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Cannabis for End of Life

cannabis for death, cannabis and dying, cannabis for palliative care

*Note: I know many people would rather read a blog than listen to or watch a video. That's why I provide this rough transcript of our conversation, which is not meant to be a perfectly edited blog post. Thanks for your understanding (and not blasting me in the comments.)

What you will learn:​
  • Who is Olga Nikolajev?

  • How Can Cannabis Be Used at the End of Life?

  • Why Cannabis May Be a Better Choice than Morphine

  • What Conditions Can Cannabis Be Used For At The End of Life?

  • Using Cannabis to Legally Help with the Psychological Pain Of Dying

  • How Can THC be Used in Palliative Care?

  • Why Self-Titratring Medication Makes Sense In Palliative Care

  • Why Using Cannabis Can be Difficult in End-of-Life Care

  • Why Start Low and Go Slow May Not Be the Right Advice for Palliative Care

  • What About Drug-Drug Interactions?

  • What Cannabis Ingestion Methods are Frequently Used at the End of Life?

  • How Can Cannabis Be Used to Help with Grief

  • Baby Boomers Will Want More Control Over How the Spend the End of Life

  • Why Health Care Providers Are Still Not (Necessarily) On Board

  • Why Olga Loves Talking about Death, Cannabis and Sex!

  • Why You Should Consider Inviting Cannabis Into the Bedroom

  • How to Become a Death Doula

  • The Intersection Of Politics, Death, Dying and Cannabis

Andrea Meharg: Welcome back to another video from Reveal my name is Andrea Meharg and I'm a Certified Cannabis Coach and Educator. And I'm here on YouTube because I'm passionate about learning about cannabis and all the great things it can do for you, and then teaching you about all those things as well.

This is part of a series of interviews that I'm doing with experts in their fields about a whole bunch of different questions I have about cannabis. And I'm excited for this one as well. Although the subject is maybe not as happy and cheery as some of the subjects that we talk about around here. Today, we're going to be talking about using cannabis for end of life care or cannabis for death and dying or palliative care with Olga Nikolajev and I'm gonna start out by reading her very extensive biography.

Who is Olga Nikolajev?

cannabis for death, cannabis and dying, cannabis for palliative care

Andrea Meharg: So Olga Nikolajev is an end-of-life Nurse Educator with over 25 years, a professional experience as a registered in various healthcare settings, including hospice, palliative care, Olga has been involved in national provincial and local community efforts to shift the way we view and approach our dying experience, death and grief, including how we care for each other at the end of life and beyond. Since 2017, Olga has facilitated online thanatology program courses through Centennial College.

And in 2018 started facilitating the end of life doula course through Douglas College, across Canada, virtually and in person. Olga is the founder and director of a death awareness and educational community practice and is the founder and director of the Death Doula Ontario network, which she founded in June of 2020, right in the pandemic.

Olga has been honored to share her end of life's knowledge with over 700 participants and students, and is most proud of creating a safe and brave space for personal stories, exploring our struggles with grief and end of life care. Olga has a diploma in nursing with a certificate in multidisciplinary palliative care, a master's degree in religion and culture certificate in cannabis science, and is a Cannabis Competent Nurse. Olga continues to educate herself in the area of thanatology psychology and spirituality. That is a lot that you have going on and a lot of ex a professional experience that you bring into this space into a subject that although it's gonna happen to all of us, we don't super love talking about. But you do talk about it super eloquently. The reason I have you on here today is because I got to listen to a really excellent presentation that you did for EduCanNation a little while ago. And you were talking about all the ways that cannabis can be used to help us help our loved ones, our friends, our families at the end of their life.

How Can Cannabis Be Used at the End of Life?

Andrea Meharg: So can you start out just by telling us how can cannabis be used at the end of life?

Olga Nikolajev : All right. Well, thank you, Andrea, for, um, inviting me to be part of another way to disseminate some good information around, um, cannabis and specifically how cannabis can be used at the end of life. I think there are a number of different, um, utilities, I think for cannabis and, and let us remember, um, or maybe people don't know this, but you know, medical cannabis, as we, as, uh, a lot of us know has been in utility for the last 20 years. So there already are a number of folks who might be deemed or be receiving a palliative care approach who may be obtaining some form of cannabis more than likely specifically more the synthetic, um, more pharmaceutical forms of, cannabis specifically THC. So it's not that it's, it's a completely new kind of area, especially when it comes to end-of-life care where it becomes, I think really interesting is that we are continually learning more and more about the endocannabinoid system and about cannabis as a plant with multiple different cannabinoids and what each compound can be actually utilized for, especially when it comes to pain or insomnia or inflammation. So there's a variety of ways that I think cannabis can be used, um, across the lifespan. Not only at the end of life but certainly it has some advantages to be able to address specifically for folks who may not have benefit from some of the other pharmaceuticals, um, or who may want to kind of still have some sense or of awareness.

