So, where does medical cannabis fit into this discussion, and what potential does it show for those in hospice and palliative care?
That's what we are here to explore, but first...
What is palliative care, and how does it differ from hospice care?
Often confused with hospice care, palliative care is an approach to healthcare that focuses on improving the quality of life for patients and their families facing serious or life-limiting illnesses, not just terminal diagnosis.
Unlike hospice care, which primarily serves those in the last months of their lives, palliative care can be introduced at any stage of illness to provide relief from chronic pain, anxiety, and a number of other distressing symptoms that often go hand in hand with serious health conditions.
A holistic approach
Palliative care doesn't only focus on the physically distressing symptoms of illness, but also addresses emotional, social, and spiritual needs.
And that makes perfect sense.
When confronted with a serious or life-limiting illness, the impact on your emotional and social well-being can be just as significant as physical symptoms.
That's where hospice care comes in.
The role of hospice care
Hospice care is a form of palliative care that focuses on providing comfort and support to those with terminal illnesses in their final months of life.
The goal is to help patients live as comfortably and fully as possible, surrounded by loved ones, during their last few months. Hospice care also offers support to family members and caregivers during this difficult time, and can often continue to provide bereavement support after the patient's passing.
What challenges do palliative care patients face in symptom management?
Apart from the physical symptoms of chronic, incurable diseases, patients also face a heavy mental burden. Dealing with the realities of declining health, managing pain and discomfort, and facing end-of-life decisions can all take a toll on a person's mental well-being.
Pain management
Pain is often the most noticeable symptom in palliative care patients. It can be caused by the illness itself or as a result of treatments such as chemotherapy or surgery. Pain not only affects a person's physical comfort but can also have a significant impact on their mental health, leading to anxiety and depression.
Nausea and vomiting
Nausea and vomiting are not uncommon for those with life-limiting illnesses, especially for patients undergoing certain conventional treatments that may cause these side effects. Being unable to eat, sleep, take medication, or even continue treatment can take a huge toll on a patient's quality of life, disrupting their daily routine and causing further distress.
Mental health challenges
Accepting that one has a terminal illness, facing end-of-life decisions, and dealing with the physical symptoms can all be emotionally and mentally draining for patients. Rates of anxiety and depression are unsurprisingly higher among palliative care patients, which only adds to the overall distress of their situation.
Sleep issues
Getting enough restful sleep can be a challenge for patients with serious illnesses, and not getting enough quality sleep can worsen other symptoms. This can lead to a vicious cycle of pain, discomfort, and then more lack of sleep, further affecting a patient's overall well-being.
Can medical cannabis help?
While medical cannabis can help provide a certain level of relief from many of the symptoms faced by palliative care patients, it is not a 'magic cure'.
Cannabis-based medications can be beneficial for some patients, as they offer a natural and effective alternative to traditional medications, but this needs to be approached on a case-by-case basis and under the guidance of a palliative care specialist.
An expert opinion
Releaf's palliative care and substance abuse specialist, Dr Edith Israel, has worked with palliative care patients for just shy of two decades, in both NHS settings and private care hospices. We caught up with Dr Israel and asked for her thoughts on the potential benefits of medical cannabis for palliative care patients.
Dr Israel told us:
"The legalisation of medical cannabis and the emerging science backing up its application in clinical settings has increased the potential for cannabis-based therapy to play an important role for some patients receiving palliative care.
I have seen the impact that cannabis-based medicines can have on helping with pain, nausea, appetite, and even sleep. It is a very versatile medication that may offer relief to patients in their most difficult and vulnerable times, especially when conventional pharmaceuticals are ineffective.
While there are some concerns in terms of governance issues and policies, the changing landscape around medical cannabis means that we can work with patients to explore the potential benefits carefully and sensitively."
What does the research say?
- For pain, there is an abundance of evidence pointing towards the effectiveness of medical cannabis in providing pain relief. A 2022 review of previous clinical trials found that of "984 chronic pain patients, including those with neuropathic pain, back pain, arthritis, post-surgical pain, headaches, and abdominal pain, two-thirds of patients reported pain relief as the main benefit of marijuana use".
- Medical cannabis is a recognised treatment for reducing nausea and stimulating appetite. This systematic review examined the effects of THC on reducing vomiting and nausea in patients with cancer, concluding "THC treatment started two hours before each antineoplastic treatment and was continued every 6 hrs for 24 hours. Vomiting was completely prevented. The side effects observed were negligible."
- In terms of easing the burden of mental health issues, this 2017 review found "low doses of THC appear to reduce anxiety, while higher THC doses may cause increased anxiety", while "CBD appears to decrease anxiety at all doses that have been tested".
- Sleep issues can also be reduced with the introduction of medical cannabis into a treatment plan. This 2022 retrospective chart review, while only small in scale with 38 participants, found that "71% reported a subjective improvement in their sleep or related condition".
The Releaf Palliative Care Scheme
With all of the above in mind and World Hospice and Palliative Care Day upon us, Releaf is thrilled to announce our Palliative Care Scheme.
This initiative aims to provide palliative care patients with priority access to compassionate and expert care from our medical cannabis specialists, at a reduced financial cost.
How does the scheme work?
- Patients interested in signing up with Releaf under the Palliative Care Scheme first need to head to our fast and free medical cannabis eligibility checker. It takes less than one minute to complete and will help assess if medical cannabis may be a suitable treatment option.
- Once completed, eligible patients will be prompted to create an account with Releaf and to book an initial consultation with our palliative care specialist.
- After palliative care patients book their initial consultation, they can contact the Patient Support Team at +44 20 4525 8421 for a full refund.
- Palliative care patients receive priority care with a dedicated Patient Support team member assigned to their case and access to a dedicated palliative care patient support phone number and email inbox.
- Palliative care patients also receive priority on prescription processing and delivery.
Final thoughts
With research into medical cannabis ever-expanding and real patient success stories backing up the emerging science, it's clear that medical cannabis has the potential to greatly improve the quality of life of those in palliative care.
It's not a 'one size fits all' fix or a substitute for traditional treatments, it's worth considering if you're dealing with pain, nausea, appetite, sleep issues, or mental health concerns during your palliative care journey.
Releaf's Palliative Care Scheme is all about offering compassionate and expert support during tough times. We're providing access to a natural alternative that shows promise in easing symptoms linked to palliative care. We hope this initiative can positively impact the lives of patients in palliative and hospice care, along with their loved ones and caregivers.
If you are looking for more answers to the more frequently asked questions, we have an extensive blog and education hub to explore, both filled with resources that UK medical cannabis patients, prescribers, and educators have been asking for.