Marijuana: 4 Facts Every Nurse Needs To Know

This article was republished with permission from SCRUBS Magazine.

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Since the beginning of the last century, the use of marijuana in the United States has been a legal taboo, no matter what the reason. This has changed dramatically at the beginning of this century, as more and more states are passing legislation allowing its use in controlled circumstances. As a nurse, you should familiarize yourself with those laws as they apply to the state where you practice specifically, but there are a few general facts that we should all make ourselves aware of.

Marijuana for Pain Management

One of the largest benefits found by researchers for the use of marijuana medically is with pain management. The cannabinoids found inside of the plant have been shown to alleviate chronic pain that comes with illnesses like:

  • Certain forms of cancer
  • Diabetes
  • HIV and/or AIDS
  • Fibromyalgia
  • Arthritis
  • Multiple Sclerosis

Researchers who advocate for the use of medical marijuana as a pain reliever cite the addictive qualities of pharmaceuticals versus cannabis. It is no secret that a patient can become addicted to pain relief medications when taken for an extended period of time, even simple ones such as Tylenol. This tendency is not as prevalent when marijuana is used to alleviate pain.

Research also suggests that the natural chemicals found in marijuana are helpful in alleviating the symptoms associated with some diseases, like gastrointestinal disorders and sleep apnea. For individuals who live with these chronic conditions, having access to the drug has proven to be invaluable for increasing their quality of life.

If you happen to be a nurse in one of the states that have allowed for medicinal marijuana, you should understand that it is not offered as a prescription. Your patient is not going to be able to stop by their local pharmacy on their way home and legally pick up a bag of pot. It is authorized by a physician or APRN, but not prescribed – a legal distinction that nurses should be aware of. Patients are given a special authorization card which allows them to buy the drug from a dispensary. Having this card prevents them from problems with law enforcement in those states where recreational marijuana use is still prohibited.

Nurses and Support for Therapeutic Marijuana Use

Medicinal marijuana may seem like a new political topic, yet the American Nurses Association (ANA) has been in support of its use since 2008. Their House of Delegates also provides support for a nurse’s ethical obligation to advocate for a patient’s right to use cannabis as a means of therapy.

How is Medical Marijuana Ingested?

Patients using marijuana as a part of their medical treatment plan will most often smoke the substance, or inhale the smoke it gives off. It may also be vaporized, where the active ingredients are released but no smoke is formed. Less common is to take the drug as a liquid extract or eat it by adding it to candy, cookies or brownies when cooking. The method of ingestion has little effect on how the body reacts to the chemicals, and is usually based on a personal preference for the patient.

Marijuana and Addiction

Physical addiction to marijuana is rare and most often seen in individuals who use the substance consistently over a long period of time. Most of the symptoms associated with smoking or inhaling the drug, such as short term memory loss, disappear once the effects of the drug wears off.

For those patients that have developed an addiction to marijuana, you might note withdrawal symptoms when it is not made readily available. These symptoms include irritability, insomnia, poor appetite, anxiety, depression, agitation, cravings and mood swings. If you suspect a patient is experiencing one or more of these symptoms as a result of their medically authorized marijuana use, bring it to the attention of their primary care physician immediately.

Whatever your personal beliefs and feelings are regarding the use of marijuana, as a nurse, you should be able to recognize its benefit as a natural drug. Cannabis has been used for hundreds of years to treat dozens of ailments. Now we have the opportunity to improve the quality of life for thousands of patients who suffer daily from the symptoms of chronic illness.

What do you think? Share your thoughts in the comments section below.


This article was republished with permission from SCRUBS Magazine.

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20 COMMENTS

  1. As a nurse that has lost 2 brothers to drugs- both started out on Marijuana and thought- gee this did not hurt me, let’s see what heroin will do. I clearly see Marijuana as a gateway drug. However, in the hands of end of life patients, possible chronic pain- I do see the benefit. My big issue is with children having access to it- and they are crafty- it happens. It has happened with the Fentanyl patches and lead to overdosing and death in kids/ teens. Much more research needs to be done!!

