When a loved one is going through the process of dying, there is the question of how to make their end of their life as comfortable and pain-free as possible. This is where cannabis may come into the picture.
The medical and recreational use of cannabis in the US and Canada has grown dramatically in the past decade. In the US, all but four states allow some form of cannabis – whether CBD oil, or recreational cannabis products with THC (the part of the plant that produces a psychoactive “high” effect). In Canada, all forms of cannabis are legal for both medical and recreational use for any adult of legal age.
More studies are being conducted to better understand the medical benefits of cannabis, including its use for the end-of-life experience.
Exploring the Benefits and Risks of Cannabis for End-of-Life Care
What is Cannabis?
Cannabis refers to the dried leaves and flowers of the plants Cannabis Sativa or Cannabis Indica. The plant contains active chemicals called cannabinoids that cause drug-like effects throughout the body, including the central nervous system and immune system. There are many words used to refer to cannabis, including marijuana, which has racist roots in the US.
There is an ongoing debate among doctors, researchers, politicians, and patients about whether the “real medicine” in cannabis is CBD or THC. Chela Fiorini and Dave Coennen are coaches, advocates, and family caregivers who specialize in cannabis use for people who are fighting cancer, managing chronic conditions, living with dementia, or facing the end-of-life. Together, they wrote the book CBD for Seniors: 12 Things to Know When Trying CBD or Medicinal Cannabis to Ease Symptoms of Aging and Improve Brain Health. Fiorini and Coennen argue that “from our experience as family caregivers, the answer is both, at the right dose.”
Cannabis use and Palliative Care
Palliative care is an approach to end-of-life care that improves the quality of life of patients facing life-threatening illness and their families. If you have been with someone as they pass away, you know that the end-of-life process can often come with many discomforts– both physical and emotional. In a study by Mucke et al., researchers found that participants with terminal illness reported an increase in pain reduction, body weight and caloric intake, and a reduction of nausea and vomiting after consuming cannabis.
In addition to these findings, studies have shown the positive effects of cannabis for multiple other symptoms people may face at the end-of-life.
Cannabis use for End-of-Life Anxiety
End-of-life anxiety can be debilitating. While THC can often trigger an increase in anxiety for users, CBD has been found to have the opposite effect for many people. A study which treated participants who had anxiety that impacted their sleep found that 79% of patients had decreased anxiety for the length of the study. These findings suggest that cannabis could be highly beneficial for those at the end-of-life who are facing additional stressors due to their anxiety about dying.
Cannabis use for Pain During the End-of-Life
Morphine is one of the main medical interventions at the end-of-life. The chemical compound in morphine changes the brain’s response to pain and slows rapid breathing, which can ease the anxiety of someone struggling to catch their breath at the end-of-life. A 2018 study found that cannabis, specifically CBD, enhanced morphine antinociception – meaning it could work with morphine to be a much more effective pain management tool when the tolerance to morphine starts to increase over time.
“At the end of my mom’s journey living with Alzheimer’s Disease, when she was in hospice and receiving palliative care, I came across a study that found CBD helped morphine work better,” states Fiorini. “As Mom was dying, she had a terrible death-rattle, despite all the morphine she was on. I tried a few drops of 30:1, full-spectrum CBD oil (2-3mgs) between her lips and gums every hour, and it completely eased her breathing for four days, until she peacefully left us. The hospice staff has told me many times that my mom’s passing was the most peaceful they had ever witnessed.”
Cannabis use for Dementia and Memory Loss
Dementia is the persistent loss of intellectual functioning to the extent that it interferes with daily life. A common type of dementia is Alzheimer’s Disease, which is known primarily for the intensity of memory loss. Cannabis interacts with many systems in the body and brain, including the endocannabinoid system – one that is often changed due to dementia. Cannabinoids have been shown to have neuroprotective properties and may reduce neuroinflammation, which can prevent and alleviate some of the symptoms that come with dementia such as aggression, agitation, and other behavioral difficulties.
In addition, cannabis has been found to alleviate nausea, increase appetite, and increase quality of life.
How to Use Cannabis for End-of-Life Care
Unfortunately, the use of cannabis is prohibited in most retirement and assisted living facilities, which can make it difficult for people at the end of their lives to receive this kind of treatment. Luckily, there are many ways to consume cannabis that have made it easier to access, especially in regions where it is legalized.
Cannabis can be smoked as a dried flower, consumed as a candy or food item, taken in higher concentrations as a tincture, and can even be absorbed through the skin through lotions and bath bombs. Regardless of the way one is taking cannabis, it is important to stick to the “start low, go slow, keep track” process. Meaning, start with a low dose and see how you feel before consuming more, take your time, and have a way to track your response to cannabis.
Risks of Cannabis use During End-of-Life Care
There are risks to using cannabis, such as an increased heart rate, lung issues if you choose to smoke, nausea and vomiting when used in high doses, and worsened mental effects for some people.
If you live in the US, check your state laws before using cannabis, and ensure that the products you are using have regulated doses to prevent over-consumption.
Cannabis use can be beneficial in easing anxiety, managing pain, and dealing with agitation for those struggling with memory loss and other issues at the end-of-life. Like any end-of-life intervention, cannabis will not be the right choice for everyone. However, with more data showing a positive impact cannabis products may have for patients at the end-of-life, it is likely we will see an increase in cannabis use for end-of-life care.