There is a worldwide growing evidence that use of cannabis-based medicines is helpful for tailoring symptom control in palliative care patients. In 2017, a German law allowed prescription of cannabis for medical use for this group of patients including THC, nabiximols, nabilone and cannabis flowers and extracts. However, the number of high quality studies on that topic is low.
This presentation focuses on the effects and safety of cannabis-based medicines in frequent symptoms occurring in a palliative care situation. Based on pharmacological and clinical studies the use of such a treatment can be recommended for a number of symptoms such as loss of appetite, pain, nausea and vomiting. For some substances the use is on-label in Germany, e.g. for chemotherapy associated nausea, when other supportive treatments have failed. Other indications are refractory cancer cachexia or spasticity in multiple sclerosis. For some other symptoms prescription is off-label but supported by single center or case studies. This includes add-on treatment of epileptic seizures, and other late stage neurological symptoms.