Marcie Cooper’s path to educating nurses on cannabis in hospice was cleared by a family tragedy, after her father suffered a heart attack that left him brain dead.
“I wanted to let him go, but the final say wasn’t up to me. He was weaned him off the ventilator, and put on a feeding tube,” she shared. “We watched him waste away, and I kept praying for him to be set free.”
Cooper was already in training to become a Registered Nurse, and she would go on to receive her Master of Science in Nursing; but, the experience inspired her to be a hospice nurse, eventually becoming an Advanced Holistic Nurse – Board Certified.
She couldn’t make a difference for her father, but she could help others by giving them the compassion her situation lacked.
Cooper is currently Assistant Clinical Director of a palliative and hospice center in Denver, overseeing 40 patients; as well as part-time After Hours Field Nurse on the weekends for a larger hospice with 220 patients.
Due to the sensitivity of the work she does, the names of the organizations she works for have been withheld. Though, her work is solid, with many continuing to be helped daily, the stigma keeps many medical professionals from being open about this topic.
Care at Home
St. Christopher’s Hospice in England was the first official hospice, developed and founded by Dr. Cicely Saunders in 1967, who felt that bringing the patient home for a more comfortable passing was better for both patient, family, and loved ones.
According to Psychology Today, the focus of hospice has always been on pain relief, symptom management, and comfort, not cure; with four levels of care denoted, routine, continuous, general inpatient, and respite.
Cannabis use in hospice is becoming more widely accepted, with more patients turning to the plant for its analgesic properties; allowing them to be more present than with traditional end-of-life care pharmaceuticals, such as morphine, typically prescribed for end of life care.
What this means is, more hospice nurses are learning about the benefits of cannabis, adding another layer of care for their patients—many of which are already using cannabis through their illness.
Cooper attended the University of Memphis’ Loewenberg School of Nursing, landing a job initially in the oncology unit at Baptist Memorial in Memphis.
“The hospital experience was distressing to me, and I came home crying every day,” she shared. “Lots of chemo and blood transfusions—and very little healing—too much suffering.”
After witnessing the heartache of an oncology ward, Cooper decided she needed a few more tools under her belt, and began studying holistic nursing, becoming proficient in Acudetox, essential oils, and hypnotherapy from the National Acupuncture Detoxification Association (NADA).
The hard fact that the south just wasn’t progressive had her looking west, to Colorado in 2009.
“I moved to Denver and that’s when everything changed,” she said. “I was hired to do the boring job of MDS Coordinator at the Denver North Care Center, a dual diagnosis addiction recovery center, if they let me be the Holistic Therapy Practitioner.”
At the time Colorado was already legal for cannabis as medicine, and its administrator, Tami Kendall, NHA (nursing home administrator), was thinking of creating a space for cannabis patients to medicate.
“Dual disorders mean the patient was already suffering from mental disorders when they began self-medicating with damaging and addictive drugs,” she explained. “It’s a common tale. Dr. Kendall said she’d rather they go outside and smoke a joint, than be in here having a melt-down. She got it, I wasn’t in Mississippi anymore!”
Cannabis, she found was a good tool in addiction recovery, especially in dealing with Post-Traumatic Stress Disorder (PTSD), and other emotional disorders. She ended up studying Chinese medicine, learning Accudetox, a protocol developed in the Bronx in New York in the 1980s, helpful in addiction recovery.
“With Chinese medicine we look at emotions, and the same emotions that happen with PTSD happen in recovery,” she explained. “I thought this type of therapy would also be helpful in hospice, as they deal with grief, anger, fear—the three main emotions.”
After a year working in recovery, she landed a job at the oldest and largest hospice in town, where holistic therapies were already in practice.
Just Add Cannabis
Cooper is in tears as she explains what happened next.
