Can Cannabis Help Alleviate Symptoms of Terminal Illness?

Numerous studies have found that cannabis, or marijuana, can be effective in managing symptoms of loss of appetite, nausea, and pain in patients with terminal illnesses such as cancer. These benefits are largely achieved through the active compounds in cannabis, such as tetrahydrocannabinol (THC) and cannabidiol (CBD), which can provide a variety of therapeutic effects in the body. A wide range of available strains and types of cannabis results in different amounts and active compounds present in the plant itself, which can influence the effects experienced after intake. 

Opioids and other strong medications are often prescribed for pain management in patients with cancer, but sometimes result in problematic side effects such as constipation and, rarely, respiratory depression. While these side effects can be effectively managed by a knowledgeable care team, promising findings from a recent study showed that augmenting these medications with cannabis enhanced pain management while also reducing the amount of opioids needed. Constipation was also relieved due to the lower dose of opiates. Some studies have also suggested that THC and CBD can slow the growth of or destroy certain types of cancer cells in the laboratory, although these options are not approved for the management of cancer. 

Cannabis has also been used to ease existential and spiritual suffering at the end of life. Terminal illness can cause intense feelings of sorrow, hopelessness or anxiety. In some individuals, cannabis use can produce a sense of calm or euphoria which temporarily eases this emotional suffering. However, both the dosage and chemical makeup of cannabis compounds is an important consideration in this regard. Higher concentrations of THC, in particular, can actually increase anxiety in sensitive individuals, so care should be taken to ensure that the person receives an appropriate dose. 

Although ongoing research includes many promising findings regarding the use of cannabis in patients with terminal illnesses, there are still concerns about its use. For example, FDA-approved cannabinoid drugs such as Dronabinol and Nabilone provide many of the benefits discussed here, but may cause side effects such as increased heart rate, dizziness, fainting, or the worsening of anxiety or depression in some individuals. Additionally, while 38 states and the District of Columbia have legalized the use of medically approved cannabis, the federal government still designates cannabis as a Schedule I drug with “no medically acceptable use and a high potential for abuse” thus limiting the ability of federally funded research into its benefits and risks. 

Sources

“Marijuana and Cancer”. American Cancer Society. https://www.cancer.gov/about-cancer/treatment/cam/patient/cannabis-pdq

“Medicinal Cannabis Can Safely Relieve Cancer Pain and Curb Total Meds Use”. BMJ. https://www.bmj.com/company/newsroom/medicinal-cannabis-can-safely-relieve-cancer-pain-and-curb-total-meds-and-opioid-use/

“Anxiety and Cannabis, A Review of Recent Research: April 2023”. Drexel University Medical Cannabis Research Center. https://drexel.edu/cannabis-research/research/research-highlights/2023/April/anxiety_cannabis_fact_sheet/ 

Pathways: “Is Medical Marijuana Beneficial For End of Life Care?” Pathways Health.https://pathwayshealth.org/is-medical-marijuana-beneficial-for-end-of-life-care/ 

“State Medical Cannabis Laws”. National Conference of State Legislatures.  https://www.ncsl.org/health/state-medical-cannabis-laws