Medicinal cannabis: A primer for nurses

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PATIENTS TRUST and depend on nurses, who need to have informed and valid answers to patients' questions about the use of medicinal cannabis for various health disorders. Conditions for which cannabis has been approved for medicinal use vary from state to state. To date, 30 states and the District of Columbia have legalized its use for many conditions, although not all have legalized every form. Several additional states have legalized the use of nonpsychoactive forms of cannabinoids for seizures or epilepsy only.1 Even in states where using medicinal cannabis isn't yet legal, patients may have questions in anticipation of it becoming legally available there.
Healthcare providers provide documentation that authorizes patients to use medicinal cannabis in jurisdictions where it's legal. If a healthcare provider determines that a patient has a disorder that qualifies him or her to use medicinal cannabis, the provider issues an authorization for use rather than a prescription. An authorization for use doesn't provide information such as cannabis strain, dose, or frequency of consumption. Depending on the state system, the patient takes the authorization form to a medicinal cannabis dispensary or a recreational cannabis store with medicinal products. Recreational stores that provide medicinal products employ personnel who've been trained in the dispensing of medicinal cannabis to patients. Medicinal cannabis isn't available in traditional pharmacies where no trained personnel are available for providing guidance and recommendations to patients.1,2
In the best scenarios, healthcare providers are knowledgeable about the therapeutic effects of medicinal cannabis and provide education about various strains, including which one has been shown to be effective for the patient's diagnosis. They need to have as much knowledge about the various products as possible. In general, clinicians including nurses need to know how to optimize the use of medicinal cannabis and how to answer their patients' questions.(See American Nurses Association position on use of medicinal cannabis.)
This article provides a synopsis of the different strains of medicinal cannabis and their contents, as well as some basic information about dosing. Additional resources are provided for those interested in deepening their understanding of medicinal cannabis. Although many jurisdictions have legalized medicinal cannabis under state law, the sale and use of all types of marijuana continue to be illegal under Federal law. Nurses should check with their board of nursing for guidance on legal issues affecting nursing practice in their state.
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