The Compassionate Role of Cannabinoids

Dear Green Nurse,

I just saw your podcast on Palliative Care, Hospice and End of Life. Can you please explain to me your experience in working with these types of patients and how cannabis may be helpful.

Sincerely ,
Reflecting on Compassion

Dear Reflecting.

As a palliative care and former hospice nurse, I’ve had the profound privilege of supporting patients and their families through some of life’s most vulnerable and sacred moments. In that time, I witnessed firsthand the transformative potential of plant medicines—not only in alleviating physical symptoms but also in fostering peace, dignity, and even moments of joy during the final chapter of life.

The first hospice patient I supported in using cannabis as medicine was a middle-aged man diagnosed with Stage IV lung cancer in 2017. We were introduced after I gave a presentation on the use of cannabinoids for end-of-life care at a hospice facility. He was in unbearable pain, overwhelmed by discomfort despite being ready to let go. Desperate for better pain relief, he was on over 100mg of morphine daily in divided doses, yet it barely made a difference. His condition was dire—he had a tracheostomy for airway management, a feeding tube for nutrition, and was severely cachectic, unable to eat.

A generous community of caregivers donated a high-dose THC Full Extract Cannabis Oil (FECO) for him, and I was invited to guide him and his care team on its use. Sitting with him, his hospice nurse, and his social worker, I spent over 90 minutes educating them about cannabis oil, its properties, and its application. When he took his first rice-grain-sized dose of high-THC FECO oil, we waited together to see its effects.

When it finally took effect, the transformation was profound. He looked at me, tears in his eyes, and smiled—a moment of relief after enduring so much suffering. Almost immediately, he went to the fridge, retrieved an Ensure, and fed himself through his G-tube. The oil’s impact was that swift and significant.

I taught him how to properly dose the FECO oil twice a day, and in the two weeks that followed, his quality of life improved noticeably for someone who was actively dying. He was able to host friends to say goodbye and, most importantly, experienced a peaceful passing with effective pain management. His sister later expressed her gratitude, sharing how much it meant to her that his final days were marked by minimal suffering and dignity.

This experience not only underscored the potential of cannabinoids in end-of-life care but also highlighted the importance of compassionate, personalized support for patients in their final chapter.

The blog below “The Compassionate Role of Cannabinoids in Palliative, Hospice, and End-of-Life Care” explores how cannabinoids can act as a powerful bridge to more compassionate and empowered endings. Beyond symptom relief, they offer emotional and spiritual support, helping individuals navigate the complexities of the dying process with greater ease and grace. In my experience as a hospice nurse, I firmly believe that cannabinoids, along with other plant-based entheogens, should be readily accessible to patients. These tools can provide not only critical physical relief but also the mental, emotional, and spiritual care so essential to holistic end-of-life support.

With You and Yours on the Journey … With Love
The Green Nurse

The Compassionate Role of Cannabinoids in Palliative, Hospice, and End-of-Life Care

As palliative and hospice care advances toward more patient-centered, integrative models, the use of cannabinoids is gaining recognition as a compassionate and effective therapeutic option. For individuals managing cancer-related symptoms, neurodegenerative diseases, or advanced chronic illnesses, cannabis provides a multidimensional approach that aligns with the core objectives of comfort, dignity, and enhanced quality of life at the end of life.

Cannabinoids such as THC, CBD, and their acidic precursors, THCA and CBDA, have shown significant potential in alleviating symptoms, offering emotional and spiritual comfort, and improving overall well-being for those facing serious or terminal illnesses. In this evolving space, the role of the Cannabis Nurse has proven invaluable—as a guide, educator, and advocate, they bridge the gap between plant-based medicine and compassionate clinical care, ensuring patients receive both informed and empathetic support.

Cannabinoids: A Natural Ally in Symptom Relief – Managing distressing symptoms such as pain, nausea, anxiety, and insomnia is a cornerstone of palliative care. Cannabinoids have shown significant promise in addressing these challenges, with a 2018 meta-analysis highlighting their effectiveness in reducing pain, stimulating appetite, and enhancing emotional well-being (Mücke et al., 2018). Unlike opioids, which often cause side effects like sedation, confusion, or respiratory depression, cannabis offers symptom relief with fewer adverse impacts—empowering patients to maintain clarity, dignity, and autonomy.

A key objective in palliative care is to alleviate suffering while preserving a patient’s quality of life. Cannabinoids, particularly delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), have demonstrated efficacy in mitigating pain, nausea, anxiety, and insomnia in terminally ill individuals (Mücke et al., 2018). Unlike conventional opioids, cannabinoids provide effective pain relief with a lower risk of respiratory depression or cognitive impairment, allowing patients to remain lucid and engaged in their care.

