There are mixed views in research concerning the use of controlled substances (marijuana, heroin, and other hallucinogens) in the treatment of terminally ill cancer patients. The purpose of this paper is to present a general discussion of the use of drugs in the area of pain control for cancer patients and, in particular, the use of marijuana and heroin for relief in the terminally ill.
In general, drugs are used in the final stages of cancer to treat pain and to ameliorate other symptoms that may occur in cancer patients. Common analgesics available currently in the care of cancer patients are Pethidine, Buprenorphine, morphine, methadone, codeine, and dextropropoxypheae, all legal drugs in the United States. They are classified as opoid analgesics and synthetic opoid analgesics, administered in varying degrees for the purpose of helping the patient to manage pain associated with cancer. These drugs are generally effective, although at times they are accompanied by the unpleasant side effects of nausea, drowsiness, confusion, dizziness, and constipation (World Health Organization, 1986, 55-65). Methadone is generally not used in elderly patients, those with confusion, or those with significant respiratory, hepatic, or renal failure.
Apparently, there is controversy in the medical field regarding the concepts of physical addiction and dependence. For the purposes of definition, physical dependence is characterized by withdrawal symptoms if treatment is stopped abruptly. Tolerance is characterized by decreasing efficacy with repeated administration, and it may lead to required increases in dosage. Addiction is characterized by "drug-seeking behavior"--focusing on actions to get the drug, lying, and attempts to control the source of the drug. There are also differences between physical dependence and psychological dependence.
Sometimes doctors and nurses become unduly anxious about patients' dependence and use inade...