Organizational and legal measures to prepare the system of palliative and hospice care of Ukraine for the widespread use of medical cannabis

Abstract

In Ukraine, the procedure for the legalization of medical cannabis, which is needed for approximately 6 million patients with cancer in the palliative stages, multiple sclerosis, epilepsy, lateral amniotic sclerosis, fibromyalgia, arthritis, HIV/AIDS, glaucoma, post-traumatic stress disorder, Alzheimer's, Parkinson's disease, Tourette, Lennox-Gastaut, Dravet syndromes, irritable bowel, back pain, chronic pain due to spinal cord injuries, diabetic neuropathy, postherpetic neuralgia, is being completed. Cannabis is necessary for such patients to overcome spasticity, chronic pain, nausea, vomiting, anorexia, increased eye pressure. It can be a supplement to treatment with other pharmaceuticals or an alternative to them. On the eve of the entry into force of the relevant law, it is necessary to determine the main directions for the rapid development of the necessary by-laws (clinical protocols, instructions, etc.) for the rapid start of the wide use of cannabis in clinical practice, in particular in palliative medicine. Using the methods of systematic analysis and bibliosemantic, a study of scientific literary sources in Google Scholar and PubMed was conducted to study the main properties of medical cannabis, the medical and social risks of its use, in particular side effects, the increase in illegal recreational use of herbal cannabis. The experience of other countries where medical cannabis has already been legalized (USA, Canada, Australia, Denmark, Germany, Israel, Switzerland) has been studied. The list of normative legal acts of Ukraine that can regulate the use of medical cannabis has been defined: 27 evidence-based clinical guidelines; 27 standards and protocols of medical care. Possible scenarios are identified and the necessary measures are proposed for the adoption of legal acts for the final decriminalization of cannabis, the determination and forecasting of the need for palliative patients, the creation of conditions for the cultivation of Ukrainian herbal cannabis and the manufacture of domestic pharmaceuticals, reimbursement of their cost to patients. Keywords: chronic pain, narcotic painkillers, marijuana, PTSD, anorexia.