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The Australian government has long realised the importance of palliative care. Since 1999, the national government’s Palliative Care Program has delivered over $100 million of quality enhancement benefits [1].  

 Some of the allocations made for enhancing the quality of Australian palliative care were distributed to national benchmarking, local service improvements, clinical research, education of would-be medical practitioners, education of patients, initiatives to reach out to the minorities, and so on.    

 Palliative care is such an important branch of medical care that it’s a qualifying condition to access restricted medicinal options such as opioids and cannabis.  

 What is palliative care? 

 According to the World Health Organization or WHO, palliative care is “an approach that improves the quality of life of patients and their families facing the problems associated with a life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual [2].”  

 To be concise, palliative care refers to “end-of-life care.” However, the patient who receives such care does not always necessarily mean that he is nearing death. Regardless of the condition, palliative care always strives to elevate the patient’s quality of life which often means bending some medical rules to fulfil a patient’s dying wish or to make the patient more comfortable. 

 Unheard of things such as having a quartet play for 24 hours inside the room can be granted as part of palliative care. Some patients would request alternative medications such as medical cannabis to ease their pain and their other complaints.  

 Regarding medications used, anti-rheumatic and anti-inflammatory (54%)were the most prescribed drug type, followed by analgesics (35.4%) and drugs for constipation (6.8%) [7]. 

 Australia authorises the use of prescriptive medical cannabis for palliative care under current access schemes even if the matter’s evidence-based research is yet to be completed [3].  

Using medical cannabis in palliative care 

 Cannabis is considered for palliative care because of several reasons, but perhaps the most significant reason is the plant’s compounds and their potential effects on the human body.  

 Some clinical trials suggest that cannabis’s cannabinoids, tetrahydrocannabinol (THC) and cannabidiol (CBD) have several decent efficacies for a number of symptoms associated with palliative care such as pain, chemotherapy side effects, loss of appetite, weight loss, and AIDS (acquired immunodeficiency syndrome) [4]. 

 However, it is recommended that future large-scale studies should be conducted before any conclusions are made on the status of cannabis as a standard medicine for palliative care.  

Here are two of the landmark studies on cannabis for palliative care: 

1. Multicenter, double-blind, randomized, placebo-controlled, parallel-group study on the efficacy, safety, and tolerability of THC: CBD extract and THC extract in patients with intractable cancer-related pain  

 The study compared the effects between a THC and CBD extract combination with a THC extract and a placebo for treating pain in patients with advanced cancer. The results suggest that the combination of THC and CBD extracts performed better in reducing pain by 30% compared to placebo and the sole treatment of THC [5].  

 2. Cannabis and cancer chemotherapy: a comparison of oral delta-9-THC and prochlorperazine 

 This study which uses the double-blind method, compared the effects elicited by THC and the traditional prochlorperazine medication for post-chemotherapy effects (nausea and vomiting).  

Among the 214 patients tested, the results show that both THC and prochlorperazine effectively reduced chemotherapy-induced nausea and vomiting within a wide range of tumour types [6].  

 Much of what cannabis can offer for palliative care is the idea that it’s an option, readily available when a patient needs it. Cannabis might not be suitable for each type of biochemistry. Still, the idea that it could provide comfort to others is a highly regarded form of a contribution to Australia’s palliative healthcare system.  

CanView does not endorse the use of Medicinal Cannabis without lawful prescription. Just like any Medicine, Medicinal Cannabis may have both positive and negative side effects on the user, and should only be prescribed to patients by a Health Professional with the authority and expertise to do so. The information provided by CanView is for informational and educational purposes, and is of a general nature. If you are interested in accessing Medicinal Cannabis please talk to your doctor and request a referral to a Medicinal Cannabis clinic.  

Endnotes: 

 1. Mitchell, G. 2011. Palliative Care in Australia. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3241066/ 

 2. WHO. 2020. Palliative Care. Available at: https://www.who.int/news-room/fact-sheets/detail/palliative-care#:~:text=Palliative%20care%20is%20an%20approach,associated%20with%20life%2Dthreatening%20illness. 

 3. Australian Government| Department of Health. 2017. Guidance for the use of medicinal cannabis in the treatment of palliative care patients in Australia. Available at: https://www.tga.gov.au/publication/guidance-use-medicinal-cannabis-treatment-palliative-care-patients-australia 

 4. Green Choices. N.D. Medical cannabis as a treatment option for palliative care. Available at: https://www.greenchoices.com.au/conditions/palliative-care 

 5. Johnson, J. et al. 2009. Multicenter, double-blind, randomized, placebo-controlled, parallel-group study on the efficacy, safety, and tolerability of THC: CBD extract and THC extract in patients with intractable cancer-related pain. Available at: https://pubmed.ncbi.nlm.nih.gov/19896326/ 

 6. J T Ungerleider, et al. 1982. Cannabis and cancer chemotherapy: a comparison of oral delta-9-THC and prochlorperazine. Available at: https://pubmed.ncbi.nlm.nih.gov/6284334/ 

 7. Palliative care-related medications. Available at: https://www.aihw.gov.au/reports/palliative-care-services-in-australia/palliative-care-services-in-australia/contents/palliative-care-related-medications