when patients are prescribed marijuana

[brownbook]

We were discussing at work (out patient surgery,) how do hospitals deal with patients who are on prescription marijuana when they are hospitalized? This is in California.

Is there any problem or issue with the hospital pharmacy continuing their prescription as an in patient?

[elkpark]

I haven't lived in a state in which "medical MJ" is legal, but I would guess the fact that smoking is not allowed in hospitals would be an issue. You can't tell people they can't smoke cigarettes in the hospital for safety and health reasons, but it's okay to smoke mary jane. Also, people aren't generally allowed to take home medications in the hospital without the hospital physician having ordered it, so the hospital physician would have to be willing to order it.

It will be interesting to hear from anyone who has actually dealt with this in a medical MJ state.

[toomuchbaloney]

cannabis is available for medicinal use in a variety of forms that do not require smoking...

[OCNRN63, RN]

Since it's still a federal crime, I doubt that hospitals would allow it to be prescribed/dispensed. It seems to me that if they did, they would run afoul of any number of regs, and risk losing their CMS certification. That would cost them, big time, and that's not even taking into account the fines they'd incur.

[nurseprnRN, BSN, RN]

I was just able to go to an excellent program at a national legal nursing conference on medical cannabis (note, this is the appropriate terminology, for reasons I will clarify shortly) by a reputable source, a certified addictions and pain management nurse who has worked in the field for 20 years. I was as skeptical as I see these posters until I saw her slides.

The pharmacology of cannabis depends on the desired effects. We all know that brains have endorphin receptors that work with morphine-like substances produced in the body (at least, we have known for the last several years); did you know that the brain also has endogenous cannabinoid receptors? That there are cannabinoids that occur in different percentages in different strains of the plant? That have many effects in common with the endorphins? That have nothing to do with getting stoned, and that can be taken orally? That will not get the patient high, but have therapeutic effects on many body systems that use the cannabinoid receptors?

Before you get all fluffed up about people toking in the rooms, getting furious munchies, and saying, "Like wow, man," take some time to look into current research on this subject. You'll be surprised.

[Meriwhen, ASN, BSN, MSN, RN]

No patient in any state--even California--can be prescribed marijuana. It remains a Schedule I drug, and because of that, the most that a MD/healthcare provider can do is recommend its use. They can not and do not write scripts for it...and FYI, the "medical marijuana" card is not a prescription--the card merely allows the authorized holder to purchase MJ for medicinal purposes without ending up with a drug charge.

In terms of what can be given in a healthcare setting, there's always Marinol.

[TheGooch]

What about the other patients? Marijuana smells awful and you can get high from the smoke.

[Altra, BSN, RN]

GrnTea, in this thread there has not been discussion on the merits of prescribing cannabis ... just on the legalities and logistics of possible use by hospital inpatients.

[MunoRN, RN]

We consider it a dietary item and family friends are free to bring it in for the patient. Smoking is not allowed, although a significant percentage of those who use it for medicinal purposes don't smoke it but ingest it in various edible forms.

[MunoRN, RN]

No patient in any state--even California--can be prescribed marijuana. It remains a Schedule I drug, and because of that, the most that a MD/healthcare provider can do is recommend its use. They can not and do not write scripts for it...and FYI, the "medical marijuana" card is not a prescription--the card merely allows the authorized holder to purchase MJ for medicinal purposes without ending up with a drug charge.

In terms of what can be given in a healthcare setting, there's always Marinol.

Marinol really isn't an alternative to medicinal cannabis. The primary cannabinoid that has medicinal effects is cannabidiol (CBD), THC is a different cannabinoid and has limited medicinal uses and really should never be taken by itself (not combined with CBD). Marinol is synthetic THC (Not CBD).

[Been there,done that, ASN, RN]

I would not worry my pretty little head about this. The doctor has prescribed the medication, pharmacy dispensed the medication... I administer the medication. End of story.

[BlueDevil, DNP]

No patient in any state--even California--can be prescribed marijuana. It remains a Schedule I drug, and because of that, the most that a MD/healthcare provider can do is recommend its use. They can not and do not write scripts for it...and FYI, the "medical marijuana" card is not a prescription--the card merely allows the authorized holder to purchase MJ for medicinal purposes without ending up with a drug charge.

Thank you, I was going to say this. The misconceptions about "prescription" MJ drive me crazy, a pet peeve. But health care providers should understand the difference.