cannabis for death, cannabis and dying, cannabis for palliative care

Why Cannabis May Be a Better Choice than Morphine

Olga Nikolajev : Um, because we know that oftentimes, um, morphine is kind of the gold standard in palliative care as a way of addressing someone's pain and oftentimes leaves the person [00:05:00] in a very foggy state or not as aware state. So I think, uh, clients, patients, families are also looking for maybe medication or substances that can alleviate the pain and allow them to still have some awareness so they can con continue to have conversations so they can still be present with us as much as possible, but before they actually die. Um, and I've also heard that with some folks, the importance is on being able to still have some awareness so they can continue to do their own spiritual work. Um, and sometimes I have heard from spiritual guides or chaplains or counselors morphine again, some of the medication that is used at the end of life does not allow sort of this conversation, or even dare we say connection through sort of more of the spiritual realms they've described this notion that the person is kind of in a fog that they're not able to reach them and sort of connecting with them spiritu so cannabis, I think has been used um, um, in palliative care, there's a number of different research studies that talk about how it can be used, uh, in relation to, to cancer or chronic pain. And again, those are more so, uh, the synthetic forms such as Nabilone or, um, Nabiximols, those are all those pharmaceutical terms that oftentimes rattle in the brain and aren't always easy to, to, uh, pronounce. But there's also again, um, the movement as well for people to kind of self-medicate. Considering that now cannabis is, is recreational. It's legal. Uh, people may have more access. And so they're seeking to find how can this substance help me?

And some of them are reaching out to, um, cannabis educators like myself to say, you know, how can CBD help me or. I'm a little bit hesitant in trying something that has THC, because I've heard I'm gonna get a little bit loopy. And so most of the time, um, I do actually provide a lot of mentorship support to the end of life, doulas who may be helping a client family kind of navigate, um, the cannabis use. So. Some folks think that cannabis will cure all and that it will alleviate all pains in all symptoms. And we know the reality that that's not the case because all of us have our own unique endo cannabinoid system. And so we may have different requirements as well.

Andrea Meharg: And if cannabis cured everything, I mean, , you know, it would be in a much different situation than we are now, for sure. There's limitations to using cannabis for any condition.

What Conditions Can Cannabis Be Used For At The End of Life?

Andrea Meharg: I hear you saying that the conditions that it's used most commonly for is pain, but also having some sort of acceptance or closure around just like what's happening with the end of life. Is that fair or are there other places where you're seeing cannabis be used? That can be really helpful in palliative care?

Olga Nikolajev : I, I, I think within the constructs or within the structure of palliative care embedded in our, in our healthcare system, I think there's more of a focus on alleviating some of the pains and symptoms maybe of the dying process, but the focus is more on the, on the physical. So most of the research, like I said, deals with, um, cancer, pain, neuropathic pain, nausea, insomnia, um, cancer anorexia, all of the ways that, you know, um, um maybe the treatment of cancer actually has some adverse effects. And so many people are using cannabis or have been cannabis a, as a secondary, as a tertiary medicine to assist in alleviating some of the side effects of some of the treatments, really. I mean, we know, um, within our, uh, the EduCanNation collective where personally folks have, um, had their own journey with cancer and have utilized, they've been to cannabis in that way to help them to kind of overcome some of the. Um, you know, the puky-ness or the nausea or the aches and pains that happened because of treatment options that are there. And so those folks, again, it's not that cannabis is only reserved for the end of life, right? These can cannabis can be utilized, like I said, through the lifespan. And so somebody who may have a life limiting illness, And as receiving active treatment, it can be utilized um, as I said to reduce some of those side effects of the treatment.

