Cannabis and Healthcare 2014

2014 saw the beginning of legalized cannabis shops in Denver Colorado. What does this mean for us as Healthcare professionals, will we see a reduction in alcohol related diseases? Or will we see an increase in Cannabis related diseases? Nurses Announcements Archive Article

The eyes of the world are watching the new experimental POT shops, which have recently opened in Colorado, selling legalized Cannabis for everyday consumption, for everyday people. Who would have thought that this would happen in our lifetime! The lines went round blocks and shops feared they would run out quickly.

It is estimated that 37 shops opened their doors 1st January 2014, and by January 6th 2014 speculation is mounting that shops will soon run out of supply.

It is estimated that over 1 million dollars was spent in the first 24 hours on legalized Pot.

Do we think that people want cannabis to be legalized, do people think we should be allowed to buy 'pot' from shops, yep I think we can safely say if this past week has shown anything, that everyday people want to buy pot.

Although it has to be pointed out that in all photos, videos and media shows there appeared to be a huge population of men shopping and buying pot than women! I did not actually see a woman in the shops, I am sure there were some?

I can see it now, 'Honey can you pop out to the pot shop for me'

Alcohol companies are fearful for a drop in profits, and I think they should be! For the addictive personality swapping one addiction for another may well be the way forward.

As healthcare professionals we should consider how this might actually benefit our patients, the cost to lives, reduction in violent crimes, reduction in ER visits and all the other health care benefits we are lead to believe happens if you smoke cannabis.

There are many research projects out there, attempting to prove that cannabis is safe, that cannabis has many health properties.

According to one source there has never been an overdose of cannabis because you have to consume 20,000 to 40,000 times the amount of THC (short for Tetrahydrocannabinolin),which is present in a joint to be at the risk of dying.

Police worry that using cannabis increases the chances of moving onto harder drugs, but there are no scientific studies to date that support this claim. Police also worry that using cannabis will increase violent crimes, behavior and suicidal tendencies, again at this time there is no scientific study to confirm this belief.

In 2010, overdoses were responsible for 38,329 deaths. Sixty percent of those were related to prescription drugs. In the same year, a total 25,692 died of alcohol induced issues , including accidental poisoning and disease from dependent use.

Benefits to our patients include but are not limited to...

  • Antiemetic for general patients
  • Increased Appetite for the chronic sick and elderly patients
  • Decreasing neuropathic pain, especially with MS patients
  • Reduction of pressure within the eyes of glaucoma patients
  • Some studies have shown reduction in tumors in cancer patients (although studies are not conclusive but we can expect a lot more studies in the future)
  • Reduction of nausea in chemotherapy patients and increase of appetite

Side Effects

Short-term (one to two hours) effects on the cardiovascular system can include increased heart rate, dilation of blood vessels, and fluctuations in blood pressure

Short-term memory loss

Increase in psychosis (newer studies are disputing this)

Schizophrenia (newer studies are disputing this)

Drop of about 8% IQ in patients under 18, although starting after 18 does not appear to cause an IQ drop

Driving is impaired and studies in the UK say if you drive within 3 hours of smoking cannabis you are twice as likely of having an accident.

An interesting side note, shares in one cannabis growing company increased their share prices by 53% overnight!

I highly doubt that a lot of people will do business elsewhere because some company fired an employee for testing positive for pot. Boycotts do little.

It wouldn't be a single employee. Depending on the industry, it could be a majority of the employees.

And to the contrary, there are many examples of successful boycotts and many scenarios where boycotts are effective.

You don't think Seaworld is reeling today from consumer and entertainer alike boycotting the theme park? How about the pink slime/hamburger boycott that quickly changed the hamburger industry? In 2011, one young women started a successful boycott movement against big bank debit card fees. British Petroleum's Deepwater Horizon spill resulted in a hugely successful boycott with the CEO ouster, the company changing names, etc. The examples are almost endless.

What is the difference between marijuana and alcohol?

Acknowledging that this is probably a rhetorical question, I would point out 2 important differences.

One, marijuana is still considered an illegal substance by the Federal Govt.

Two, alcohol clears the body in a few hours, marijuana can take weeks.

My employer, like many of us, has a random drug test policy for nurses. If I test positive for cannabis derivatives policy requires I be punished regardless of my performance only because it is an illegal substance because it in no way proves I was impaired on the job, whereas if I tested positive for alcohol, a legal substance, it would. My point being, corporate random drug testing for marijuana is a pointless invasion of privacy

Specializes in Med/Surg, Academics.

The one thing I'm concerned about is that there is currently no test that can determine if a driver is impaired by pot use. If pot is going to be legalized, it should have all the same restrictions and laws that alcohol does, especially with driving. However, at this point, there is no legal way to prove impaired driving.

