Marijuana: legal in patient belongings?

[FutureDNP2021, ASN, RN]

Our state just legalized recreational marijuana this week. So my question for AN is, what is your opinion on what we should do with it when (non-cancer) patients have/use edibles on a healthcare unit? Its legal, so should we treat it like cigarettes & send it to security lock-up until they're released? Do we discard it because it is still a federal crime? Do we send it to pharmacy to register it as a home medication? If so, how do you feel about dispensing it to patients along with their other medications? BTW, our hospital has not addressed this fully in policy as of yet.

Thank you for your input!

[JKL33]

Since it is Schedule I according to the DEA, your facility needs to come up with an answer pronto. I'm not sure how the policy could possibly include licensed individuals handling it in any way - - what licensed professional is going to sign up to handle/prescribe/dispense/administer a C-I substance when the federal government says it is illegal? Especially anyone with a DEA license. In a facility that contracts with the federal government (CMS)?! Some of these acts would constitute felonies. Random thoughts.

[MunoRN, RN]

My facility's policy defines it as a non-medication, it's grouped with things like ginger root for nausea. Smoking and vaping is not allowed on hospital property, but patients are free to bring in their own food items, even those that contain marijuana. Our palliative care team often asks patients have been using marijuana outside the hospital and if it helps with their symptoms, if so we encourage family to bring in edibles, drops, etc.

Even when used as medical marijuana, it is never actually prescribed, a patient receives a "recommendation" or "authorization" which is distinct from a prescription. When patients come into the hospital and it's found in their belongings it kept with their belongings and returned to the patient on discharge.

Hospitals are regulated by state governments, so their policies on marijuana only have to jive with state laws unless the federal government at some point choses to challenge that. Hospitals do receive federal funding via CMS, and tie many regulatory requirements to that reimbursement, but currently enforcing federal marijuana laws is not part of the CMS Conditions of Participation.

[JKL33]

...but currently enforcing federal marijuana laws is not part of the CMS Conditions of Participation.

Interesting. Good info. I was thinking along the lines of:

§ 482.11 Condition of participation: Compliance with Federal, State and local laws.

(a) The hospital must be in compliance with applicable Federal laws related to the health and safety of patients.

I trust the lawyers have ascertained that this is in some way not applicable.

[ChryssyD]

I was working at an in-patient hospice. Some patients would go outside to smoke on a little patio. I was a smoker at the time (now 8 years nicotine-free, yay!) so one day I'm out there with several ladies. One of the ladies pulls a joint out of her pocketbook and proceeds to toke away.

Now, I have to admit I was a little taken-aback. But I eventually decided that, you know what, I'm a nurse, not a cop. The lady is dying, and if she wants to get high once in a while, it's not my place to tell her no (BTW, this was a state where weed wasn't and still isn't legal, even for medical use). Had I found it in her belongings beforehand, I'm not sure I would have said anything other than "Be careful."

Your facility definitely needs to write a policy about this pronto--it should have been done ASAP after weed was legalized. For now, consult your manager or supervisor--kick this one upstairs.

[klone, MSN, RN]

We treat it like any other patient belongings.