Medical cannabis across the supportive care continuum: complements and alternatives for hospice and palliative care

This project explores the role of cannabis in supportive care. Looking at both samples of terminal patients and non-terminal cancer patients in the Illinois Medical Cannabis Program (n = 4,066), we examined their intentions for hospice entry, their use of hospice and palliative care services, their reports on a range of self-reported outcomes, the role of cannabis as an alternative or complement to prescription opioids, and the differences in pain symptom severity for palliative care patients using cannabis. The results of these studies show that cannabis is an option for patients at EOL and can operate as either a complement (used in addition to) or alternative (used in place of) to supportive care like hospice or palliation, or to prescription opioid medications. Patients near EOL in our sample are overwhelmingly using cannabis as an alternative to supportive care, regardless of whether or not they are planning for hospice enrollment. Cancer patients using opioids with gastrointestinal issues have strong associations with complementary cannabis use in palliative care and often report positive cannabis use experiences, attributing self-reported improvements to cannabis use. We also found that cannabis is operating as an effective alternative to prescription opioids for many patients, regardless of their engagement in supportive care services. There is evidence of positive associations between concurrent use of cannabis and opioids and the management of a range of symptoms, including gastrointestinal issues. The results show cannabis is an option for persons with terminal illness and has become a therapeutic complement for individuals who have enrolled in palliative care used at higher levels of pain.