Cannabis has been used medicinally around the world for thousands of years to manage a wide variety of conditions, and through research, many of those conditions including pain, nausea, insomnia, and mood enhancement have been proven. The rapidly growing use of medicinal cannabis in the United States is leading to an increase in the number of patients asking about its use, particularly for those with terminal illnesses.

Facing end-of-life is one of the most challenging things a person will go through. It is a painful and emotional time for the patient, family members, and caregivers. End-of-life care focuses on making patients more comfortable and offers support during their final stage of life, addressing the whole person, rather than just the disease, focusing on things like pain, physical distress and emotional and spiritual issues.

Historically, end-of-life care utilizes a combination of opioids, benzodiazepines, and antipsychotic medications to help ease patients’ suffering. While often necessary, these medications come with many agonizing side effects, particularly with the higher doses typically needed to achieve relief of symptoms, leaving the patient more lethargic and more confused, with nausea, vomiting and depression. Cannabis has been shown to reduce harm and unwanted side effects when used alone or in combination with medications.

Palliative patients frequently experience a wide range of symptoms from physical discomfort and psychological disorders as well as existential and spiritual concerns. Cannabis is one of the few compounds that can help with pain, nausea, insomnia, anxiety, depression, shortness of breath, agitation and even fatigue, which are all common complaints in palliative care.

Because cannabis is still classified as a Schedule I substance, labeling cannabis as having no therapeutic benefit, hospices find it difficult to advocate for its usage without risking losing government reimbursement and support. Conflicting rules, ongoing stigma, research restrictions, and product scarcity—all resulting from a lack of awareness and education among patients and physicians—have hampered the advantages of introducing cannabis into palliative care.

However, in some states (and countries), palliative and end-of-life care are considered qualifying conditions for the prescription of medical cannabis. Family members and caregivers reported that cannabis played a beneficial and therapeutic role by reducing the need for narcotics (patients were more alert and responsive with cannabis over narcotics), nausea, anxiety and depression were also reduced, and cannabis brought a sense of calm or spiritual peace to the patient.

What do the professionals think?

A total of 310 palliative professionals including nurses, administrators and physicians from 40 different states responded to the nation’s largest survey on practice, experience and opinions regarding medical cannabis and palliative care. Regardless of legality, an overwhelming 91% indicated they would support the use of medical cannabis for hospice and palliative care.

Unfortunately, there are several barriers to the use of cannabis currently – half of the physician respondents indicated they do not write orders to certify patients for medical cannabis (normally it’s your primary physician), state legal status and concerns about efficacy and safety (due to lack of education), and hospice/insurance may not cover the cost of cannabis.