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A Literature Review With A Therapeutic Focus
Increasingly, aging and end-of-life (EOL) populations are seeking medical cannabis (MC) for refractory symptoms and pharmaceutical reduction. This is well-documented in studies such as Hazekamp et. al. (2013) and Abuhasira et al. (2018). Additionally, a new a health care specialty focusing exclusively on cannabis for geriatric populations has been introduced by medical providers such as Eloise Theisen (2017). The therapeutic link between MC and aging populations reaches back to the earliest days of the modern MC movement. The San Francisco Buyer's club, established in 1991 under San Francisco’s Proposition P ballot initiative, primarily served adults over 70 years of age and people with AIDS. Although few formal studies of cannabis and older populations exist at this time, clinical practice guidelines and recommendations are emerging based upon anecdotal evidence gathered by health providers and patients.
Pain and discomfort experienced at death differs from pain and discomfort experienced at other times. The physiological process of dying occurs once in a lifetime and involves a unique set of mechanisms. The potential of targeting the body's own endocannabinoid system (ECS) to address persistently challenging symptoms of dying has not yet been mobilized. The time has come to begin exploring innovation in EOL symptom management using MC solutions.
Current medicines are effective for only a portion of the dying population, leaving another group without therapeutic options. Unmanageable symptoms that manifest during the dying process are most accurately understood as a "pathway" of central nervous system (CNS) dysregulation. This pathway, frequently described as the “difficult road”, is marked by terminal agitation, painful involuntary movement, seizure activity, intractable hiccups, and other symptoms that are often impossible to reverse.
Though no completed studies of MC and EOL populations exist, this tide is turning. The first ever study of MC and EOL populations is currently in progress at The Connecticut Hospice in Branford, Connecticut (Marijuana in Combination 2018). This study is approved by the U.S. Federal Government (Martin 2017) and is entitled, " Marijuana in Combination with Opioids in Palliative and Hospice Patients." The Connecticut Hospice Study aims to determine optimum THC:CBD ratios for EOL symptom management. Currently, no other formal studies or theoretical analyses of MC and EOL populations exist.