Avis Favaro
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able to access the drug, in part because of outdated restrictions that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.
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.
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