  2. The tar n nicotine in one marijuana cigarette have been studied many years ago and have said to be 20 times higher than that of one cigarette. So people with early COPD will have adverse effects. As far as sleep apnea goes I cannot imagine how well that would help sleep apnea. It is understood and established as a medical fact that when you are sedated sleep apnea becomes worse. I too share in the concerns regarding exposure to people who do not use that. I did read the nurses issue and that is something that she chooses to do so THC will always show up in her urine regardless if she only uses it at night you can use Vicodin when she goes to work however that is not accurate either we cannot be under the influence one we are dispensing medications to patients. Also I am concerned about young children inhaling the residual effects of mom or dad’s marijuana cigarette and the effects it may have on their health. And driving while impaired. You are impaired if you have smoked marijuana and it doesn’t surprise me that car accidents have increased. Also there is the issue of people choosing to put it in candy and food for children to accidentally overdosed and possibly die. I am in Florida and recently saw a sign that said medical marijuana and was pretty shocked. I did know that they were building it into you so I voted against it for legality however thought it would be helpful in certain conditions like terminal cancer and HIV where patients are losing large amounts of weight due to inability to eat. As far as a means to control diabetic neuropathy’s and vascular disorder pain, I believe using marijuana cigarettes would be detrimental to the cardiovascular system the same way that smoking is. I am a nurse and I’m not judge mental about what is prescribed for a patient however, since this article says that it will not be prescribed to me, that shows that there are not enough studies and the doctors are not comfortable writing prescriptions for this where they may in the end wind up being sued. So the way out of that is to authorize the card at the patient’s request of course and where would liability fall? There is no prescriber in fact, so its like a use it at your own risk type of thing. I think that as a registered nurse if I encountered a patient in the home care setting was thinking of getting medical marijuana I would present them with education regarding everything I mentioned and more. It is not my job to be judge mental however it is my job to educate people and patients alike so that when they make a decision it is truly an informed decision. I believe we need much more research and I am concerned also about where is this marijuana coming from and are there certain things it is laced with that or man-made and how can they say that it is bacteria free. There are just too many unknowns for me and I would never tell a patient yes I think you should do this. I would present them with the education and knowledge that I have and also direct them to sites that they can research for themselves. We need more research.

  3. The federal government’s position on medical marijuana—total denial that marijuana has any medical benefits—is an embarrassment to science, to countless health care professionals and to patients nationwide. But worst of all, the federal government has blocked the path of inquiry into the benefits of medical marijuana. They refuse to allow large scale clinical testing. They have systematically and consistently prevented the kind of studies that would lead to FDA approval, and then they—and their apologists–complain that the FDA has not approved it. But science cannot be suppressed indefinitely.

    There is an entirely new scientific field emerging with the recent discovery of the Endocannabinoid System. This system details the cannabinoid receptors that exist in every organ of the human body, and explains why marijuana is effective for such a wide range of diseases, symptoms and conditions.

    It is a morally bankrupt position to forbid suffering patients to have access to the medical benefits of marijuana. This is especially true when licensed physicians are recommending marijuana for these patients, and when this safe, effective and inexpensive therapeutic agent is readily available.

  4. Actually, ANA support for medical marijuana/cannabis goes back even further, to 2003, when the ANA said patients have a right to this medicine: “Therefore be it resolved that the American Nurses Association will: — Support the right of patients to have safe access to therapeutic marijuana/cannabis under appropriate prescriber supervision.” — American Nurses Association, HOD Action Report, 2003. (The effective date of the Position Statement adopted by the ANA Board of Directors was 3/19/04.)

    Nurses empower patients to gain a central role in the healthcare industry by supporting their right to safe and legal access to medical marijuana/cannabis. When patients can produce their own medicine and titrate it to control their symptoms, under appropriate prescriber supervision, this reduces the current central roles of the pharmaceutical and the health insurance industries. Nurses advocate for, support and educate their patients who use marijuana/cannabis medicinally.

    Faced with the refusal of the federal government to allow large scale clinical trials that would prove the safety and efficacy of medical marijuana, patients are taking a more active role in governmental affairs–testifying in legislative committees, etc., and using the media and the social media in insisting on securing their right to use medical marijuana/cannabis.

    Nursing organizations have taken a leadership position on medical marijuana/cannabis. The emerging science of the Endocannabinoid System continues to validate our early advocacy and support for this issue. The ANA and numerous state nursing organizations have endorsed medical marijuana/cannabis for a decade or more. Our impact and experience in governmental affairs–which controls so much of the healthcare industry–will continue to grow as we continue to have the courage to speak truth to power.

    The American Cannabis Nurses Association is a national organization whose mission is to advance excellence in cannabis nursing practice through advocacy, collaboration, education, research and policy development. More info is at: http://americancannabisnursesassociation.org/

  5. As a former LEO charged with vigorous Meatijuan interdiction and eradication I had mixed feelings about Medical Marijuana. The is I did until I moved into a medical career. Since then I have worked for and with medical marijuana concerns in California, Oregon, and Washington state. Many of you are right. Federal Research Studies are sparse. That being said there are many international and private studies that speak highly of it’s medicinal use. In states where it has been approved I advocate it. If not I advise my clients that it is illegal to use and stop the conversation there. I don’t use it. It wasn’t legal until recently in Florida and they are still working the bugs out in the law. If it becomes legal, if a physician aothorizes it, if there is no reasonable research that finds it harmful, I am bound to support my patients wishes and those of a legal practitioner. It’s that simple. We are patient advocates, not law makers. We must provide care prescribed under the laws of our states and the oath of our profession.

  6. Not only concerned with the lack of peer-reviewed scientific research on this; but I am a little concerned regarding the effects on children. We finally were able to rid our public places and cars of secondary tobacco smoke. Now what about exposure to the lingering of MJ? Patients who have tobacco will send sensitive individuals into a reactive airway response when in an enclosed area with them. Now I am hearing complaints about the lingering smells of MJ on clothing having a similar effect on the non-MJ users.