cannabis for death, cannabis and dying, cannabis for palliative care

Using Cannabis to Legally Help with the Psychological Pain Of Dying

Olga Nikolajev : Where I think there's a possibility to open things up and I get really excited about is the fact that we're now hearing um, and there's a lot of work being done in relationship to psychadelics so, um, you know, those identified substances that really have an opportunity to maybe reduce some of the severe death anxiety that people may be feeling way before they reach end of life. Again, somebody who might be diagnosed with the life-limiting illness and all of a sudden they're in the, in the process of their grief and, and their death anxiety is really increased because like most of us, we would think we have a lot of time. And so they're faced with that kind of shock that their life is gonna end sooner that they may have anticipated. And so we know that across Canada, there, there have been those groups such as Therapsil who are looking at how to utilize psychedelics and really working with patients to obtain the legal right, to possess those sub substances. That's the part of the other education that I do is many of the end-of-life doulas or folks who work in this field also actually don't realize that, you know, psychedelics such as magic mushroom, psilocybin, MDMA ketamine, all those substances, LSD is actually still, there's still illegal. Um, and so there's only, um, only a few folks who are able to have access to that. And it's very much, you know, we're, um, kind of a right, very regulated um, you know, opportunity for people to have some of that access. And so I wanna potentially have a look at, you know, how can we utilize cannabis because in, you know, cannabis to me and I think that's that's as common known fact is that it is a mild psychedelic. It may not provide for you the kind uh visual or audio or, you know, kind of expansive visions or what have you, but it still has the ability to provide sometimes a disassociation with one's experience. So we can have mm-hmm an opportunity to reflect on, to not be so impacted by. It allows us to also connect. Sometimes cannabis can be utilized as a way of connecting to nature, feeling all of that connection. And so you can imagine that folks at the end of life or those who have been diagnosed with a life-limiting illness feel that sense of disconnection. I now need to prepare for leaving right, for disconnecting with folks. And that can be oftentimes very painful. So I see cannabis as an opportunity for folks to maybe help them to reconnect, to hold onto those connections, to see maybe a, um, have a different viewing point of their experience.

Andrea Meharg: That's so beautiful to think about. I wasn't sure where you were going when you were talking about using psychedelics, but then they're illegal. And I was thinking, oh, well, it's gonna be patients once again, who are gonna force the legality of these substances. But that wasn't where you were going. You were talking more about, well, we have this fully legal substance in cannabis that provides milder effects, but definitely that feeling of connection. Which is caused by the molecule THC, which is The High Causer. And it is the molecule in cannabis that many people are afraid of consuming because they're afraid of getting too high or feeling really sick or really anxious all the things.

How Can THC be Used in Palliative Care?

Andrea Meharg: So can you tell me about how THC specifically can be used in end of life care? And do we have to be concerned about THC interacting with many pharmaceuticals, which some people might be on like multiple pharmaceuticals.

Olga Nikolajev : I oftentimes say, remember as a way of accessing some innate, knowledge in everyone in the audience, and I'm not sure if they have that memory in their conscious dream. The fact is that many of the synthetics that are used in palliative care, are primarily THC. Primarily. CBD at the end of life is not always utilized because it's more about, um, you know, inflammation. It's more, they can be used. I'm not saying that they're not, but I think that, uh, it's more so the THC with more of a focus on pain relief. Uh, by the way, um, the natural dying process is not necessarily painful. You know, our bodies are created in such a way that we have a lot of protective mechanisms in our body, you know, as it relates to not being able to absorb trauma or learning how to kind of cope and, and guard are, um, maybe our, our psyche or our personhood or our, our internal reality. And so oftentimes the pain that folks are trying to alleviate is actually the pain caused by the illness or by the cancers or by the tumors, those kinds of things. Natural dying is not, um, usually painful. Um, and so again, within palliative care, I think that, I think the synthetics of THC are used already again. When we open things up and enable folks to have access to cannabis, a lot of those fears will come about because I think that there's still that historical of retention of the, you know, the, uh, losing one's ability to kind of function or being overwhelmed by this euphoria or hallucinations or those kinds of things. I can tell you as a, as a cannabis consumer, myself, I have had an, um, experience where maybe I have had a little bit too much and I could feel the anxiety, but I've also had the opportunity to learn how to moderate and learn how to actually have that relationship with cannabis. So I have a sense of when I need to kind of slow it down when I need to stop when I may need to. You know, maybe have some other substances or other activities and, and by substances, I mean, food or drink, or, you know, certain things that will sort of damper a little bit of that intense effect of THC.

Why Self-Titratring Medication Makes Sense In Palliative Care

cannabis for death, cannabis and dying, cannabis for palliative care

Olga Nikolajev : I also think, um, in some way that, you know, as cannabis educators, we oftentimes, educate folks to go low and slow as a way of helping them to learn about the cannabis, learn about how to titrate up usually, right? Cuz we're starting low and then have an ability to kind of monitor their own experience with it. I think that's a really key piece, you know, it's quite different than, um, let's say from a, a nurse practitioner or a physician who says, you know, take this medication three times a day and here are the side effects. Right. It's a very different kind of a relationship. And so yes, the fear is there. And so again, I think there's an opportunity to maybe help facilitate right. Help people to guide them through the process. So they get to learn more about the effect of cannabis on their particular endocannabinoid system.

