Cannabis and Healthcare 2014

[madwife2002]

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 6^th 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!

[tbjockny]

As a recreational smoker all I have to say is I know plenty of people who have tried other drugs before weed. I hate the "weed leads to other drugs" argument. You make informed decisions to try each drug...weed doesn't make that decision for you; I've never had any temptation to try any other drug or smoke cigarettes.

I see it no differently than alchohol or cigarettes. Don't do it in public where others might find it offensive, don't work or drive while under the influence. Be responsible.

I also have no problem with parents who smoke. Know a million amazing parents who do..when their kids aren't around . Unequal to state don't smoke weed around kids, yet 99% drink casually and smoke cigarettes in front of their children. Don't do any of it around them then.

[toomuchbaloney]

It troubles me that we have nurses on this forum asking what the differences between marijuana and alcohol are. That HAD to have been rhetorical.

It troubles me that health professionals are apparently ignorant of the abundance of evidence speaking to the dangers of routine and long term ingestion of alcohol to the point of impairment. It troubles me that some seem to believe that there are long term dangers to ingestion of cannabis when there are none clearly documented using good scientific method. Sure, one can say that people who begin using cannabis early in adolescence may have cognitive, memory, or IQ changes. We can say that about people who begin abusing ANY drug in adolescence, right?

It troubles me that health professionals believe that the effects of a good drunk are gone in a few hours while the effects of THC linger. Have any of us here ever worked the day shift with a co-worker who drank too much the night before? They remain impaired whether or not they are still drunk. They are slow, cloudy thinkers who may be physically unwell. They likely slept poorly because of their ETOH levels and are therefore possibly sleep deprived. Have you ever worked day shift with a co-worker who got really stoned the night before?

I am nearly 60 years old and have been working in health care for more than 3 decades. I have worked with all sort of substance abusers and users as peers and collaborators. By and far, the pot smokers were not a problem. No problem at all in fact. You can't trust those who abuse opiates or bennies, they may take from the patients and may work impaired. They will ask you to cover for them. The drunks will eventually show how they prioritize by calling off and showing up late. They are frequently "under the weather" at the start of the shift but manage to heal by the end. I have seen none of that with pot smokers. NONE. By and large they come to work ready to work when they are supposed to work. Mostly, you have no idea unless they tell you.

Americans have a "fear" of cannabis that was closely associated with the anti-Mexican racism of the early 1900's and transferred to blacks and other "racially inferior" groups by the 1930's. The alcohol lobbyists were historically and continue to be instrumental in funding anti-marijuana campaigns and legislation. As we mature and evolve past these irrational fears we may come to understand the human endocannabinoid system better by conducting intensive and meaningful research. We may yet discover some interesting things about this plant and it's uses and benefits beyond a pleasant euphoria associated with improved carbohydrate metabolism. What we do know is that it is a really good anti-emetic and anti-anxiety med. We do know that it can help insomniacs with none of the side effects of the typical sleep aids. We do know that it can be an effective antidepressant, again, with none of the typical side effects that are often associated with that group of pharmaceuticals.

I am hoping that Alaska legalizes it next, in which case I will be filling a pipe and getting out my guitar.

[tokebi]

My personal view on marijuana notwithstanding, I was floored when I learned recently that it is classified as schedule I drug by DEA... that's same class as heroin, and LSD. What in the world...

[Asystole RN]

My personal view on marijuana notwithstanding, I was floored when I learned recently that it is classified as schedule I drug by DEA... that's same class as heroin, and LSD. What in the world...

Keep in mind that is marijuana the plant.

There are medically accepted marijuana derived drugs that are currently on the market, most famously Marinol.

[jadelpn, LPN, EMT-B]

It should be illegal for employers in those states (CO, WA) to terminate/refuse to hire employees/prospective hires on the basis of a THC positive drug test. Same goes for licensure and the SBON. The substance is legal, what rationale could they possibly use to override the law? Our company/facility/institution doesn't condone the use of marijuana, therefore we can selectively hire/fire people on that basis? Authority shouldn't legally be theirs to make that call.

I'm sure a hospital doesn't condone the use of tobacco, but employees aren't tested for and subsequently fired for use of that cocktail of harmful "substances." Shoot, people at my hospital take frequent breaks to satisfy their nicotine addiction at the expense of productivity and patient care - but that vice is a nonissue. Your patient codes in the 10-15 minutes while you were appeasing your urge and the response time/resuscitative efforts of the temporarily short-staffed unit leads to an avoidable patient casualty. Also while there are no effects of acute impairment secondary to tobacco use, the negative effects on one's health are substantial and well-documented. So what makes tobacco (well, nicotine) addiction acceptable for hospital workers from an HR perspective?

Alcohol consumption does cause acute impairment. It also has numerous well-documented negative health effects, especially with long term use. Obviously it is legal, but due to its judgment-altering effects, is strictly prohibited from use on-the-job. That makes sense; the same as it would make sense to prohibit marijuana from use on-the-job. Can an employer terminate an employee for getting drunk at a wedding occasionally... or on the weekend... or every weekend... or every day after work for that matter? Now this is hypothetical, but if somebody's work, demeanor, and judgment aren't affected (functional alcoholics) how would they ever know? It's not like EtOH is tested for on a regular basis. Do employers even test for it (with suspicion or not)? Not where I work.

