Advocacy and scope-of-practice implications for nurses are shifting in line with the acceptance and legality of cannabis use throughout the United States. Back in 1850, marijuana was sold OTC and was openly used as treatment for a variety of maladies – but by 1936, every state had passed legislation to eliminate that availability and restrict its use and possession. 1937 saw the Marihuana Tax Act become law, prohibiting all non-medical use of cannabis within the United States.
In 1970, the Controlled Substances Act made marijuana a Schedule I substance, prohibiting its use for any and all purposes, bringing the responsible cannabis industry to a screeching halt. Schedule I controlled substances are deemed to present a high potential for abuse and have no medical value. The classification is one that prohibits practitioners from prescribing cannabis and also prohibits most research using the substance except under tight government supervision.
Marijuana in the New Millennium
Beginning in the early 2000s, medical marijuana programs (MMPs) began popping up in various states, and a process to obtain cannabis for medical use became somewhat standard. Patients had to have a qualifying condition certified as being valid by the health care practitioner, and were then required to register with an MMP and visit a medical marijuana dispensary to receive the product. A few of the qualifying conditions included cancer, glaucoma, a terminal illness, chronic nausea, Chron’s disease, multiple sclerosis, and ALS.
Today, nurses must now become familiar with the effects of cannabis on patients, regardless of the reason for use. With recent legislation lifting many of the major barriers to recreational use in several states, nurses have the duty to work to separate symptoms of medical conditions from effects of marijuana.
In some cases, this may complicate the process of diagnosing patients if personnel are not familiar with the effects of cannabis – for example, one possible effect of cannabis use is an increased heart rate. If a patient who uses marijuana presents with this symptom, is it temporary and just from the marijuana or is there a medical reason behind the condition? A nurse needs to be able to piece the clues together to make an educated decision for the benefit of the patient.
Nurses and Patients who Use Cannabis
Cannabis in general increases appetite and causes a sedation effect. It’s also a euphoriant, so these effects may lessen medical symptoms and increase the user’s sense of well-being while diminishing pain. A few of the possible effects of cannabis include dry mouth, decreased urination, increased paranoia and anxiety, and impaired attention span. Users may also experience nausea, vertigo, and even suicidal ideation, contrary to many of the positive effects.
It becomes clear why the increased availability, legality, and use of cannabis has the potential of complicating things for nurses and medical professionals if they are not attentive to patients’ use of cannabis and they don’t familiarize themselves with its properties and effects.
Nurses may also need to learn how to properly and safely administer medical marijuana to a patient. Some MMPs allow an employee of a nursing or medical facility (or a hospice provider) to act as a designated administer of the substance. In cases such as these, informed decision-making should be done with not just the patient, but also the family members and other caregivers. Nurses must become acquainted with everything from safety considerations to the means to monitor and evaluate the patient’s response to cannabis.
Ethical Considerations with Marijuana-Using Patients and Nursing
While documentation and communication become critical to the patient’s plan of care, ethical considerations are also extremely important. According to the National Council of State Boards of Nursing, nurses should always approach patients who use cannabis without judgment regarding their pain management preferences and choice of treatment, and medical professionals caring for individuals who use cannabis should always avoid conflicts of interest. Nurses also shall not certify an MMP qualifying condition for himself or herself, or for a family member.
Staying Current with Rapidly Changing Developments
The cannabis industry is one that is decades old, and it has undergone a wild transformation through the years from providing a readily available, OTC product to a tightly restricted one to an illegal one, and it’s now on its way back to becoming readily available once more.
There are excellent cannabis conventions and expos around the country that feature discussions by marijuana industry experts, networking opportunities, workshops, and more for anyone who wants to either tap into the industry or learn more about cannabis, its responsible use, and its numerous benefits. Many nurses and medical professionals find great value in these conferences for learning crucial information about the substance for the benefit of their patients.
With today’s rapid developments in the legality of the substance, weed news can be difficult to keep up with. However, it’s vital that nurses are aware of the effects cannabis can have on patients in order to provide the best quality of care for those who seek marijuana for pain management and an overall improvement to their quality of life.