Why Using Cannabis Can be Difficult in End of Life Care

Olga Nikolajev : Where sometimes it becomes difficult is when people at the end of life may not have enough time to learn about it. Right to kind of titrate themselves to kind of have a feel. And so it, sometimes it might be helpful to kind of have a medium dose or a higher dose and help them to kind of have a sense of what that might feel like when they get into the spaces that are a little bit unnerving. Right. There's also a sort of a preloading of one's experience. So if somebody already has uh, fear or some hesitation they're already in an anxiety state. And so they're already in the mind frame of anxiety already in the fear. And so that's gonna add to the anxiety that they may be feeling with cannabis, or they may be thinking that it's going to specifically alleviate, um, some of their pain or concerns. And when it doesn't, they might be disappointed or they say, well, it didn't. because it takes time for us to kind of learn and to, um, you know, partner with the cannabis plant and all of those different compounds to see which, which kind of cultivar or dosed or ratio. There's a lot more conversation now, uh, about ratios of THC and CBD in those different compound. Um, you know, instead of only focusing THD and CBD, so it's a combination of things. So again, we need to really expand the education. Enable people to have an experience that can be guided and, uh, helping them to maybe come up with some of their own, you know, mindfulness, self regulating kind of practices so that if they do take too much, they know how to do that for themselves. So I take a lot of the knowledge that I have from the psychedelic research, because it, it is kind of translatable onto cannabis. You know, the importance of set and setting. Intention. Why do you wanna take the substance, maybe cannabis isn't the best thing. Right. But again, because it's available to us, a lot of people are uptaking it, I've had a lot of client families who, you know, have conversations with me about what about that CBD oil I get on Amazon and I'm like, no, let's have a conversation. Right. Or they'll come back to me and say, The CBD didn't help my pain. I said, well, yeah, because you need a little bit of THC. You need something that's gonna alleviate some of that stress, right. Kind of drop you down into, um, not, um, completely being associated with that pain.

Why Start Low and Go Slow May Not Be the Right Advice for Palliative Care

Andrea Meharg: You're right that so many times in this community and cannabis educators and coaches will tell you to start low and go slow. One of the things that I really like about something that doc Dr. Dustin Sulak says is he says that we're forgetting the other part of that sentence. So it's start low, goes slow, but don't be afraid to go all the way and that means don't be afraid to take a higher dose of THC, especially if you've set yourself up with the right intention, you have a support system around you, you know what to expect, you know, what to do if you feel too high. And the reason that he can confidently say that is that Unlike taking a really high dose of morphine, which could actually kill you. Taking a super high dose of THC may feel really bad. Like if you take too much, but it will not kill you. It's not a lethal or toxic drug at all. You can feel really bad. Don't get me wrong, but you're not gonna pass away because you went all the way with THC. However, I wanna come back to the drug-drug interactions here.

What About Drug-Drug Interactions?

Andrea Meharg: Are there certain drugs that people who are at the end of their life who are considering THC, are there people who should not do that because of certain drugs that they're on?

Olga Nikolajev : Yeah. So number one I would say is that you, um, already know that there are some contraindications for people utilizing cannabis And part of that is because of how the body sort of um, uh, responds to the cannabis. So folks who may have some cardiovascular, um, issues, because the heart rate goes up because there's sort of um, you know, ex excitement, you could say, especially with THC. That might be contraindicated for them. The physical condition, not, not the, the drug interaction, same thing with folks who may be at risk or already have some compromising mental health issues who may be at risk of psychosis because the cannabis, especially again, the THC may tip them into their psychosis. Right. And that, um, if you never experience that, that can be even more anxiety provoking than sort of this cannabis, um, cannabis high. Um, the reality is that for end of life, so you know, people may be on medication. And so I think that that is the work of the nurse practitioner or the primary care provider, maybe to work alongside the cannabis educator as a way of moderating, which drugs do interact. And which don't, um, and I don't have as much detail, but certainly there is literature and relationship to you might wanna be careful with this drug and so on, forth and so forth. The other thing that a lot of people may not realize is that as a person enters those last few weeks or days of their life, they will be taking off some of of that medication. Many medications people have as a way of sort of reducing the illness or helping them to manage some of those signs and symptom. And they may be, uh, medication that are more protective or like I said, managing, um, their disease. And so now they're progressing to the end of life. We no longer need to manage the disease. Where I think there is that interaction again, or contraindication might be when people are provided with some heavy duty opioids, right. Or whether it be even fentanyl or, or morphine, then again, it's an added layer, right? It's an added sort of, um, um, maybe a, a, a sedative. So we know that CBN has more sedative uh, sort of qualities. And so it's not that it's going to cause their death, but it could impact the effectiveness or even the strength may increase it or may decrease it of maybe the morphine or some of those opioids. Right. That's where, um, there might be some interaction.

