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Does cannabis have a place in hospice?

As Americans age, hospices are exploring new ways to bring peace and calm to the often slow and painful process of end-of-life care. In 2015, the Centers for Disease Control and Prevention reports that an estimated 1.4 million individuals on Medicare were patients in a hospice setting.

Quadrupling in size over the last 20 years, hospices are investing in creating a patient-centric approach that dismantles the perceptions of some that hospices are unfeeling institutions. From massage to aromatherapy, some hospices are adding to their existing programs to include music and integration of family into meaningful experiences. While many hospices are focused on offering a thoughtful quality of care, some end-of-life-care specialists also advocate for marijuana.

MorseLife Hospice and Palliative Care study focused on advances in hospice care identified changing attitudes regarding medical cannabis. Investigators pointed out that “87 per cent of Americans support the use of medical marijuana as a treatment option for terminally ill patients, with nearly three in five Americans (58 per cent) expressing strong support.”

The American Academy of Hospice and Palliative Medicine recently shared a video on how hospices can integrate medical marijuana into care, perhaps signalling even more acceptance of cannabis as a part of a patient’s care plan.

Pathways Home Health advocates for marijuana in hospice care. “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,” they noted.

Stuck in political limbo

While some hospice programs in the U.S. are embracing medical cannabis, others are facing uncertainty about whether or not to allow medical marijuana, even when it’s legal in their particular state. With more states either allowing or considering permitting cannabis medically and recreationally, hospices are taking an evidence-based, risk-management-forward approach to ensure that not only do they comply, but that the compliance is both legal and ethical.

Changing attitudes are allowing researchers to gain more insight and information regarding the role that cannabis and CBD can play in hospice and palliative care settings.

Published in October 2019 in the Journal of Palliative Medicine, a study gathered medical cannabis views from more than 300 palliative care professionals from over 40 U.S. states.

Study authors suggest opportunities exist to better support hospice providers and patients with education, research and policies that elevate the use of medical cannabis. /

Study authors suggest opportunities exist to better support hospice providers and patients with education, research and policies that elevate the use of medical cannabis. / PHOTO BY HIGHGRADEROOTS / ISTOCK / GETTY IMAGES PLUS

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 medical cannabis is appropriate for hospice patients to have access to and use, investigators concluded.

Citing barriers such as legal status, clinical safety and societal influence, study authors nonetheless suggest 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 some clinicians and doctors looking to supplement old pain medicines with newer treatments, cannabis could remain top of mind for years to come.

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