Cannabis continues to show results in Palliative Care

Sooner or later, all of us are going to come down with a serious illness, and if it lasts long enough, we’re going to need something to tide it over. However, even though the rise of hospice and palliative care has made the often painful experience more tolerable, the opioid epidemic has led practitioners to consider other options. That has led some of them to the cannabis farmer. However, most studies in the US don’t dare to test your average dispensary product due to federal illegality. However, a recent survey of 184 cancer patients in New York State looked into the products they procured from local dispensaries. And the results were encouraging: 85.11% found relief in at least one symptom, while only 3.72% reported any adverse effects. Considering the far less conclusive responses found in a recent New Zealand meta-analysis for the synthetic pharmaceuticals, that’s encouraging news for medical cannabis programs in the US.

What The New York Paper Discovered

For this study, the patients were both registered in the New York State medical marijuana program and receiving ambulatory palliative care at SUNY-Upstate Cancer Center in Syracuse, NY. All of the patients suffered from some form of advance-stage cancer, and by the end of the study, only 53% of them were still alive. One of the more distressing discoveries was the problem of access: while all were certified, 39% never got a chance to use medical cannabis at all. However, for those who did, 48% received a reduction in pain and 44% reduced their use of opioids.

And this is with fairly limited options. Because of their condition, none were smoking flower or even consuming edibles. Vaporizing was the consumption method of choice (53%), followed by solutions (19%) and capsules (18%). Most were receiving a LOT of cannabinoids — the rule of thumb was about 470 mg of product, although exact ratios of cannabinoids were not specified. Often, patients are receiving guidance from the pharmacist as to what sort of cannabis medicine they should take and for how long they should take it. The actual products the patients are taking are not specified in the program’s records, so aside from general information on the type of product used and cannabinoid ratio (frustratingly, the paper does not specify which exact portions of the ratio are CBD or THC), it is difficult to determine which products are responsible for what sorts of relief.

But what is known is that for those people that can access a dispensary and afford the medication, the products and the care they receive does indeed help reduce some of their suffering. Moreover, authors suggested the medicine could assist in improving greater quality-of-life issues for the patients interviewed, such as reducing anxiety or improving sleep. However, a significant drawback, especially for those who never used cannabis regardless of their eligibility, was cost. Since insurance doesn’t cover medical cannabis, it’s all paid out of pocket. The paper’s authors concluded that if the patients were taking their medications as instructed by their pharmacist, the median cost would be $294.83/month.

The Problem of Access

Cannabis use by patients in palliative care is nothing new; in the book Stoned, palliative care physician David Cassarett discusses various anecdotes of patients using cannabis or even growing their own. In the case of one cancer patient suffering from rectal cancer who received benzodiazepines and morphine for free, he found that cannabis worked better. Cassarett compared him to a Vietnam vet he treated who also joked with him about using cannabis for PTSD. “Like Caleb, that veteran needed help. He’d found something that relieved his symptoms, and he needed my support.”

Most of the papers still can’t touch anything other than the FDA-approved medications already on the market — this survey was one of the first to begin to explore how state-approved products are doing, and it acknowledges that deeper work needs to be done on what products work for which people. Considering the literature that’s already been published on the established pharmaceuticals however, it appears that the New York state program may be onto something.