What Cannabis Ingestion Methods are Frequently Used at the End of Life?

Olga Nikolajev : The other thing that is really important to remember, and that's kind of the question in relationship to the form of administration of cannabis, is that people at the end of life, again, may experience shortness of breath, difficulty breathing. They may also come to a point where they're not interested in food and water because they may start to have some difficulty in swallow. So then it's looking at what forms of administration can we actually provide for people. So there might be suppositories topicals, you know, if we could still have some edibles, but again, think about the fact that the body itself is starting to slow down. The digestion is slowing down. So again, that sometimes, you know, that's a requirement for the uptake of some of the, uh, the medicine and may not necessarily, um, kind of have its optimal effect. Right? So there's kind of a window of opportunity for, for all medication. I think until it gets to the point where somebody may only be able to have, uh, injectable. Right. So it really depends on every single situation.

How Can Cannabis Be Used to Help with Grief

cannabis for death, cannabis and dying, cannabis for palliative care

Olga Nikolajev : Where I think cannabis can also be really helpful is in reducing the, the, um, sort of the effect or the impact of people's grief. To give them some opportunity to maybe obtain a substance, not an antidepressants that they might, um, sort of create a codependence on, but maybe a form of mild THC and good ratio of THC and CBD to kind of help them to regulate the, the impact of their grieving process. Because grief lives through the whole body and it oftentimes causes what's called the bottoming bottom heavy of our brain. So it really activates our amygdala, and our fight or flight or freeze or fawn response. And we actually lose that ability to really activate the frontal cortex, which is in charge of a lot of executive decision making and our ability to moderate or control or manage our emotions.. So I think that there's, again, an opportunity in the same way that psychedelics are also being used with folks who are, maybe have a form of grief that's quite complex or debilitating to offer an opportunity for them to have sort of a different frame of, um, sort of mindfulness or, or perspective. So they can, um, you know, have a, a, sort of a better handle on their grief or, or have different insight into their grieving process.

Andrea Meharg: That's fascinating to me to think about using cannabis specifically for grief. I didn't know it lives in your body. And, um, I was thinking about when you first started talking, I was like, oh, she means for the people who are left behind, of course, that's how beautiful for the process of death and dying that those who are surrounding the person who's passing away may also utilize cannabis. But no you're talking about for the person themselves like that. It, that it can be used for so many different facets of the end of life is indicative of the whole plant. Right? Every time you learn something about cannabis, you're like, it does that too. So that's, that's amazing.

Baby Boomers Will Want More Control Over How the Spend the End of Life

Olga Nikolajev : And we're we're just learning. And so there's a huge opportunity, you know. I think about the fact that our baby boomers, their life is coming to a close they're, a large population who were really instrumental in sort of pushing the envelope in our society, making demands, you know, those kinds of things. And I think that they're gonna be really instrumental in sort of saying, this is what I want. I wanna have a little bit more influence on, on my end-of-life experience. Um, and this is what I would want. And then there's also elements within healthcare where there's a lot more sort of focus on. Um, shifting healthcare from a paternalistic, do what the doctor says to a partnership of saying I have some information and knowledge as a healthcare provider, but you, as the patient, as the client have far more information around, how is this going to be integrated into your life? All of the other pressures, um, outside of, you know, the physical concern, right? So some of the, um, psychosocial, spiritual element. And I think, you know, cannabis or psychedelics or some of these, what are sometimes called, um, you know, plant medicine, even though LSD and ketamine are not necessarily plant medicine, but some of these sort of, um, transformative um, medicines can actually really help us to even shift our approach to end of life, to shift our consciousness as a way of kind of seeing things in a broader perspective and have more sense of control, which oftentimes is a fundamental thing that people fear. And do lose at the end of their life. right? They, they lose their physical ability, mental ability um, all of the ways of connecting governing their life in the way that they want. So how can we empower people in their life experience and a big proponent of empowerment, and again, even, even in healthcare, you know, how can healthcare providers sort of partner with their patients and clients to work on goals of care plan or how to alleviate some of this, this pain that also includes the physical, the mental, the spiritual. And I would say too, you know, when you go back into history and, and part of my study and world religions and spiritual kind of paths is also acknowledging that many of these plans were utilized to obtain higher levels of awareness, um, you know, altered states of consciousness, which then require an integration. To make an impact on the person's life and society to create some big changes. So I'm hoping that's what, and I think that that's probably the risk as well. You know, those in power, um, there is a risk for enabling the general population to have more awareness and more consciousness, because then they'll make more demands and the structures will fall and they will have to be changed. That's the reality. And that's what we are kind of hoping for.

