and suicidal thoughts. However, it is useful for its fast-acting benefits. There is some research to suggest that medical marijuana can help some of the symptoms associated with depression, particularly difficulty sleeping, but it is still an under-researched area of medical care.

Best Cannabis Strains for Terminal Illness

Medical cannabis a versatile and natural therapy for people diagnosed with a terminal illness. The diverse health benefits of the cannabis plant address many of the common symptoms terminally ill patients face.

Here are some of the best strains of medical cannabis for terminal illness and the symptoms these strains treat:

  • Northern Lights. Northern Lights is an Indica strain of medical cannabis. Northern Lights help with many of the major symptoms that terminally ill patients experience, including pain, depression, insomnia and loss of appetite.
  • Sour Diesel. Sour Diesel is a Sativa strain of medical marijuana for terminal illness. Sour Diesel is an excellent strain for managing terminal illness symptoms like pain, depression, fatigue and loss of appetite.
  • Sunset Sherbet. Sunset Sherbet is a hybrid strain of cannabis, meaning it’s crossed between the Sativa and Indica strains. Sunset Sherbet helps relieve terminal illness symptoms like nausea, pain, insomnia and depression.

There are countless different strains that can offer relief for terminal illness symptoms. Be sure to consult your local dispensary experts for more information on choosing the right strain for you.

Best Cannabis Uses for Terminal Illness

If you’re planning to use medicinal marijuana to treat your terminal illness symptoms, then it’s important to decide how you’ll consume it. You have a few different options. Here are some of the options for consuming medical cannabis for terminal illness:

  • Inhalation. Smoking marijuana, or inhaling it, is likely the most common method of use for medical cannabis. In addition to being easy and convenient, inhaling marijuana also provides fast-acting relief. For people suffering from chronic pain or depression, this is an important consideration.
  • Edibles. Another option for consuming medical cannabis for a terminal illness is to take it orally. This can be done through a cannabis-infused edible product such as chocolate. While taking cannabis orally delays the effects, it is a much longer-lasting effect than inhaling marijuana. Additionally, many patients prefer edible products over smoking because it doesn’t cause respiratory problems.
  • Drinkables. Drinkable cannabis products are another great innovation when it comes to methods of consuming medical marijuana. Drinkables are cannabis-infused drinks that are easy and convenient to use. Drinkables some in soda-like products, or you can brew cannabis tea. Like edibles, the effects from drinkable cannabis products tend to be stronger and longer-lasting.

Cannabis Side Effects and Precautions

Medical marijuana for terminal illness is generally very safe to use. There are limited side effects for most people who consume medicinal cannabis products. Some patients who are suffering major depression because of their terminal illness diagnosis may be concerned that marijuana products may heighten their depression symptoms. However, there is no research to suggest that prescribed medical marijuana can harm the terminally ill.

Additionally, marijuana does not interact negatively with other end-of-life treatments. No amount of it will result in fatal overdose. Further research is necessary to see if these trends in medical marijuana use hold true. However, its use for terminal illness is promising thus far.

If you’re planning to take medical cannabis for terminal illness symptoms, it’s important to follow the dosage instructions exactly as prescribed. For many people, the effects of marijuana make take a while to kick in. This is why it’s important to start with a small dose and gradually build from there.

Medical cannabis is a safe, alternative remedy for treating many of the terrible symptoms associated with terminal illness. If you or someone you love has been diagnosed with a terminal illness and would like to learn more about medical cannabis as an alternative treatment option, make an appointment with a local, qualified physician through MarijuanaDoctors.com today or sign up for our newsletter.

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