3 things every nurse should know about medical marijuana

[Randy RN ASN]

1. The Endocannabinoid System

Before giving a med in the hospital, it's important to understand what that med is and how it works on the body. That is why I believe every nurse should understand some fundamental concepts about marijuana, specifically in regards to the endocannabinoid system.

Marijuana has dozens of cannabinoids, with THC (the chemical that promotes euphoria) and CBD (the chemical with the major medicinal benefits) being the most abundant. Within our bodies we have what is called the endocannabinoid system, which consists of receptors for these cannabinoids to bind too, as well as the endocannabinoids that our body makes naturally, e.g. anandamide. These receptors are found throughout the CNS, being most populated in areas of the brain such as the hypothalamus, hippocampus, cerebellum and spinal chord, which control appetite, memory, balance, and pain perception respectively (Volkow, 2013).

2. Side Effects: Short-term and Long-term

If there are so many receptors on the brain, what does that mean about the potential side effects? That's an important question to consider, because according to the British Journal of Psychiatry, Cannabis use may lead to an acute functional psychosis, similar to an acute schizophreniform state.” If used in large amounts, Cannabis use may lead to a chronic psychosis, which persists after abstinence (Johns, 2001).”

Furthermore, the National Cancer Institute (NCI) has found that other side effects may include: Increased heart rate, decreased blood pressure, muscle relaxation, red/dry eyes, slowed digestion, decreased peristalsis, feeling dizzy, altered memory, hallucinations, and paranoia (depending on the strain of cannabis). Also, symptoms of withdrawal are noted to be mild compared to opiates, but can include irritability, insomnia, restlessness, and hot flashes (Cannabis and Cannabinoids, 2014).

Marijuana, like any other drug, has its potential for side effects, and long-term psychosis is a very serious and certainly important side effect to keep in mind when weighing the benefits and risks.

3. Benefits and Various Uses

Some of these benefits, as mentioned by both the ANA and National Cancer Institute include, the ability to reduce inflammation, provide pain relief, slow and even kill certain cancer cells, stimulate appetite, decrease nausea and vomiting, decrease tremors in patients with MS, decrease intraocular pressure associated with glaucoma, as well as improve sleep and sense of well being (ANA, 2008 & Cannabis and Cannabinoids, 2014).

These are just a few of the possible treatments that we know of right now. I imagine that many other uses will arise once it is properly regulated and studied.

References

ANA (American Nurses Association), Board of Directors (2008, December 12). Position Statement: In Support of Patients' Safe Access to Therapeutic Marijuana. Retrieved May 16, 2015, from American Nurses Association

Cannabis and Cannabinoids. (2014, November 6). Retrieved May 5, 2015, from Bad Request

Johns, A. (2001, February 1). Psychiatric effects of cannabis | The British Journal of Psychiatry. Retrieved May 5, 2015, from Psychiatric effects of cannabis | The British Journal of Psychiatry

Volkow, N. (2013). How does marijuana produce its effects? Retrieved May 5, 2015, from How does marijuana produce its effects? | National Institute on Drug Abuse (NIDA)

[Grumble88]

Good information and definitely something any nurse should be aware of considering how "hot" the topic of legalization is right now. The one thing I would point out is that marijuana (not synthetic THC) does not cause psychosis in individuals without a genetic load predisposing them to a psychotic disorder, but it can and does kick off psychosis in individuals predisposed to it earlier and in a more profound manner. I don't have a reference on hand, but the latest Kaplan&Sadock text gives an excellent review of this information.

[Randy RN ASN]

Grumble88, thank you for the comment. You are correct about the psychosis predisposition.