    With its lasting effect, are we not also concerned about the proper disposal of its waste both human and production? I don’t know, so many questions, so little research!!

  7. The article does not site any reliable, credible or valid resources. Where are the RCTs and other robust research on this topic? The only research I have been able to find have been very small sample sizes and quantitative.

    If the ANA is in support since 2008, why is it that as a member since 1984, this is the first I see it mentioned? I have supported the use of medical marajuana for end life pain and nausea, in cancer patients and other debilitating diseases. Our state does not legalize medical use but MI does. Also our state does not authorize APRN to prescribe it.

    Until the laws change in our state and there is more research on this, I will hesitate to recommend it for chronic pain use or in lieu of prescription narcotics. Would love to see more research especially with its prevalence and sanction.

  8. I have looked into the research and there is very little. We have a MJ dispensary here and they admit to no standardization. They are going by what the patients say! Not right. They are making candy, and other forms of MJ and go from less t more in it. They ask pt’s if they ever used and if not give the one wit less in it to start as they know the person will become tolerant to it and need larger doses!! It is addictive and we have more accidents now as people are using and driving. Making it legal before any standardization was set up is a big mistake. Right now we have doctors coming to the local motel and charging 250.00. for a medical Marijuana cad. No questions asked or taking pt’s word that they have a problem. I am very cautious about this whole MJ thing. Yes, it treats pain like any other narcotic. But do not give such access. Word is that parts of Colorado are like the Chinese Opium dens when they doped up the whole country and took their freedom away. My pint is that it is being hyped up with no research studies short term of longitudinal to back it up. Some small subject studies are out there. It is dangerous to have the brownies, candy, etc as kids get into it and overdose, there is not standardization and more accidents with vehicles are being reported. I am open to anything that helps as I am a Hospice RN, but until we can dose properly and know how much to give instead of experimenting. We need to push for research and more regulation! It is a lucrative business. Cartels are now in CO as per citizens I know as well as family and soon will be in NV. Legalization without regulation has just brought them here instead of in MX and South America.

  9. There have been no reported cases of lung cancer from marijuana smoking. Also stated in the article that it is not as addictive as pain meds, so I think the risk of addiction to cigarettes is much higher than marijuana. I have seen the benefits of this drug on multiple individuals and think it could be a great advantage to them.

  10. I took nicotine for 18 years to real relieve chronic pain with so so results. Medical marijuana works twice a well and I don’t need to take a pill and harm my liver. As an RN, I could work with no repercussions. Just need evidence of my prescription. I have been prescribed marijuana for pain. I only use it at bedtime. Never at work. But I can’t get a job because of the THC in my urine. I WANT to work. I’m constantly receiving job offers until I tell them I have my medical marijuana card. I don’t do it at work, but could take my vicodine. This is unfair, rules must be changed.

  11. I find it disturbing the ANA and nurses support this…what other drug comes to public use without research based phase 1-4 clinical testing…this is ridiculous…all to date benefit has been anecdotal and whether you want to believe it or not, facilitating medical marijuana is a red herring for the overall accepted use of recreational use…so..we already have a huge problem with alcohol, so why add one more potential layer of abusive substances that affect both mind and body….and yes there has to be an effect on the lungs, similar to tobacco or maybe worse, particularly if kids start using younger.

    • Totally agree…. with the current heroin / opiate epidemic many of those who suffer substance use disorder started with marijuana. I am shocked at such a one-sided approval of what many people feel is a gateway substance

  12. Wish it was a schedule II drug so it could be researched more. What is concerning is some preliminary peer reviewed research showing possible detriment to cardiac muscle cells. Nurses should also be aware of the gastric distress with nausea and vomiting with some patients.

    Nurses should also be aware that THC is fat soluble meaning if he or she party on Friday and get drug tested on Monday…you will probably have a career change…

  13. My research has said that combustion at high temperature does release some undesirable chemicals, but vaporizing does not. It is a safer way to inhale cannabis. Surprisingly, cannabis is a bronchodilator and one report says smoking or vaping provides the same action as the use of a rescue inhaler in asthmatics. Edible forms provide a safe means of ingesting cannabis. Topicals are helpful for muscle pain and spasms. This plant has so many benefits and I am in favor of it being available to everyone.

  14. I was a nurse in an addiction center some years ago. We saw many long term users with a lot of memory problems. Has that just been ignored. Also, what about past reports of birth defects from the medication, I dont see that anywhere.

  15. Big difference between smoking (or vaping) and eating. Much easier to dose properly when smoked. When smoked it’s very hard to do too much, that’s not the case when eaten. Also quicker acting when smoked.

    Smoking might be an issue for patients with respiratory problems. However for most patients the small amount of smoke involved is not an issue.

  16. I also, have not heard the dangers of smoking Marijuana…. Having Teenagers in the home we believe in education. All, they are hearing in the media is Marijuana is “Okay”. I assume there are many of the same dangers in smoking it as regular Cigarettes?? Please respond… I am sure we don’t need all of our youth getting high all the time!! thanks

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