Specializes in Acute Care, CM, School Nursing.
...A nurse in the ED would likely prefer a waiting room full of pot-heads over a waiting room full of drunks.

I love this sentence! What a visual: "Oh, man. We're all so hungreeeeee..." LOL

The problem with how we legalized marijuana in our country is really an issue. Everyone says tax it and end the war on drugs save money and make money. Win Win. Not the case in Colorado and Washington. We completely legaized marijuana, which means we can buy it , sell it, grow it, do what ever we want. In countries like Amsterdam you can only buy it and use it. That is how Holland makes its money. The Government grows it and sells. In the U.S. it will be much more difficlut to actually tax something that is legal to grow, no diffrent than those of us that grow our own gardens. So the war on drugs will be over to an extent but then it will turn into the war on tax evasion, and we will still need more regulators in the field.

The next issue will be testing. We will have to develop a better testing system. Companies can only tell an employee that they cannot be high while at work, just as they do with alcohol. If a person wants to smoke on Friday night but work on Monday they should be able to. The effects will be gone by then just as the effects of drinking would be gone. However they would still test positive. This is another issue that was not fixed before legalization and will cause unnecessary job losses and lawsuits.

Of course taxing something that you can grow in your own patio or back garden can be difficult, but is not impossible, and still the government can get millions from taxes. Not everybody has the skills, the time, the patience , the space etc to grow their own tomatoes, and some people just prefer go to the professional or the shop to buy. Same happen with eggs, you just need a hen to get your own eggs, but most people just buy them in the store. that is where the state get their taxes, the only difference is that some people prefer home produced stuff, and other just want to buy. simple.

the other benefit is public protection as buying cannabis from the illegal market is money that you don't know where is going to end, it could just easily go to fund terrorism, crime, slavery, etc, and in return people could obtain low quality or adulterated cannabis that can risk their health beyond the potential risk of the cannabis itself. In my experience working in an Emergency Department, in 8 years I have never come across any patient admitted where cannabis could be the cause or involved in any health condition or accident. I am not saying that does not happen, and there are patients that recognized they are users, but their presentation to the ER was not related to that. in the other hand many admissions have alcohol or tobacco use involved, and alcohol and tobacco is legal, so does that make any sense?

Specializes in Med-Surg, Oncology, Neurology, Rehab.

It is now legal, like alcohol. People can't drink on the job so they should be able to treat legal pot in the same way. This is so hypocrtical. the big shots can still booze it up and turn thumbs down to pot use, I just don't understand:banghead:

i guess that is the same as smoking tobbaco, you can smoke at home and still has a horrible smell, far worse that cannabis to me, and you can smell it from your home if someone is smoking next door. Same principle applies to drinking and smoking tobacco in the presence of ill, elderly, pregnant or children, there is jut not difference. About ban someone of using cannabis in their homes, if is consumed as a medicine, it is legal to ban someone consuming his medication at home if you don't agree or dislike it, are you morally and legally entitled to prevent them taking their treatment? As i said before, law necessarily has to be based on scientific facts, and the problem here is not consuming cannabis, it where , how and when people consume it. there are other presentations like ingestion, oil, inhalers, sublingual, etc that reduce the exposure to other people, and like in any substance affecting the neuro system, consumers can not perform some task like driving, handling machinery, surgery, etc.. if they are under the effect. that is just common sense.

To me, this is the difference:

If someone wants to drink alcohol beside me, who cares? But if someone wants to smoke marijuana by me, my son, or children in the home that do not have a choice then I certainly do care and find it completely different than alcohol use because of contact buzz which actually does occur. The fact that the person smoking marijuana is not only exposing themselves to it like an alcohol user is, is what makes marijuana users different than alcohol users. If there were restrictions on where you could, such as in designated bars, then I would be all for it.

I totally agree, and i add that there are many other presentations and preparations to consume cannabis, like cakes, brownies, oil, cream, inhalers, spray, etc. smoking is always a health risk regardless of is the smoked substance is tobacco, cannabis, heroine or cocaine... so smoking in public places should be banned, as to do it in a closed space in the presence of vulnerable people. Smoking in a private place or home, with no exposure to other vulnerable people is a private issue and as health professional all we know that health education and promotion can have some effect, but ultimately everybody has the last word about what they do with their bodies.

I agree in most of your comment, but cannabis is becoming legalized in more states and more countries, in what appear to be a trend, so I wont be surprised if is more widely available and eventually could be legalized by the federal government, is just question of time, scientific evidence and public pressure.

regarding detecting drugs at work, i just copy and paste a table with some information of detection time for some drugs in urine and blood. there are other methods to test it in hair etc, and probably more in development or to come in the future. I do thing that corporate drug testing, specially when not affecting to staff performance is pointless and an invasion of privacy, and if done should be done with any substance or none..