So again I ask, what rationale could they possibly have for action based on a THC positive drug test if the substance is legal? The ethics of doing so are tantamount to taking action based on tobacco or alcohol use.

There are many facilities who will not hire cigarette smokers, test for nicotine, and will fire someone for smoking if it is banned. I am amazed at how many there are!

Pot does stink (as do cigarettes) and the smell does cling on someone, one could argue that nicotine does have some medicinal value, (ie: with parkinson's tremors).

There are other countries that it is legal to get your maitenence dose of heroin and a clean needle too.

Bottom line, companies do a lot of there own regulating, regardless of if a substance is legal or not legal.

[jadelpn, LPN, EMT-B]

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).

Well, I beg to differ. As someone who lived with a chronic, daily pot user---when one needs it to get up and stay awake, go to sleep at night, and craves it---well, then I would call that an addiction. And there are many, many people that this is a fact of life.

[twinkerrs]

Well I beg to differ. As someone who lived with a chronic, daily pot user---when one needs it to get up and stay awake, go to sleep at night, and craves it---well, then I would call that an addiction. And there are many, many people that this is a fact of life.[/quote']

That is psychological addiction. I think most people are referring to physical addiction. Most people can quit pot cold turkey without any physical effects. People can become psychologically addicted to just about anything.

I am hoping arkansas legalizes at least medical marijuana I would try it for my 9 year old autistic son in a heartbeat. According to research it would lessen the aggression and would not be as hard on his body as the medications he has to take to function that we don't even know what kind of damage we will show in 20 or 30 years.

As far as legalization if marijuana had a huge baker like anheuser Busch or Phillip Morris to push to legalize it would be legal everywhere because the kick backs for our lawmakers would put all of the legislating for morality to bed.

[zack1a]

The "addiction" debate seems to be one I encounter quite often. To be honest, I find it rather embarrassing how few nurses understand the difference between physiological and psychological addictions.

Psychological addictions have no physical withdrawal symptoms. An addiction to Mediaography would have no physical symptom if you were to stop, or at most, your carpal tunnel symptoms may be relieved.

Conversely, opiod or alcohol addiction have severe withdrawal symptoms. This is blatantly apparent after a long night out. What we call a "hang over" is withdrawal and thats after one night. One of the absolute worst, if not the worst, withdrawals a person can go through is that from long term alcohol use. Simply put, it can kill you.

When was the last time you found yourself pushing Ativan after a stoner rolled in?

[Asystole RN]

That is psychological addiction. I think most people are referring to physical addiction. Most people can quit pot cold turkey without any physical effects. People can become psychologically addicted to just about anything.

I am hoping arkansas legalizes at least medical marijuana I would try it for my 9 year old autistic son in a heartbeat. According to research it would lessen the aggression and would not be as hard on his body as the medications he has to take to function that we don't even know what kind of damage we will show in 20 or 30 years.

As far as legalization if marijuana had a huge baker like anheuser Busch or Phillip Morris to push to legalize it would be legal everywhere because the kick backs for our lawmakers would put all of the legislating for morality to bed.

If you want to medicate your child why would you consider giving him a raw plant? There are marijuana derived drugs already on the market that have controlled doses, easy to take, and are socially acceptable.

What is the rationale for giving a child a raw plant to either ingest or inhale?

If your child is in pain you do not grab a bunch of opium poppies?

[Asystole RN]

The "addiction" debate seems to be one I encounter quite often. To be honest, I find it rather embarrassing how few nurses understand the difference between physiological and psychological addictions.

Psychological addictions have no physical withdrawal symptoms. An addiction to Mediaography would have no physical symptom if you were to stop, or at most, your carpal tunnel symptoms may be relieved.

Conversely, opiod or alcohol addiction have severe withdrawal symptoms. This is blatantly apparent after a long night out. What we call a "hang over" is withdrawal and thats after one night. One of the absolute worst, if not the worst, withdrawals a person can go through is that from long term alcohol use. Simply put, it can kill you.

When was the last time you found yourself pushing Ativan after a stoner rolled in?

Did you just make that up? I am embarrassed that you do not know that a "hangover" is not withdrawal but rather a physiological response to ingesting large amounts of alcohol impurities "congeners", dehydration, and GI irritation.

[zack1a]

No, I did not make that up. Although what you're saying regarding dehydration is also true, most of the symptoms of a hang over can be cured by ingesting more alcohol.

[MunoRN, RN]

If you want to medicate your child why would you consider giving him a raw plant? There are marijuana derived drugs already on the market that have controlled doses, easy to take, and are socially acceptable.

What is the rationale for giving a child a raw plant to either ingest or inhale?

If your child is in pain you do not grab a bunch of opium poppies?

Derivatives of the primary therapeutic/medicinal component of marijuana isn't actually available in the US.

Cannabidiol (CBD) is the component of marijuana that has been found to be effective in treating a number of conditions, including cancer, chronic pain, psychosis, epilepsy, etc. THC is the psychoactive component of marijuana and has limited therapeutic/medicinal uses, and arguably should not be taken by itself (not combined with CBD) for any purpose, even recreationally.

Marinol is not a synthetic version of the therapeutic component of marijuana, it is synthetic THC.