In 2013, after her mother, Myriam, was diagnosed with brain cancer, Diana Peña, a makeup artist and hairstylist in Rancho Cucamonga, began researching whether cannabis could help. Doctors had given Myriam a prognosis of three months to live, Peña said, and there was “not a whole lot they could do” except extend her life a bit. But with cannabis treatments, Peña said her mom outlived expectations by more than a year, with a better quality of life than she could have expected without it.



The experience changed the course of Peña’s life. In December 2013 she co-founded Myriam’s Hope, a medical marijuana collective with an emphasis on serving very ill people. The organization offers a menu of cannabis oils and edibles that Peña says are of a higher quality than those available elsewhere. Myriam’s Hope has grown to serve approximately 3,000 patients, Peña said.



Stories of medical successes like Peña’s are common among people who work with cannabis. But the question of which serious illnesses medical marijuana actually treats remains largely unanswered.



According to the National Cancer Institute, some of the chemicals found in pot have demonstrated “anti-tumor activity” in animal testing, but the extent to which they might shrink or destroy human tumors is not well understood. Much more widely accepted is that the drug can help with relieving pain and other symptoms associated with cancer and other serious illnesses. It’s common for patients on chemotherapy to find that marijuana suppresses their nausea and improves their appetite. Some patients with severe pain use cannabis as an alternative to opioids and their undesirable side effects.



This brings up very interesting questions about what cannabis can offer the sickest, most heavily medicated patients, those in hospice care. But so far there are few good answers.



The National Hospice and Palliative Care Organization doesn’t have a position on cannabis use by patients, instead leaving it up to the doctor. “I would imagine different physicians would come down differently on the issue depending on their experiencing using this — and, of course, whether it would be legally available,” a spokesman wrote in an email.



As with most things involving medical marijuana, good data is hard to come by. But a January study in the journal Gerontologist found that cannabis “may be an effective substitute for prescription opioids and other misused medications;” as well as “an alternative for the undertreatment of pain at the end of life.”



With legalization, seniors have become the fastest-growing group of marijuana users in the country. Retirees have time on their hands and they don’t have to worry about being drug-tested at work. Many have found that they prefer cannabis to opiates and some of the other pharmaceuticals they take.



But this new market doesn’t necessarily extend to only the oldest and sickest patients. The Woodstock generation is now in its 60s and 70s, but Americans in their 80s and 90s are less likely to associate weed with fond memories of their youth, and are the age group most likely to oppose legalization.



For these patients, the stigma surrounding the drug and their physical limitations may prevent them from accessing it. While Californians voted to legalize medical marijuana in 1996, it’s not available in hospitals or old-age homes, meaning patients depend on friends and family, whom they might be uncomfortable to ask.



In some facilities, patients “have to either hide it or go home,” Peña said, especially those organizations scared of losing federal funds. “I've talked to other patients where the nurses are OK with it.” Some nurses, she said, will even administer it. (Others familiar with the issue say similar things.)



In the years since she started Myriam’s Hope, however, Peña said she has seen the mainstream begin to take cannabis more seriously. With more than half the states endorsing marijuana’s value as a medicine for patients with terminal illnesses, Peña said it “has to be a closed-minded doctor who doesn't want to see this is helpful for patients.”

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