“I had witnessed so much suffering when I was working in the oncology unit, that it really left a mark on me,” she said. “One day, I saw a Facebook posting stating that cannabis cures cancer, and I was really angry. I’ve seen everyone from children to grandparents suffer and die from cancers, and I just couldn’t see how cannabis could help! I thought it was irresponsible to say so.”
Then she began researching and met Justin Kandor online, reading his book Cannabis Extract Report.
“Then I got really, really angry!” she exclaimed. “We have people suffering and dying everyday—I’ve lost friends and family I wish I could have helped. When I think of all the lies they’ve told us about this plant. How dare they keep this from us?”
Since coming into the cannabis space, Cooper said she has many success stories to share on how cannabis helps with end of life care in hospice.
“I’d say at least fifty percent of hospice patients are already cannabis patients,” she shared. “I found my voice and got to a place where I could talk to them about it. I could say, ‘have you tried cannabis? It might help your pain. One man was taking 180 milligrams of OxyContin three times a day and sleeping 23 hours a day, still miserable, with no life at all. He really wanted to make his daughter’s wedding, which was weeks away.”
With Cooper’s suggestion, his family purchased the oil and they were able to wean him off the opioids, allowing him to be awake and mindful up to six hours a day.
“His quality of life was improved drastically in a short amount of time,” she shared. “He was eating, laughing, and present—spending quality time with his daughter. And, though he missed the wedding, the last six weeks of his life spent enjoying his family were priceless. That’s the power of this plant.”
Is There Something Else?
The most challenging times for Cooper have been in the wee hours of the night, when patients are in the most discomfort, and the morphine isn’t working.
“That’s what they say at two in the morning, after taking morphine five times a day, barely awake, they tell me they don’t want to take any more morphine and isn’t there something else?” she said, sadly, in tears. “Now I can say, yes, there is something else, we have recreational cannabis here in Colorado. You don’t even need a doctor’s script, you can get these products and add them to your protocol, reduce your meds and get relief.”
Cooper said her tool bag used to consist of acupressure, essential oils, and more, but cannabis, she explained, is a game changer.
“When they have a nurse that looks at them and says, yes, this is OK, it changes everything—they have respect for my knowledge—and their families listen, too,” she said. “That’s huge, as families are divided on cannabis use, and they need to hear it from a medical professional in order for it to be real.”
Cooper said she’s also had to educate other hospice nurses, as well as family members.
“I sent a nurse out to see about a patient who was close to passing, struggling to breathe, and they hadn’t given morphine, because they just wanted her to have CBD—cannabinoid only tincture,” she said. “I told them she needs THC for the pain. The nurse said the patient was too agitated and cannabis with THC would make it worse. But the agitation was due, in part, to withdrawal symptoms from the morphine they were withholding. Cannabis oil can quell the pain of withdrawal, while dealing with the pain. So, I’m sitting there thinking the nurses need as much education as the patients and their families.”
Another issue is education on the differences between CBD and hemp hybridized from cannabis, isolates from Industrial Hemp, and whole plant concentrates.
“Many are under the impression that CBD is enough for pain,” she added. “If it’s hemp hybridized from cannabis it should have trace THC, but even that might not be enough for end of life pain. People fear THC, but at the end of the day, the proof is self-evident. I won’t tell anyone not to use morphine or pharmaceuticals, because sometimes they are warranted. I only know what I’ve witnessed—that cannabis gives a better end of life experience, while dealing with the pain.”
Cooper has taught nursing, adding cannabis to the syllabus. She also gives talks at nursing homes and senior centers to standing room only crowds.
“Everyone is hungry for knowledge on cannabis,” she concluded. “The nurses are eager to learn, and the geriatric population are suffering and hungry for education on this plant. When I speak, I like to end with a joke, so I’ll leave my favorite one here. An elderly man and woman are sitting together, when the man says, ‘my joints are stiff.’ The woman replies, ‘you are rolling them too tight!’ In light of the disinformation and disrespect this plant has gotten over the years, sometimes humor is the only way to break the ice.”