A Case Series of the Role of Cannabis Based Medicine in the Palliative Care Setting
Complex refractory pain is highly prevalent in the palliative care setting. Opioid therapies play a pivotal role in pain management, but have an extensive side effect profile and frequently fail to provide sufficient relief, despite dose optimisation or concurrent use of standard adjuvant analgesics.(1) Therefore, identification of novel analgesics to alleviate pain would be very beneficial.(2)Currently, there is equipoise within the available clinical evidence of the efficacy and safety of cannabis-based medications in the management of pain.(3) This is a case series of three patients with complex pain, with inadequate pain relief with standard multimodal analgesia. Each of these patients were commenced on Sativex, an oromucosal spray composed of two cannabis extracts, delta-9- tetrahydrocannabinol and cannabidiol, and the dose was titrated until therapeutic benefit was
achieved. All three cases demonstrated a positive analgesic effect without any adverse symptoms.