Marijuana and Sickle Cell Management?

Drysolong · Sep 29, 2004

i was visiting a friends house yesterday for dinner. my friends mother has been working as an rn for over 35 years. somehow we got on the subject of marijuana. the hospital she works at is in the inner city, and she has alot of under insured patients.
she went on to tell me that this man came in with a sickle cell crisis. and during a gathering of the patients history, the patient admitted to his nurse that he uses marijuana for its analgesic effects. the nurse explained to the patient that smoking anything can cause a sickling to occur thus can cause a crisis...
not knowing that anyone was able to hear her, the nurse did tell the patient that if he cut up the marijuana, put it into a pan with heated/melted butter (making sure not to boil the mixture because of changing the chemical compositon) then allow the butter to cool to room temprature, he can spread the mixture onto toast and eat it. this way he would achieve the analgesic effect he desired without triggering a crisis.
not wanting to get into the fact that this nurse told the patient how to perform an illegal act..... but any thoughts on the physiological truths or mistruths to this adivise? it does sound interesting to me. what do you folks think?

i am just a beginning nursing student, but in my opinion, the only issue here is that the nurse gave instructions on performing an illegal act. i don't know how related this is, but i know of a lawyer who went to federal prison for giving advice on an illegal matter and also abusinessman who gave "advice" on how to commit a criminal act. there is a particular word for this, which i can't think of right now. but it's not good.

jasonn · Sep 29, 2004

i am just a beginning nursing student, but in my opinion, the only issue here is that the nurse gave instructions on performing an illegal act. i don't know how related this is, but i know of a lawyer who went to federal prison for giving advice on an illegal matter and also abusinessman who gave "advice" on how to commit a criminal act. there is a particular word for this, which i can't think of right now. but it's not good.

totally agree that giving illegal advise is unwise not to mention unethical.

however, curious to opinions on the physiological aspects of my post. or what would you say to a patient that presented this solution to managing his problem. remember this patient had little or no insurance, and some sickle cell patients are reluctant to visit the hospital during a crisis r/t the fact that many times they a pegged as "drug seekers"

Long Term Care Columnist / Guide · Sep 30, 2004

Well, I'm disappointed, as I thought I was a very ethical person........I have been known to advise patients experiencing intractable pain and/or nausea to ask their doctors about obtaining a medical marijuana card. (This happens to be legal in my state, and is strictly regulated.)

Granted, I've never had any real moral objections to marijuana use anyway, and I think it ought to be packaged and taxed just like tobacco and alcohol. (I'd much rather see people smoke pot, which only makes one mellow and hungry, than get drunk and turn into ***holes. I also think that if folks are going to buy it and use it anyway, the public should benefit from it.) For some people, it's the only drug they can tolerate or afford; however, I only recommend this option to pts. who have exhausted all the usual means of pain/nausea control and failed to obtain relief. If that makes me unethical or a bad nurse, I plead guilty.

jasonn · Sep 30, 2004

Well, I'm disappointed, as I thought I was a very ethical person........I have been known to advise patients experiencing intractable pain and/or nausea to ask their doctors about obtaining a medical marijuana card. (This happens to be legal in my state, and is strictly regulated.)
Granted, I've never had any real moral objections to marijuana use anyway, and I think it ought to be packaged and taxed just like tobacco and alcohol. (I'd much rather see people smoke pot, which only makes one mellow and hungry, than get drunk and turn into ***holes. I also think that if folks are going to buy it and use it anyway, the public should benefit from it.) For some people, it's the only drug they can tolerate or afford; however, I only recommend this option to pts. who have exhausted all the usual means of pain/nausea control and failed to obtain relief. If that makes me unethical or a bad nurse, I plead guilty.

thanks for the reply... actually eating it as i described sounds like a smart idea for someone who has sickle cell and who may not be apply to afford conventional treatment IMO. As far as the "unethical" statement , the more i think about it, what would be more unethical---- not giving someone advise that would benefit them just because george bush and crew say its illegal, or giving them information that they can choose to use.

Sadie04 · Sep 30, 2004

Well, I'm disappointed, as I thought I was a very ethical person........I have been known to advise patients experiencing intractable pain and/or nausea to ask their doctors about obtaining a medical marijuana card. (This happens to be legal in my state, and is strictly regulated.)
Granted, I've never had any real moral objections to marijuana use anyway, and I think it ought to be packaged and taxed just like tobacco and alcohol. (I'd much rather see people smoke pot, which only makes one mellow and hungry, than get drunk and turn into ***holes. I also think that if folks are going to buy it and use it anyway, the public should benefit from it.) For some people, it's the only drug they can tolerate or afford; however, I only recommend this option to pts. who have exhausted all the usual means of pain/nausea control and failed to obtain relief. If that makes me unethical or a bad nurse, I plead guilty.

I couldn't agree more. They are trying to pass a bill in my state to allow medicinal use of marijuana which I think is a great idea. It not only helps with nausea, it can also be an appetite stimulant for chemo patients.

Drysolong · Sep 30, 2004

Well, I'm disappointed, as I thought I was a very ethical person........I have been known to advise patients experiencing intractable pain and/or nausea to ask their doctors about obtaining a medical marijuana card. (This happens to be legal in my state, and is strictly regulated.)
Granted, I've never had any real moral objections to marijuana use anyway, and I think it ought to be packaged and taxed just like tobacco and alcohol. (I'd much rather see people smoke pot, which only makes one mellow and hungry, than get drunk and turn into ***holes. I also think that if folks are going to buy it and use it anyway, the public should benefit from it.) For some people, it's the only drug they can tolerate or afford; however, I only recommend this option to pts. who have exhausted all the usual means of pain/nausea control and failed to obtain relief. If that makes me unethical or a bad nurse, I plead guilty.

If marijuana use for medical purposes is legal in your state (operative word, legal) then you wouldn't be unethical or breaking any laws in your state. So for you, the legal aspect is moot. When I become a nurse and am knowledgeable about medical treatments that may be possibly against the law in my state and legal in other areas, I would probably mention to my patient what is being done in the other area, but that it is illegal where we reside. (hint hint to the patient and family, and possible legal protection for me)

Yes, many laws are not in the best interest of the public, as well as FDA regulations that prohibit certain drugs that are being used freely and successly in other countries. I am very patient-focused, but I have seen what can happen in America's court system to good people with good intentions. I will do all I can for my patients, but my nursing license is going to be very important to me and I will protect it.

redheadRN · Oct 2, 2004

I work in LTC, and our new physician has prescribed a few residents Marinol, which is a concentrated pill form of THC, the active ingredient in marijuana. We have found it highly effective for patients with chronic pain (mild to moderate), including one with hemophilic arthritis. Also an effective antiemetic. Point being, I guess what this nurse did is provide a street version of this medication. And yes, I know what we should promote legally as nurses, but we need to remember that we should advocate and help our clients first. Not make them feel guilty for receiving pain relief in one of the few means they have available. God bless this man and ALL his nurses.