{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:59:44Z","timestamp":1787065184660,"version":"build-2736575974"},"reference-count":29,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T00:00:00Z","timestamp":1702598400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:p>Background: Opioid therapy is critical for pain relief for most hospice patients but may be limited by adverse side effects. Combining medical cannabis with opioids may help mitigate adverse effects while maintaining effective pain relief. Aim: This single-arm study investigated the impact of combined medical cannabis\/opioid therapy on pain relief, opioid dose, appetite, respiratory function, well-being, nausea, and adverse events in hospice inpatients. Design: Adult hospice inpatients using scheduled oral, parenteral, or transdermal opioids for pain were administered standardized oral medical cannabis, 40\u00a0mg CBD\/1.5\u00a0mg THC or 80\u00a0mg CBD\/3\u00a0mg THC. Descriptive statistics detailed demographic and clinical baseline characteristics, the Mann-Whitney test compared outcomes, and the longitudinal mixed effects regression model analyzed longitudinal effects of combined therapy. Setting\/Participants: Sixty-six inpatients at The Connecticut Hospital, Inc. were assessed over 996 treatment days; average age was 68.2 \u00b1 12.9\u00a0years, 90.9% were white. Cancer was the most common diagnosis. Results: The medical cannabis\/opioid combination showed a significant longitudinal reduction in pain intensity ( P = .0029) and a non-significant trend toward lower opioid doses. Well-being, appetite, nausea, and respiratory function showed non-statistically significant changes. Three patients (4.5%) experienced minor, reversible adverse events potentially related to medical cannabis. No serious or life-threatening adverse events were seen. Conclusion: Combination medical cannabis\/opioid therapy showed statistically significant pain relief and may have the potential for reducing opioid dose and mitigating opioid toxicity, offering a safe pain management alternative to opioids alone for patients in end-of-life care settings, and warrants further investigation in larger controlled trials.<\/jats:p>","DOI":"10.1177\/10499091231213359","type":"journal-article","created":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T15:30:51Z","timestamp":1702654251000},"page":"1002-1010","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Medical Marijuana for Pain Management in Hospice Care as a Complementary Approach to Scheduled Opioids: A Single Arm Study"],"prefix":"10.1177","volume":"41","author":[{"given":"Theodore","family":"Zanker","sequence":"first","affiliation":[{"name":"Department of Medicine, The Connecticut Hospice, Branford, CT, USA"},{"name":"The John D. Thompson Hospice Institute for Education, Training, and Research, Inc, Branford, CT, USA"},{"name":"Department of Psychiatry, Yale-New Haven Hospital, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9772-9495","authenticated-orcid":false,"given":"Joseph","family":"Sacco","sequence":"additional","affiliation":[{"name":"Department of Medicine, The Connecticut Hospice, Branford, CT, USA"},{"name":"The John D. Thompson Hospice Institute for Education, Training, and Research, Inc, Branford, CT, USA"},{"name":"Department of Internal Medicine, Hospice and Palliative Medicine, Yale School of Medicine, New Haven, CT, USA"},{"name":"Palliative and End-of-Life Care Education, Yale School of Medicine, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Prota","sequence":"additional","affiliation":[{"name":"The John D. Thompson Hospice Institute for Education, Training, and Research, Inc, Branford, CT, USA"},{"name":"Department of Pharmacy, The Connecticut Hospice, Inc., Branford, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Palma","sequence":"additional","affiliation":[{"name":"The John D. Thompson Hospice Institute for Education, Training, and Research, Inc, Branford, CT, USA"},{"name":"Department of Pharmacy, The Connecticut Hospice, Inc., Branford, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoung A","family":"Viola Lee","sequence":"additional","affiliation":[{"name":"Yale School of Medicine,Systems Biology Institute, New Haven, CT, USA"},{"name":"Department of Biostatistics, Yale School of Public Health, New Haven, CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruixiao Rachel","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yixuan","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Yale School of Public Health, New Haven, CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Cunningham","sequence":"additional","affiliation":[{"name":"Department of Medicine, The Connecticut Hospice, Branford, CT, USA"},{"name":"The John D. 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