Andrea Meharg: This is interesting because if we can figure out how to use cannabis before the end of life care, like by the time I get to end of life, you're damn right. I'm gonna be. Like, oh, no. I prefer to take several hundred milligrams of THC and enjoy the ride. Um, I hadn't thought about what that means for the system.

Why Health Care Providers Are Still Not (Necessarily) On Board

Andrea Meharg: As we become as a general population, more educated about the ways in which many, many, many plant and natural medicines can help us. And that. Um, you know, before I found cannabis myself, I would've never questioned my doctor. Like my doctor knew everything about my health and when I tried to do everything to come out of my depression and my doctor just offered me more antidepressants. And then I was like, well, actually cannabis is working. And she said, but I'll give you more antidepressants. Instead it was a real eye-opening moment for me to be in my own power saying, no, I'm going to use cannabis because this is actually helping me get back to a quality of life. And since then we have butted heads.

Olga Nikolajev : Again, it's not for the lack of not trying. It's not, I don't think it's for the lack of not wanting to support, but it is oftentimes, you know, when we fear something. So even healthcare providers have their own internal fear of cannabis because they may still, you know, kind of hang onto the, the reefer madness stories. Right. And they are really embedded in, in the science that chews up the molecules really, um, synthesizes things or, or brings them down to these minimal things. So antidepressants increase your serotonin period, that's it. And there needs to be more complexity then to recognize that the system does not work in isolation. The whole body mind spirit works together. And so, again, this is an opportunity because we know that the endocannabinoid system is through the whole system and affects a number of different sort of processes or organs as a way of bringing homeostasis to the whole container, right. To the whole system. Which antidepressants may only work on one particular chemical in the brain. And so it's a, it's a shift in sort of the, the philosophy of, of care or health even right where it's not necessarily only about the allopathic and focusing on the disease. Cuz most of our healthcare system is disease-specific. It's not person or wellness. It's an illness system, right. It's really focusing on the illness. And so it doesn't touch the totality and it doesn't also address, you know, again, back to the, the level of control, uh, uh, self control or feeling that we have some control in this particular, um, you know, experience with illness is that we're not in partnership in working with the healthcare providers, some of them, of course, yes. They're on board and they do have that, um, equal playing field, but it's, you know, again, how can we empower ourselves? Because the reality is right. We're the ones who are gonna have to manage our life. So, um, it's, it's shifting all of it is kind of playing out and, and we'll see how. How it plays out, right? It's one of the main reasons why I got into more public, uh, end of life education, because I have seen both in the healthcare system, as well as the funeral system where there's such a protection of the information that could be very helpful for client families to better understand, so they can make better informed decisions of their care and every person has the right to, um, say no to a particular treatment that is being offered to them. Right. It's not about doctor says, and this is what you have to do. Let's have a conversation about the things that are gonna work best for you. Here's what I know. Here's what, you know, what's missing, bring in some more folks to provide some more education and then we can work together. Right? Ultimately it's the person who's gonna be carrying on that information their own self-management. Right. So that's, that's a big thing.

And, again, I I've always said for 20 years, I've said hospice, palliative care end of life care approach can really influence and transform our healthcare system because fundamentally it is person centered. And it is about equalizing those powers and enabling people to make decisions that will work for them. And again, you know, that comes from some of the psychedelic world and some of the cannabis educator is that we do wanna empower our people to use, whatever tools that they have and that we recognize that inside we all have an inate sort of wisdom or awareness and that we're, if we're offered good information and good knowledge, we can make the best decisions for ourselves.

Andrea Meharg: And that's why people like you and I get up every morning and get excited to talk about this type of thing. Because for me, it was transformational to learn about cannabis. It changed my whole entire life, and I just needed a little tiny bit of knowledge, like literally just a bit like where. I learned about the endocannabinoid system. I was like what changed everything for me? And so I, you know, thank you so much for doing this type of work, especially around a subject. Like you're taking cannabis taboo and death and dying taboo, and sandwiching them.

