Cannabis and Palliative Care: Promise for Older Adults?

For an older person receiving palliative care, pain relief can mean being comfortable enough to share a meal, hold a conversation, or rest without constant distress. Those everyday goals help explain why cannabis continues to attract interest, even while questions about its effectiveness remain unsettled.

A new scoping review, “Pain Management Strategies for Older Adults in Palliative Care,” identifies an encouraging finding: all three cannabis studies it included reported improvements in pain.¹ However, the authors classify that evidence as moderate to low level. Their findings support further investigation, rather than establishing cannabis as a proven treatment for this population.

The opportunity is to turn that promising signal into a clearer understanding of who might benefit, which preparations deserve testing, and whether relief improves daily life without introducing unacceptable burdens.

What the Palliative Pain Review Found

Accepted for publication in Ageing Research Reviews in October 2026 and available as a journal pre-proof, the paper maps 117 studies involving older adults receiving palliative care. It examines opioids, non-opioid medications, procedural treatments, non-drug approaches, education, and interventions combining several types of care.

A scoping review provides a broad picture of the research landscape. It helps identify approaches worth investigating and populations that remain overlooked. It does not necessarily establish how much better one treatment works than another.

Opioids and multifaceted interventions were the most frequently studied strategies, appearing in 37 studies each. Cannabis appeared in three studies within the non-opioid medication category, involving preparations with different THC and CBD ratios.

The following findings come directly from the review:

Across the entire review, 68% of studies supplied moderate- to low-level evidence. The uncertainty surrounding cannabis therefore sits within a wider challenge: building strong evidence for pain treatment in older palliative care populations.

Why Three Positive Studies Do Not Establish Effectiveness

Three favourable studies are a useful reason to investigate further. They are not a 100% patient success rate. Counting studies that report improvement does not reveal how many participants benefited, how substantial their relief was, or whether the improvement exceeded an appropriate comparison treatment.

Consider a patient whose pain improves after cannabis is introduced alongside changes to existing medicines and additional clinical support. That improvement matters, but the treatment change alone cannot identify which component produced it. Controlled comparisons help separate the contribution of cannabis from other influences.

The review also acknowledges that counting statistically significant findings can be affected by outcome reporting and the testing of multiple outcomes or time points. A positive result at one assessment does not necessarily mean sustained relief.

The practical lesson is to preserve both parts of the finding: the cannabis studies produced encouraging results, while their designs and limited number leave important questions unanswered.

How Broader Cannabis Pain Evidence Adds Context

The authors place their cannabis findings alongside broader research that has produced mixed results. This context matters because cancer pain, chronic nerve pain, and pain associated with other life-limiting illnesses are different clinical problems.

The 2025 AHRQ review of cannabis for chronic pain found small average improvements, mainly in neuropathic pain, with certain THC-containing preparations. These benefits came with increased dizziness, sedation, and nausea. Those findings do not establish equivalent benefits for older people receiving palliative care.

Similarly, the ASCO guideline on cannabis in cancer care states that evidence is insufficient to recommend for or against cannabis or cannabinoids for cancer pain. That is different from proving that no individual can benefit, but it also falls short of supporting routine use.

A useful article about cannabis should make room for this middle ground. Patients can report worthwhile experiences while the evidence remains insufficient to predict those experiences reliably.

Why Quality of Life Must Guide Cannabis Research

The most useful next step may be to ask a more precise question than whether cannabis lowers a pain score: does a defined cannabis preparation help a particular patient achieve something they value?

Imagine two patients reporting the same reduction in pain. One becomes comfortable enough to enjoy family visits. The other feels too drowsy to participate. A pain score alone would miss the difference between those outcomes.

This suggests that future trials should connect symptom measurements with patient priorities. Researchers could assess:

• Pain relief alongside alertness and ability to communicate.
• Sleep quality and comfort during everyday activities.
• Side effects, treatment burden, and reasons for stopping.
• Whether benefits persist with continued treatment.

These measures would make positive findings more useful. They could also identify situations where an apparently modest change in pain produces a meaningful improvement in daily life.

Older Adults Need More Specific Evidence

The review highlights limited representation of adults aged 85 and older, people with non-cancer illnesses, and some patients with dementia or multiple conditions. Findings from relatively younger older adults cannot automatically answer questions about those groups.

Research also needs to reflect what patients actually bring to treatment: existing prescriptions, previous cannabis experience, functional limitations, and individual goals. Treating everyone over 65 as one uniform population conceals differences that could explain both benefits and unwanted effects.

Better Communication Can Improve Care Now

While stronger trials take time, clearer conversations are already possible. MyCannabis’s coverage of why older adults are turning to cannabis edibles describes interest driven by pain, sleep difficulties, and other concerns. Understanding that motivation is a starting point for useful clinical discussion.

A 2025 Canadian study of older adults’ cannabis experiences likewise identified perceived benefits alongside concerns about adverse effects, medication interactions, and access to trustworthy guidance.

For palliative care, the implication is practical: patients should feel able to describe what they use, why they use it, and what happens afterward. That information helps the care team assess cannabis alongside the rest of the treatment plan. Interest in cannabis should open a conversation rather than replace assessment of persistent or changing pain.

Consistent Products Could Make Future Findings More Useful

“Cannabis” describes a broad category, not a single standardized intervention. A CBD-dominant oil, a THC-containing capsule, and a mixed cannabinoid preparation cannot be assumed to produce interchangeable results.

Future studies would be more informative if they documented cannabinoid composition, administration route, treatment changes, and concurrent medicines consistently. Otherwise, an encouraging result can be difficult to reproduce or apply beyond the original study.

Emerging measurement tools may help. As explored in MyCannabis’s coverage of cannabinoid biosensors for personalized pain treatment, detecting exposure could eventually support more detailed research. However, a cannabinoid measurement cannot independently establish pain relief or an appropriate dose.

Readers comparing ordinary liquid products can consult the CBD oils and tinctures buying guide for Canada for label and formulation context. Product comparison remains separate from determining whether a preparation is appropriate for palliative pain. The review does not establish retail CBD oil as an effective treatment.

A Clearer Path for Cannabis in Palliative Care

The review gives cannabis researchers a useful direction: investigate the favourable findings with defined preparations, stronger comparisons, and outcomes that reflect patients’ priorities.

It also places cannabis within a broader landscape of pain care. The authors identify promising findings across several strategies, reinforcing the value of studying how treatments fit into comprehensive care rather than assuming one option can meet every need.

The encouraging prospect is greater precision. Better evidence could identify patients who experience worthwhile relief, distinguish useful formulations from ineffective ones, and clarify when side effects outweigh benefits. For older adults receiving palliative care, that progress would mean decisions grounded more closely in both scientific evidence and the life they want to live.

References:

¹ Bérubé, M., Linsotan, S., Gauthier, L., Godwin, B., Belzile, É., Pageau, F., Hadjistavropoulos, T., Verret, M., Bourque, L., Giorgini, G., Benhamed, A., van Lieshout, E., Schemitsch, E., Guénette, L., Tapp, D., Papp, S., Galant, N., Troncy, É., Labzagui, I., … Pelet, S. (2026). Pain management strategies for older adults in palliative care: A scoping review. Ageing Research Reviews. Advance online publication. https://doi.org/10.1016/j.arr.2026.103423