Research supports these benefits: a meta-analysis of randomized controlled trials found cannabinoids significantly improve pain management, appetite stimulation, and emotional health (Mücke et al., 2018). This makes them especially valuable for patients undergoing chemotherapy, managing AIDS-related wasting, or coping with advanced neurological disorders.

Cannabis Nurses play a pivotal role in integrating cannabis into palliative care. These specialized professionals are trained to assess patient needs, evaluate the risks and benefits of cannabis use, and develop tailored care plans. Guided by the Scope and Standards of Practice for Cannabis Nursing, they bring expertise in pharmacology, endocannabinoid system education, and ethical cannabis care (American Cannabis Nurses Association [ACNA], 2023). Their unique skill set ensures that cannabis is used safely and effectively to improve patients’ quality of life.

Restoring Control and Enhancing Autonomy – The loss of control is a common thread in end-of-life stories and serves as a deeply significant source of suffering during this final stage of life. Cannabis, by addressing multidimensional suffering—physical, psychological, and existential—offers patients a sense of empowerment over their care. By offering patients options beyond conventional pharmaceuticals, cannabis can restore a sense of agency. In hospice settings, patients using medical cannabis have reported improvements in pain management, mood, appetite, and sleep, which contribute to a more dignified and self-directed dying process (Barakji et al., 2023).

Furthermore, recent surveys indicate that hospice professionals are increasingly open to recommending cannabis, especially in jurisdictions where its use is legally protected (Costantino et al., 2019). As regulatory frameworks mature, this shift reflects a deeper commitment to honoring patient autonomy and culturally sensitive care.

Cannabis Nurses honor this autonomy by practicing within a shared decision-making model. They educate patients and families on product types (e.g., tinctures, edibles, vaporizers), dosing strategies, and potential interactions—empowering individuals to make informed choices aligned with their values.

Cannabis as a Spiritual and Emotional Companion – Dying is not solely a physical event—it’s deeply emotional and spiritual. Beyond the physical realm, cannabinoids may support the psycho-spiritual aspects of dying. Some patients report enhanced introspection, a greater sense of connection, and reduced existential distress when using cannabis as part of their end-of-life care (Miller, 2022). This is especially relevant in faith-based or spiritual hospice environments, where sacred plant medicine can complement contemplative practices. In this way, it aligns with the nursing standard of holistic care, addressing the mind, body, and spirit.

The integration of cannabis in hospice settings, including spiritual care discussions, reflects growing societal acceptance. A survey from MorseLife Health System (2022) revealed a surprising alignment between patients’ religious beliefs and their openness to cannabis, suggesting a shift in how people integrate medical cannabis into their ethical and spiritual frameworks.

Cannabis Nurses can guide sacred use of plant medicine, particularly in hospice settings where legacy work, grief support, and life review are central. They also assess for spiritual distress and collaborate with chaplains, therapists, and families to create meaningful rituals around cannabis use when appropriate.

Provider Perspectives and Practical Considerations – Clinicians working in palliative care have begun to recognize cannabis as an essential tool, especially for patients who have exhausted conventional therapies or prefer natural approaches (Hardy & Herbert, 2021). Despite challenges like inconsistent dosing standards, legal limitations, and insufficient provider education, growing patient demand continues to fuel innovation and exploration.

Importantly, cannabis can reduce polypharmacy by replacing or complementing medications for pain, anxiety, and sleep. This holistic reduction in pharmaceutical load can mitigate side effects and interactions, which is particularly beneficial in frail or elderly patients (da Costa & de Carvalho, 2022).

Cannabis Nursing Provides Clinical Expertise and Ethical Advocacy – Cannabis Nurses work at the intersection of science and compassion. As clinicians, they understand the complexity of polypharmacy, drug interactions, and disease-specific care. As advocates, they fight for equitable access, cultural sensitivity, and patient safety in an evolving regulatory environment.

In a 2019 survey of hospice professionals, many reported interest in integrating cannabis but cited legal ambiguity and lack of education as barriers (Costantino et al., 2019). Cannabis Nurses fill this gap. They stay current on policy changes, educate interdisciplinary teams, and help destigmatize cannabis use in vulnerable populations.

