By Dr. Carey S. Clark PhD, RN, AHN-BC, RYT
The use of medical cannabis by patients is a reality in the U.S. today, with more than 30 states allowing some form of medical access to various forms of cannabis. Every patient needs a nurse, and that includes medical cannabis patients. How do nurses learn about cannabis, the endocannabinoid system, and caring for patients who are seeking healing through the use of medical cannabis? The American Nurses Association has clearly stated that nurses should be knowledgeable about cannabis and need to know how to advocate for its medicinal use.
The American Cannabis Nurses Association is a great resource for nurses, which has a mission to “Advance excellence in cannabis nursing practice through advocacy, collaboration, education, research, and policy development” (http://americancannabisnursesassociation.org/).
Very few nursing and medical educational programs of study offer information and resources to learn about the endocannabinoid system, and until this changes, the stigma and medical ignorance around cannabis will remain.
Until the formal educational tide shifts, there are things we as nurses can do to support medical cannabis patients. We can educate ourselves and we can begin to collect our stories around caring for medical cannabis patients. I connected with a nurse in Colorado to discuss how her hospice patients are using cannabis successfully in that state, where current legalization laws allow for any adult to access cannabis legally. While hospice does not currently pay for cannabis in large part due to its federal Schedule I drug status, as an over the counter medication in Colorado, cannabis is accessed by many patients in need.
Hospice patients in Colorado are experiencing relief from the end of life symptoms through using cannabis in its many forms. While some people think of cannabis as a medicine that must be smoked, many hospice patients are benefitting from use of topical lotions, patches that provide a sustained transdermal delivery system of specific cannabinoids, and edible forms of cannabis. One of the great advantages that these patients have reported to the nurses in Colorado is that they often begin to feel relief from their symptoms within five to 10 minutes of placing a patch or applying a topical lotion or oil.
My Colorado hospice nurse friend shared many stories with me of patients experiencing greater comfort and higher quality of life with use of cannabis during their end of life experience. For instance, a 93 year old patient who only received relief from her rheumatoid arthritis through use of medical cannabis. Another patient on a pain pump was emotionally withdrawn and not able to eat; this patient tried an edible candy and soon experienced both a return of connection with others and increased appetite. A third patient, who was on 120 milligrams of morphine sulfate (MS contin) twice a day and had lost her appetite found she began to have an appetite again and was able to enjoy life. With the inclusion of cannabis, this patient was able to make a trip to her daughter’s wedding several weeks later, a goal she had set for herself to accomplish during her end of life days as a palliative care and eventually hospice patient.
There are still challenges to overcome, even in Colorado. Despite the legal status in Colorado, my hospice nurse friend who is actively involved with the ACNA, stated that many physicians in the largest and oldest hospice in Colorado refuse to educate themselves around the endocannabinoid system. Kaiser’s pain and palliative care patients who test positive for THC, risk losing access to opioid medications, despite cannabis’s legal status in the state of Colorado. This discriminatory status toward patients who receive great relief through enacting the endocannabinoid system, needs to be changed. I suggest that this begins with education of nurses, doctors, and policy makers.
A few suggested reading links for nurses who wish to educate themselves, support folks in need of medical cannabis, and create change in how we view this medicine are listed here:
Dr. Clark is a registered nurse of 21 years, with a wide background of clinical experience working in the medical-surgical, psychiatric, pediatric, home-health, and hospice settings. She is an Assistant Professor of Nursing, University of Maine Augusta, where she developed an award winning holistic RN-BSN curriculum. Dr. Clark strives to support patients in the use of medical cannabis for healing, and to educate providers around the safety and health benefits of medical cannabis. Contact information: firstname.lastname@example.org