Why Olga Loves Talking about Death, Cannabis and Sex!

Olga Nikolajev : I love speaking about the things that most people don't like to talk about, right. That this is called the unspeakables. And so those are often, uh, the three things, death, sex, and weed.

Andrea Meharg: Why don't you throw sex into like how to have how to have a great death by using cannabis and having sex? Like, would sell out right?

Why You Should Consider Inviting Cannabis Into the Bedroom

Olga Nikolajev : Consider, you know, for, for women, especially, right. You know, the, the, and I was a sexual health counselor in my, in my early teens. It was part of a practice of, you know, I was a labor and delivery nurse as well. And and so again, even sex education oftentimes is about the mechanic or the anatomy, and it's not oftentimes about how to attain sort of, you know, orgastic pleasure, how to understand, to utilize different stimuli, how to actually acknowledge the fact that we're all made a little bit differently. And so our desires a bit differently, so we can debunk some of those sort of. Um, you know, um, social ways or even the ways that are actually maladaptive to our ability to access, you know, good, healthy relationships, good self pleasuring, you know, kind of, uh, techniques, all that, all that kind of stuff. And cannabis can actually help in that arena as well as we know. Not only, you know, it can help in, in sort of, especially for, uh, menopausal women as a way of sort of increasing some of the lubricants because we lose a lot of that, but also to increase desire, to increase that connection with the partner, to explore other ways that you may have been hesitant in, um, you know, in sexual play so that you can come to literally come together in a more intimate, in a more charged way. You know, I oftentimes, when I do end of life care education, I talk about a lot about self care. And I talk about the importance of crying, the importance of alleviating heavy emotions, you know, whether it's even peeing or pooping and thinking about what you wanna let go of and acknowledging the fact that crying is really an effective way to eliminate cortisol from your system. Right? Some of the, the stress hormone. And then I also talk about flooding your whole body with wonderful endorphins by having an orgasm. Oh, we can't talk about that. Of course we're, we're all doing it. Most of us. Right? So why not talk about it? Why not educate ourselves of, you know, that it doesn't have to look this way or there are different desires that we have and then how it, how it changes throughout our whole lifespan. And the fact that for women estrogen falls, and so we [00:38:00] don't have as much of that desire, maybe cannabis, and some of those substances can really help us to rekindle our desires in a, in a different way.

Andrea Meharg: We gotta book another call. Eh?

Olga Nikolajev : I gotta get myself to write, write that book.

Andrea Meharg: I think there's a lot of people watching who would love to read that book. Thank you so much for being here and talking with us about all of this Olga.

How to Become a Death Doula

cannabis for death, cannabis and dying, cannabis for palliative care

Andrea Meharg: Uh, you have lots and lots of things going on, including the website and all the education you do there. If someone's watching this, and they're also interested in doing your type of work, a death doula, even maybe a cannabis informed death doula, can you point us in the right direction?

Olga Nikolajev : Sure. I think, um, you know, again, I think, uh, a lot of folks, um, may make the assumption that in order to access some of the end-of-life doula training, you have to come from a healthcare perspective. And it's actually not true because fundamentally. our dying and death experience is not a medical event. It's a social event. So it requires, you know, not only maybe it requires some medical intervention, but fundamentally it requires an ability for a person to assist a family to navigate. Through the emotional, practical, um, spiritual kind of areas of, of end of life care. It's very holistic. And so, um, in Canada at present, the end-of-life doula role is really a, non-regulated self-regulated self professionalized kind of role. And people come to the learning from many different perspectives. You know some may wanna open up a practice where they have a fee for service offering support to client families in that way. Some actually undertake the training so they can incorporate it into maybe the program that they already have, or I've had a number of even teams from within hospice support services or social services because the end of life doula uh information and know really crosses, you know, all of those different sort of siloed industries that care for folks at the end of life. So it gives the doula information around the hospice, palliative care, and the end-of-life care field and how they can engage with, um, ensuring that folks have good palliative care. Support or hospice care. Right? Explain some of that. Then we also primarily focus on, you know, the dying process and the dying, the different dying experiences that people may have, especially now with having medically assisted death. And then it also focuses on the post-death. So, what are the options in relationship to body disposition? Or how can we help a family, especially when they may not have a connection to a faith-based or a religious community, to incorporate ritual and ceremony? So it's quite broad. And then a lot of participants may choose. You know, very specific niche. So they may focus maybe on legacies or they may focus more on planning or education. So I would say that the best resource for Ontario is to potentially access the that I established. And I actually created it in the midst of the pandemic because of the pandemic, because I wanted to make sure that those folks who were going through the training had an opportunity to connect again. Right in that peer to peer in that community of practice, as they're developing their own practice and ongoing training, ongoing learning, right. This isn't that you do this course, and then you're done. You have to continue to educate yourself. Because the truth is end of life care is politics of the body who has the right to when, where it's very similar to birth that's politics of the body as well. Right? So, um, Death Doula Ontario Network is, is a good website to go to. There's a list of um, you know, some of the doula specific training, but also some links to hospice, palliative care training as well. That is accessible by anyone, um, oftentimes to access I'm really, uh, you know, fundamentally I am a big proponent of increasing what is called death literacy. So how is it that we enable folks to have these conversations so we can get a little bit more. Comfortable or a little bit less uncomfortable, mm-hmm what are the practical implications to think about? What is the experiential knowledge that we have and what is the factual knowledge? I think most Canadians make assumptions that the care will be there when they need it. And that's why they wanna wait, wait, wait, before they have those conversations. And sometimes they find out that it's not. Right. That they're only, um, have access to a limited amount of support. And it takes a bit of time for families to learn how to be with their person, because oftentimes it has a lot to do with addressing their own mortality. Mm-hmm every single person who works in end-of-life care has to do their own self-care and their own self-reflective practice mindfulness practice. Because every time that you are with a family, you are confronted with your own mortality. It's one of the risks. But it's also an opportunity and a privilege for us to be reminded of the sanctity of life or the preciousness of life and how fleeting it is and how short it is because none of us really know unless you've been diagnosed with the life limiting illness and have some awareness of your prognosis. When we're going to die, but we are all absolutely going to die.