Moving Forward: A Call for Integrative Care Models – To truly honor a whole-person approach to care, providers must remain informed, curious, and adaptable to the growing body of science and the rising cultural acceptance of cannabinoids. This calls for continuous education and openness to new evidence that highlights their therapeutic potential. Palliative care programs that incorporate cannabis as an option for symptom management empower patients to find greater peace, alleviate suffering, and cultivate moments of deeper connection and meaning in their final days.

Cannabinoids present a unique opportunity to address complex symptoms such as chronic pain, nausea, anxiety, and insomnia in a manner that is often more holistic and gentler than traditional treatments. By integrating cannabis into end-of-life care, providers can offer not only symptom relief but also dignity, enabling patients to feel more in control of their final journey.

Integrating Cannabis Nursing into Palliative Care – The integration of cannabis into hospice and palliative care is no longer a theoretical concept—it is an ethical imperative. As public interest grows and clinical evidence continues to emerge, Cannabis Nurses are at the forefront, ensuring safe, effective, and personalized cannabis care. They serve as educators, caregivers, advocates, and healers, bridging the wisdom of traditional nursing with the promise of plant-based therapies.

Whether easing refractory pain, helping a patient find restful sleep, or supporting meaningful legacy conversations through gentle cannabis rituals, Cannabis Nurses play a vital role in restoring the sacredness of end-of-life care. In doing so, they not only improve outcomes but also elevate the experience of dying itself.

Embracing cannabinoids in palliative care goes beyond symptom management—it is about restoring humanity, fostering compassion, and respecting the complexity and individuality of the dying process. Elevating caregiving means aligning the latest scientific advancements with the heart and soul of what it means to truly care for someone during their last chapter.

Cannabis nurses are revolutionizing healthcare by pioneering advancements in palliative and hospice care, improving the quality of life for patients and their families. Holistic Caring and The Green Nurse, a leading organization in cannabinoid therapeutics, provides education, coaching, and consulting services to support compassionate, effective care in palliative and end-of-life settings. Bloom Hemp CBD is our Green Nurse Approved CBD partner leading with quality, safety and patient centered care. Bloom Hemp CBD is USA Organic, Doctor and Nurse formulated, Ayurvedic inspired symptom targeted formulas offering a free nurse line and free emailed care plans delivered right to your inbox.

Podcast with Dr. Bob Uslander of Empowered Endings – The Green Nurse Podcast with Dr. Bob Uslander – Cofounder & Medical Director of Empowered Endings.

References

American Cannabis Nurses Association. (2023). Cannabis nursing: Scope and standards of practice (1st ed.). American Nurses Association. https://www.nursingworld.org/nurses-books/cannabis-nursing-scope-and-standards-of-practice/

Barakji, B., Gentzler, A., & Gabbard, J. (2023). Medicinal cannabis – has it found a place in palliative care? Palliative Care & Social Practice, 17. https://doi.org/10.1177/26323524241273491

Costantino, R. C., Felten, N., Todd, M., Maxwell, T., & McPherson, M. L. (2019). A survey of hospice professionals regarding medical cannabis practices. Journal of Palliative Medicine, 22(10), 1208–1212. https://pubmed.ncbi.nlm.nih.gov/31094609/

da Costa, V., & de Carvalho, W. (2022). Use of medicinal cannabis for palliative care patients: A systematic review. Journal of Biosciences and Medicines, 10(9), 242–252. https://doi.org/10.4236/jbm.2022.109017

Hardy, J., & Herbert, A. (2021). Medicinal cannabis use in palliative care. Australian Journal of General Practice, 50(6), 345–348. https://doi.org/10.31128/AJGP-02-21-5831

Holistic Caring & The Green Nurse. Holistic Caring. https://holisticcaring.com/

Miller, B. J. (2022). An honest look at marijuana and its place in palliative care. Center to Advance Palliative Care. https://www.capc.org/blog/an-honest-look-at-marijuana-and-its-place-in-palliative-care/

MorseLife Hospice and Palliative Care. (2022). Survey: Marijuana, religion, & end-of-life care in hospice. MorseLife Health System. https://morselife.org/blog/morselife-hospice-and-palliative-care-survey-findings-reveal-attitudes-about-medical-marijuana-religion-and-end-of-life-care/

Mücke, M., Weier, M., Carter, C., Copeland, J., Degenhardt, L., Cuhls, H., Radbruch, L., Häuser, W., & Conrad, R. (2018). Systematic review and meta‐analysis of cannabinoids in palliative medicine. Journal of Cachexia, Sarcopenia and Muscle, 9(2), 220–234. https://doi.org/10.1002/jcsm.12273