Medical marijuana, role of the nurse, professional organization

[hotflashion]

It would be nice if we could have an intelligent and professional discussion about this topic without a whole lot of judgement going on. I tried to find an appropriate topic before stating a new one but many (most? all?) of them have been closed.

Right up front I'd like to say that federal law and state law clash on the use of marijuana in a medical contex, so there's no need for anyone to state that again. Also, the action of any state's Board of Nursing is unknown, and should be researched by those who have questions. (So, call them and ask! And let us know what you've been told.) If you know of documented cases of license suspension or revocation, provide links to verifiable information, but please, no scary stories without facts.

I started by Googling the question "What is the role of the nurse in a marijuana dispensary?" My state is one of the ones that recently approved medical marijuana use and will soon be accepting applications for dispensaries. It's an occupational setting I would consider, so I am interested in hearing from nurses who work in dispensaries or clinics.

[yarmada]

How pathetic things have become that we must tip toe with the thought of "not getting caught". Why is morphine, opiates and all narcotics okay but this plant isn't? Why can we not take another look at this and ask ourselves if perhaps we were wrong from the beginning....Then again we know the reason don't we? They can't figure out a way to control the plant and regulate it so that their pockets become lined with money...Sickening to say the least. When people can truly benefit from something as simple as a plant and the powers that be prevent it we need to take a good hard look at what we have become in this society...

[MunoRN, RN]

When I was working in oncology I had patients who smoked it to relieve nausea and vomiting from chemotherapy (marinol wouldn't work for the obvious reason of vomiting it back up - smoking it bypassed that problem.) I just told them I was glad they were honest with me, but I couldn't get them out of jail even though I agreed with what they were doing, so don't get caught......

Marinol doesn't work because it is THC, which actually has little therapeutic value compared to cannabidiol, which is the component of Marijuana that produces most of the desired therapeutic effects.

Cannabidiol is used for treatment of nausea, vomiting, pain, anxiety, insomnia, depressed appetite, schizophrenia, parkinsons, and has been shown to inhibit metastic cancer. THC is what produces the psychotropic effects of marijuana and has some, but comparatively little effect on nausea or pain, and can actually sort of scary to take by itself. "Bad trips" are typically attributed to marijuana with a high ratio of THC to cannabidiol.

[FineAgain]

Exactly MunoRN! The endocannabinol system activation of the CB1 receptor inhibits release of neurotransmitters such as serotonin and acetylcholine, associated with pain impulse transmission, and CB₂receptors are thought to play a role in nociception, or the perception of pain.

More snippets from my paper...

[saynotojello]

I'm an NP and was recently proposed a position a a dispensary for medical marijauna. I previously worked in pain management and I can say that pre-pain management I did not totally agree with the medical marijauna but I soon learned how misinformed I was on the subject. I am 100% for the use of medical marijauna and think when it is controlled (not junk) the benefits are so muchbetter than the insane amount of narcotics pts take.

Professionally however, being associated with a dispensary makes me nervous, any NPs work there?

[ArtClassRN, ADN, RN]

The first role of any nurse should be to investigate evidence based material regarding the efficacy of medical marijuana when used in clinical trials and environments.

[ArtClassRN, ADN, RN]

saynotojello said:

I am 100% for the use of medical marijauna and think when it is controlled (not junk) the benefits are so muchbetter than the insane amount of narcotics pts take.

Really. Just try substituting some Mary Jane for an "insane" amount of narcotics and see what happens.

Try it for any amount. "Oh, Mr. Jones, you just had your gallbladder removed, and I bet that really hurts a lot. Well, Nurse Arty here is going to spare you from Big Pharma and evil narcotics by giving you some of this medicinal form of a recreational drug."

I would love to see this tested, but ethical standards would not allow it.

[ArtClassRN, ADN, RN]

MunoRN said:

Marinol doesn't work because it is THC, which actually has little therapeutic value compared to cannabidiol, which is the component of Marijuana that produces most of the desired therapeutic effects.

Cannabidiol is used for treatment of nausea, vomiting, pain, anxiety, insomnia, depressed appetite, schizophrenia, parkinsons, and has been shown to inhibit metastic cancer. THC is what produces the psychotropic effects of marijuana and has some, but comparatively little effect on nausea or pain, and can actually sort of scary to take by itself. "Bad trips" are typically attributed to marijuana with a high ratio of THC to cannabidiol.

Your statements on the efficacy of cannabinoids verge on the extraordinary. Extraordinary claims require extraordinary evidence. How has cannabidiol fared in randomized double blind placebo controlled studies?

[toomuchbaloney]

ArtClassRN said:

Your statements on the efficacy of cannabinoids verge on the extraordinary. Extraordinary claims require extraordinary evidence. How has cannabidiol fared in randomized double blind placebo controlled studies?

Don't we all wish that the US had been engaged in actively and seriously studying cannabinoids rather than simply vilifying it.

[EricNY]

The problem is that Cannabis is still considered a Schedule 1 Narcotic.

Until Cannabis is rescheduled - it is extremely difficult to get any meaningful study in place.

[toomuchbaloney]

EricNY said:

The problem is that Cannabis is still considered a Schedule 1 Narcotic.

Until Cannabis is rescheduled - it is extremely difficult to get any meaningful study in place.

Until this ridiculous categorization of cannabis is changed it will be difficult to get quite a number of things accomplished.

[Muser69]

Should be legalized nationally. Not by each state. Just change the category.

[danicamaeB]

That was interesting. Nurses should know the uses, proper administration, side effects and law about marijuana. Marijuana has been shown to alleviate symptoms of a huge variety of serious medical conditions including cancer, AIDS, and glaucoma, and is often an effective alternative to synthetic painkillers.