Cannabis in Palliative Medicine: Improving Care and Reducing Opioid-Related Morbidity

@article{Carter2011CannabisIP,
  title={Cannabis in Palliative Medicine: Improving Care and Reducing Opioid-Related Morbidity},
  author={Gregory T Carter and Aaron M. Flanagan and Mitch Earleywine and Donald I. Abrams and Sunil Kumar Aggarwal and Lester Grinspoon},
  journal={American Journal of Hospice and Palliative Medicine{\textregistered}},
  year={2011},
  volume={28},
  pages={297 - 303}
}
Unlike hospice, long-term drug safety is an important issue in palliative medicine. Opioids may produce significant morbidity. Cannabis is a safer alternative with broad applicability for palliative care. Yet the Drug Enforcement Agency (DEA) classifies cannabis as Schedule I (dangerous, without medical uses). Dronabinol, a Schedule III prescription drug, is 100% tetrahydrocannabinol (THC), the most psychoactive ingredient in cannabis. Cannabis contains 20% THC or less but has other therapeutic… 
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The results suggest that cannabis is largely an alternative to palliative care for terminal patients, and is a therapeutic complement used at higher levels of pain.
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Physicians who treat neuropathic pain with opioids should evaluate their patients for a trial of cannabis and prescribe it when appropriate prior to using opioids, to reduce the morbidity and mortality rates associated with prescription pain medications.
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Early patterns of tetrahydrocannabinol and cannabidiol use in Florida following passage of the state’s first medical marijuana law are described to describe the perceived benefits, side effects, and beliefs expressed by patients in a single outpatient academic palliative medicine practice.
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Very low quality evidence suggests that oromucosal nabiximols and THC have no effect on pain, sleep problems and opioid consumption in patients with cancer pain with insufficient pain relief from opioids.
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This patient has legitimate pain and still deserves treatment despite being at high risk for substance abuse, and medicinal cannabis can be considered a legitimate next treatment step, much preferred to a prescription for opioids.
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Marijuana has a range of adverse health effects, particularly relating to young people because of higher risk for psychosis, traffic accidents, and cognitive impairment, and there are more considerations about its ability to treat a number of diseases.
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TLDR
Across 33 countries, 57 articles were identified demonstrating that cannabinoids enhance opioid analgesia while reducing tolerance and dependence, and interrupt dependence on cocaine, alcohol, and nicotine, and can be vaporized or eaten to reduce harms associated with smoking.
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TLDR
The most robust evidence suggests that medical cannabis may be effective in the treatment of chemotherapy-induced nausea and vomiting, seizure disorders, MS-related spasticity, and pain (excluding diabetic neuropathy).
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