Andrea Meharg: It's gonna get us all.

Olga Nikolajev : Although I would like to think that the end-of-life doulas in this movement. Will enable families to have the knowledge. So it gets translated onto the next generation. So there's not going to be that need, but we had, we had a whole generation where we kind of, um, took that, that job or that role and gave it to someone else. Right. Or, or it was taken from the families and given to, you know, the professionals. Right. So it's how do we reclaim. The more of the social way that we care for each other at the end of life.

The Intersection Of Politics, Death, Dying, and Cannabis

Andrea Meharg: It must have been so interesting for you because you have such a lens of understanding how the systems are impacting the individual. But I see so many, um, parallels between what you were talking about with like the politics of the body and about the quick change between humans for a long time taking care of our own people, as they, as they got sick and died to, we give it away to the medical system and the same thing with cannabis that there's so many parallels between these passions of yours as far as just this weird point in history that we're living at right now where we don't, we don't remember that we used to live a totally different way for all of human history.

Olga Nikolajev : And, and, you know, the landscape has shifted too. Let us remember that because of the advances of medicine, because of some of these ongoing process we are living longer and longer. And the reality is that in other parts of the world, that is not the case, partly because of also the availability about healthcare. But fundamentally because life expectancy is very dependent on the social determinants of health, which have to do with shelter, clean water, accessible, healthy food, and the social structure to help people to build resilience. Right. Resilience is an individual quality, but it's far more a communal quality because if we, um, oftentimes feel that we don't have a community that we belong to or a community that helps us to be resilient, we can't build that resilience. It's hard to build that on your own.

Andrea Meharg: And bringing it back to cannabis, find me a cannabis consumer who does not feel that sense of connection. To other people to nature to the universe, to whatever it is when they take a certain dose of THC, it reminds you that you connected and that you love people.

Olga Nikolajev : And this is the opportunity for us as cannabis educators, right? To bring that insight, to say one of the best settings to be in when you're consuming a substance to regulate yourself is to be out in nature to find those connections, to even do it communally. Right. Again, we are very hyper individualized society in the west. It's not so in other parts of the world and we need to recognize right that we, oh, wait a minute. We went a little bit too far. Let us come back and bring in more the community. Right. We need to come into balance again.

Andrea Meharg: Thank you again so much for being with us. If you want to find Olga and connect with her in any way, all of her information will be down below and I really encourage you to do so. And if you love this style of learning all about cannabis through the lens of somebody who's like right in that field, please make sure that you check out the playlist down below that has all of my other interviews in there as well. Um, don't forget to head to reveal to sign up for my newsletter, where I send out all my best tips and tricks on how you can use cannabis to live a happier, healthier life. And we will see you on the next video. Bye.

Find Olga here:

Resources Mentioned

EduCanNation is a cannabis education non-profit organization devoted to improving the quality of cannabis education & care across Canada. Check them out at

cannabis for death, cannabis and dying, cannabis for palliative care

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