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  • Gina Lucero RN

Hospice and Medical Cannabis

Updated: Mar 30, 2019

Thursday March 29, 2019

Gina Lucero RN and Marissa “Charlie”Cecco LPN


Do you have a loved one that is being placed into hospice? More and more families are researching alternatives to the typical “hospice kit” to keep their loved ones comfortable, but still providing quality of end of life care. Cannabis has been shown to be an effective alternative for hospice patients. Current studies show conclusions of a study, published online March 5 on theEuropean Journal of Internal Medicine. The analysis gives a representation of cannabis users for different types of cancers, analyzing the benefits over an observational study in Israel lasted 6 months. 2.960 patients took part on the analysis, but only 1.742 had survived through the entire period: 60% of them achieved treatment success, according to Victor Novack, MD, PhD, director of the Cannabis Clinical Research Center and Research Authority, Soroka University Medical Center, Beersheba, Israel.

Benefits of Medical Cannabis

Cannabis Lowers Stress and Anxiety, Relieves Pain and discomfort, Encourages Appetite, Relief of Spasms and Helps aid in Sleep problems, also helps to control nausea and vomiting

First hospice in the US to conduct research on cannabis and hospice patients. Connecticut Hospice Inc. in Branford first Hospice in the US to conduct research on using cannabis with hospice patients and receive federal approval https://www.thecannabist.co/2016/12/20/hospice-study-medical-marijuana-dyingpatients/69726/

How does it work?

Cannabis works on the CB1 and the Cb2 receptors in our Endocannabinoid system. These receptors respond to the Phytocannabinoids that are in the cannabis plant. They fit like a lock and key for our receptors, the result is homeostasis, pain relief, anxiety relief without the side effects of sedating narcotics. There is a synergistic affect when you use cannabis and opiates. The amount of opiates is significantly reduced when combined with cannabinoid therapy.

Once we get our card what kind of strains do we use? What do we look for?

For Pain look for strains that are like Afgan Kush, White Widow, Juicy Fruit. For Nausea look for strains that are like Sensi Star, Mango Kush, Dutch Treat. For Appetite Management look for strains that are similar to : Jillybean Gods Gift, Strawberry Cough. For Fatigue Management look for strains that are like Green Crack, Amnesia Haze, Lemon Skunk. We say look for strains similar because it is the terpene profile that you will need to look for. You won’t find the exact same strains at all dispensaries. Remember this is plant-based medicine, so you may have to try several strains to see what will work best for the hospice patient.

What is the best way to administer cannabis medicine for hospice patients?

Inhalation- Vape or flower Immediate relief, helps with nausea and vomiting Onset 5 minutes. Lasts up to 90 minutes

Topical's- salves, lotions, massage oils great for muscle aches and pains, headaches

Sublingual Tinctures- onset 12-15 minutes lasts up to 4-6 hours great for systemic relief

Capsules/Edibles- onset up to 2 hours, last 8-10 hours, great for long term coverage, systemic relief

Suppositories- Onset within 15-30 minutes lasts up to 8 hours, great for patients with intractable nausea/vomiting.

How to apply for a medical cannabis card

Applying for your medical cannabis card is easy. Download the medical cannabis patient application and the caretaker application Have the physician that cares for the hospice patient fill it out and sign it. Hand deliver or use certified mail and mail application to the DOH Card will arrive within 2 weeks Call DOH to let them know that you are a hospice patient, so they can expedite. You can also have the social worker with the hospice company you are with call to expedite. You will also want to apply for a care takers card, so your hospice patient has someone that can pick medication for them since they most likely won’t be able to get to the dispensary. Here are a few helpful tips on how you can make the process smoother

Make sure required signatures are on the application, including from the patient and certifying practitioner.

Include a current, valid copy of your New Mexico identification card or your New Mexico’s Driver’s License. Most of the incomplete applications received by the Program are due to missing or expired New Mexico identification cards or expired or missing NM Driver’s License cards.

If your practitioner has indicated medical records are included with the application, please make sure you include them with your application.

Please follow the checklist on the application to ensure all required information is submitted.

IF for some reason their doctor won’t sign off on the medical card, there are private practitioners that will sign off on the card. They do charge a fee for doing this, it could range from $80.00 to $300.00 depending on where you go. Call around and get pricing. Some of the practitioners will make house calls, so when you call ask if this is an option

Ask a Nurse NM has a great team of nurses that do consultations once you receive your medical cannabis card. They set up one on one advocacy appointments, to take you to dispensaries that has a full Nursing team. Please reach out to them when your hospice patient receives their card, as they can get you set up with a nursing care plan that best suits your patient. Initial Consultations are always free. 505-933-5345

References

Marijuana in Combination With Opioids in Palliative and Hospice Patients

https://clinicaltrials.gov/ct2/show/NCT03233633

NM DOH Medical Cannabis Program

https://nmhealth.org/about/mcp/svcs/


#cannabisandhospice #Hospice

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