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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.
As a step toward filling-in this gap of knowledge, this article will: (1) discuss the processes underpinning refractory symptoms associated with the "difficult road" at EOL, (2) explore the role of the ECS in various medical conditions that bear similarity to the “difficult road”, (3) highlight the literature associated with THC, CBD, and THCA through the lens of EOL symptom management, and (4) encapsulate what is currently known regarding the safety and cautionary issues associated with MC and EOL populations. In short, the author hopes to bring attention to the urgent need for research in this area by providing a foundational theory and summary of the topic.
Within various literary and clinical contexts, the term "EOL" is used in several different ways. For example, it might refer to a period of several years during which an individual with a chronic life limiting illness experiences a gradual and irreversible decline toward death. In the context of this article, however, "EOL" refers to a period prior to death lasting days or weeks that is marked by a significant and increasingly rapid decline toward death.