Medical Marijuana for Nursing Home Patients
Ms. A is a 75-year-old patient in a 36-bed skilled nursing facility. She is there for medical issues, including dementia. A normal day for Ms. A is a waking nightmare. She is agitated, uncommunicative, resistant to eating and on a number of medication, including Seroquel, which is linked to numerous adverse effects, including some of those exhibited by Ms A.
On one particular day, Ms. A is particularly uncomfortable, yelling and agitated. In Oregon, this patient might be restrained, and will likely be given a higher dose of current medications, or additional pharmaceuticals to try to control her behavior. Fortunately for Ms. A, she lives in Tel Aviv, not Oregon.
Ms. A was a patient reported on by Zach Klein, an MSc candidate, at the Eight National Clinical Conference on Cannabis Therapeutics, which was held May 8–10, 2014 in Portland. What happened in this case was that she was administered a few puffs of smoke from a smoke machine that they had improvised. Within a few minutes, Ms. A had stopped groaning and screaming and appeared calm and relaxed. She responded to her name and even tried to speak. She even smiled for the first time in the three months she had been there.
Ms. A was part of a study to assess whether cannabis can be used as a substitute for prescribed medications for patients in a nursing home. Patient records were reviewed to determine current medical conditions, medications in use, and quality of life as perceived by staff. Cannabis was then prescribed for a variety of conditions, including agitation, tremor, spasticity, pain, Parkinson, insomnia, mood and appetite loss. Twenty-seven patients were included in the study.
After starting with the crude but effective smoking machine, methods for medicating with cannabis were expanded to include smoking, vaporizing and eating. In the case of Ms. A, she was able to gain weight and eliminate her Seroquel, along with other anti-anxiety and sedative drugs.
Overall, the study found that cannabis provided pain relief, improvement of appetite, decrease in spasticity, improved ability to eat, improved sleep and even allowed the elimination of enemas that three patients had previously required. Interestingly, the study also found improvement in other symptoms that were not explicitly being treated, including inflammation, depression, and PTSD. A total of 39 medications were discontinued in these 27 patients.
We have a long way to go in Oregon before we get to this point. A good start would be to amend the OMMP to make it easier for patients in nursing homes to use medical marijuana when recommended by a doctor. One major stumbling block is the current system, which allows only one caregiver per patient and is not conducive to such studies.
Compassionate Oregon is a fledgling organization whose mission is to advocate for medical marijuana patients. Anthony Taylor, a founder of Compassionate Oregon was instrumental in getting PTSD added to qualifying conditions. If you are interested in advocating for nursing home and other patients, check out the web site at compassionateoregon.org.