Evidence of the effectiveness of medical cannabis (MC) for symptoms experienced at the end of life, such as pain, muscle spasms, anorexia, nausea/vomiting, and cachexia, dates back thousands of years. Nevertheless, questions remain about its use in hospice, especially because MC remains illegal at the federal level. Hospices are largely funded with federal dollars which adds to the uncertainty among hospice professionals handling requests for MC.
“A Survey of Hospice Professionals Regarding Medical Cannabis Practices,” co-conducted by Marisa Todd, PharmD, BCPS, Director of Clinical Education, Enclara Pharmacia, and recently published in the online Journal of Palliative Medicine, set out to illuminate attitudes on this subject among hospice professionals across the country.
Designed to determine respondents’ comfort level with MC use in hospice, the survey examines what processes and logistics hospice programs are employing when dealing with MC, and determines what, if any, education hospice programs are providing to their staff.
At the time that this survey was conducted, plant-based cannabis was legal for medical use in 33 of 50 U.S. states and the District of Columbia. The research team tested the survey for errors and made revisions through a collaborative process. The instrument consisted of a series of multiple-choice questions with opportunities for free text commentary.
According to respondents, 91 percent support MC use for hospice patients. However, those same respondents reported that it is rare for hospice physicians to register as an MC practitioner in their practice state to issue certifications to patients and provide recommendations.
Eighty-four percent of respondents believed health care professionals would benefit from standardized protocols to better manage MC in their organizations, especially because it is common for patients or family members to inquire about MC, with 90 percent saying they have fielded questions from patients.
According to respondents, MC shows the greatest success in reducing nausea/vomiting, pain, and anxiety. Despite these benefits, for now, barriers to MC use in hospice care include discordant legal status between state and federal governments, questions about clinical efficacy and safety, lack of access, regulatory concerns, misinformation and other societal factors.
Nevertheless, hospice staff overwhelmingly support patient access to MC. Furthermore, those who practice in states where MC is not yet legal wish that it was. In order to better understand how MC could one day be commonly used in hospice, additional policies, regulations, education, and resources are needed.
If you are interested in learning more about medical marijuana and its use in hospice, view our educational webinar by clicking here.
Additionally, you can view the full Journal of Palliative Medicine article, “A Survey of Hospice Professionals Regarding Medical Cannabis Practices,” authored by Ryan C. Costantino, Natalee Felten, Marisa Todd, Terri Maxwell and Mary Lynn McPherson, here.