More palliative care patients should get medical marijuana: doctors
Published Monday, February 15, 2016 10:00PM EST
Last Updated Tuesday, February 16, 2016 12:21AM EST
Canada is in the midst of drawing up guidelines for end-of-life care, but some doctors believe that the medical system isn't doing enough to offer high-quality pain relief to patients, including the option to use medical marijuana.
Though researchers are learning that cannabis can offer many benefits in pain relief, less than 10 per cent of palliative care patients are able to access the drug, in part because of outdated restrictions that make it hard to access, some doctors say.
- College of Family Physicians of Canada guidance on authorizing cannabis for chronic pain or anxiety (pdf)
Fulvia Mrusek is one patient who is able to use medical marijuana. The 66-year-old Woodbridge, Ont., resident recently learned she has Stage 4 lung cancer that has spread to her bones, despite the fact that she never smoked.
She turned to medical marijuana because the cancer was causing her tremendous pain.
“It felt like the lightning bolts were crossing my back. It would take my breath away,” she said.
When a palliative care doctor suggested to Mrusek she try using medical marijuana in a vapourizer, she admits she was at first skeptical. It fact, the first few times she tried it, it didn’t work for her. But after five attempts, it finally worked.
“I am glad I stuck with it,” she says.
Mrusek now uses marijuana daily at home and says it has given her back her mobility. But not all palliative care patients are as lucky. Mrusek can get marijuana because she is living at home. If she were in a hospital or hospice, it would be a very different story.
Palliative care patients in most hospitals or hospices still can't use medical marijuana because very few facilities have policies for its use. It can’t easily be prescribed or dispensed because it is not a drug with DIN number. And there are questions about how to use it.
Smoking marijuana is not an option in hospitals or hospices, since such facilities have no-smoking policies. Most also have not yet developed policies on the use of vapourizers or oil.
As one hospital official told CTV News, medical marijuana use in the hospital setting or in palliative units “isn’t even on the radar.”
Dr. Vincent Maida, a wound care and palliative care specialist in Toronto says most hospitals in Canada don’t have plans to begin administering medical marijuana. Instead, they rely on narcotic drugs such as oxycontin, morphine and fentanyl -- drugs that carry harsh side effects including drowsiness and constipation. These drugs are also often misused or end up on the streets, causing untold damage, said Maida.
He says there remains a significant amount of stigma and fear mongering over medical marijuana. That’s despite recent research that has shown that adding medical marijuana to a palliative pain care plan can cut the need for medication -- while also improving appetite and reducing anxiety.
Dr. Paul Daeninck, a palliative medicine consultant with Cancer Care Manitoba in Winnipeg, says marijuana’s effects on increasing appetite is what makes the drug ideal for advanced cancer patients.
He says many Canadians have already used cannabis and know of its pain-relieving properties and are surprised to learn they can’t use the drug when entering palliative facilities.
“I don’t think there are a large number of palliative care physicians who have the knowledge (about medical marijuana) who are open to sitting down and discussing it with patients,” he said.
He says that has to change, because patients should have options for dealing with pain.
“When we have patients with hard-to-treat pain, we have to look at all the modalities we have available to us. Medical cannabis is one of those. So we have to broaden our knowledge and our attempts to help these patients.”
Daeninck hopes that Canada will become a world leader in using cannabis and cannibinoids for palliative pain relief. But that will involve asking palliative care facilities to look at other ways to control the pain, in whatever form it comes in.
With a report from CTV medical specialist Avis Favaro and producer Elizabeth St. Philip