DRUG DETECTION TABLE

(from Drug Misuse and Dependence - Guidelines on Clinical Management, UK Departments of Health, 1999)

[TABLE=class: classic, width: 100%]

[TR]

[TD=colspan: 2]Approximate duration of detectability of selected drugs in urine [/TD]

[/TR]

[TR]

[TD]SUBSTANCE[/TD]

[TD]DURATION OF DETECTABILITY[/TD]

[/TR]

[TR]

[TD]Amphetamines[/TD]

[TD]48 hours[/TD]

[/TR]

[TR]

[TD]Methamphetamine[/TD]

[TD]48 hours[/TD]

[/TR]

[TR]

[TD]Barbiturates

-short acting

-intermediate-acting

-long-acting

[/TD]

[TD]

24 hours

48-72 hours

7 days or more

[/TD]

[/TR]

[TR]

[TD]Benzodiazepines

- ultra-short-acting (half-life 2 hours) (eg Midazolam)

- short-acting (half-life 2-6 hours) (eg Triazolam)

-intermediate-acting (half-life 6-24 hours) (eg Temazepam/Chlordiazepoxide)

- long-acting (half-life 24 hours) (eg Diazepam/Nitrazepam)

[/TD]

[TD]3 days (therapeutic dose)

12 hours

24 hours

40-80 hours

7 days

[/TD]

[/TR]

[TR]

[TD]Cocaine metabolites[/TD]

[TD]2-3 days[/TD]

[/TR]

[TR]

[TD]Methadone (maintenance dosing)[/TD]

[TD]7-9 days (approximate)[/TD]

[/TR]

[TR]

[TD]Codeine/Morphine/Propoxyphene (Heroin is detected in the urine as the metabolite morphine)[/TD]

[TD]48 hours[/TD]

[/TR]

[TR]

[TD]Norpropoxyphene[/TD]

[TD]6-48 hours[/TD]

[/TR]

[TR]

[TD]Cannabinoids (Marijuana)

- single use

- moderate use (4 times per week)

- heavy use (daily)

- chronic heavy use

[/TD]

[TD]

3 days

4 days

10 days

21-27 day

[/TD]

[/TR]

[TR]

[TD]Methaqualone[/TD]

[TD]7 days or more[/TD]

[/TR]

[TR]

[TD]Phencyclidine (PCP)[/TD]

[TD]8 days (approximate)[/TD]

[/TR]

[/TABLE]

What is the difference between marijuana and alcohol?

Alcohol is addictive, and has many negative health consequences.

Marijuana is not addictive, and has far fewer negative health consequences (if you don't smoke it, then there are practically no negative health consequences).

Specializes in IMCU, Oncology.

I guess I don't understand - what's the big deal about other people using marijuana? I personally would NOT use it unless I had cancer, but I use caffeine and drink wine. I understand that others should not be affected by other people smoking, so it makes sense that if you cannot smoke cigarettes somewhere then you shouldn't be able to smoke pot.

Actually, I tried to get off coffee a few weeks ago and tried to cut down too quickly. I went 24 hours without coffee. I drank green tea instead and I guess I underestimated the amount I would need to avoid withdrawal. I awoke with the most awful headache ever in my life. I literally stumbled into the kitchen feeling like I was going to die and fumbled around to find Tylenol. Even Tylenol didn't help the pain and then the most awful vomiting I ever had started. I had to stand in the kitchen for a while with my head against the wall, because it hurt to move before I stumbled back to bed. I had no idea I could have withdrawals like that from caffeine. I knew I could get a headache and feel bad, but literally that was the sickest I had ever been. I couldn't even drink coffee because as soon as I did I vomited. Then I managed to get some caffeine powder in and finally I felt better about an hour later. Caffeine is a serious drug and I hate being dependent on it, which is why I am now tapering down on coffee.

If marijuana is not additive, and caffeine is addictive, where is the problem? If you cannot use it while at work, driving or in other dangerous circumstances just like you cannot use alcohol and it can have medicinally positive effects, then I think it makes sense that they legalized it! I agree that it should be illegal if it is harmful to a persons health, but alcohol is harmful if used beyond moderation as well as caffeine. People get drunk using alcohol and personally, I think that's more dangerous than the effects of marijuana.

I can't wait to see what the studies say regarding using cannabis for the treatment of cancer!!!

Specializes in Psychiatry.

I have never smoked a cigaratte in my life much less used pot. But I think that nicotine is way more addictive and harmful (no medicinal property of nicotine seems to be on record unlike THC) than THC. We need to legalize THC and outlaw nicotine.