This is the third portion of a lightly edited transcript of remarks on Palliative Care I delivered at The Westin Bayshore on July 10, 2016 in Vancouver, B.C. as part of the Cannabis Hemp Conference. See here for part 1 and here for part 2.
The second cluster that cannabis is effective for, and it can be effective for, is in palliation of spiritual and existential suffering. And this is certainly an area that crosses borders with a lot of the issues that this conference is focused on around spirituality and health. And these issues are very [important]. They're not just a sort of theoretical extra layer thinking in palliative care. These are sometimes the most important issue that you have to address to relieve other symptoms. Spiritual distress can sometimes manifest as untreated severe physical pain or severe anxiety. And [by] not talking about issues around end-of-life and mortality, you're not going to be able to serve that patient or that family.
And I think everyone here will know what the benefits [are] that cannabis could provide: euphoria, aversive memory extinction, sensorium enhancement, and spiritual insight catalysis. Those could play a very important therapeutic role for patients who have faced severe,multiple traumatic treatments such as radiation, chemotherapy, surgery—all the things that happen when people are still doing aggressive care, at the end of…when they're facing serious illnesses,when they're facing their own mortalities.
I think there was a very nice quote—I'll have to close here soon—there's a really great quote from William O’Shaughnessy who was the doctor who first described cannabis to Western medicine in the 1830s when he was working as a surgeon for the British in Calcutta. And he had treated a gentleman who had rabies that had spread to his nervous system, and so that patient could not swallow or drink anything without having severe vomiting episodes. And so O'Shaughnessy started giving him a few milligrams of a basically a cannabis extract capsule every couple of hours when he came to his chamber and he described how this guy, who had been completely dehydrated, completely was suffering, started to eat some orange peels,some juice, some food, and started to kind of calm down and relax. And he ultimately died in his ward in his clinic. And I think this is a first example of a modern hospice treatment for a patient with kind of a dosed approach of cannabis. And he said:“It seems evident that at least one advantage was gained from the use of the remedy: the awful malady was stripped of its horrors. If not less fatal than before, it was reduced to less than the scale of suffering which precedes death from most ordinary diseases. Next to cure, the physician will perhaps esteem the means which enable him to ‘strew the path to the tomb with flowers’ and to divest of its specific terrors the most dreadful malady to which mankind is exposed.”
I would say maladies—there's multiple maladies like this now. But this writing just showed to you the eloquence of these nineteenth-century physicians who understood that a great benefit to provide people relief when they're facing such severe symptoms. And if Cannabis can do something for that, my Goodness, what are we doing? We have to have emergency access.
The final area is experimental use of Cannabis for, as they said ‘Hail Mary’s’. And we need clinics where Cannabis can be experimentally administered under hopefully medical guidance because patients like that have multiple medical issues that need to be[addressed]. They need to be partnered with. And I would love to see those kind of regulations take place where cannabis and medical health professionals can be in the same room with the patient, and help them, guide them in that and a dosing strategy and use, and follow those markers over time and not put that burden on patients, because that's a violation of their right to health.