Cannabis has been gaining momentum as a viable and safe medical treatment over the last several years. More and more people are seeking cannabis to treat a variety of ailments. Most are hoping to replace or reduce the use of pharmaceuticals. And why not? Prescription medications can come with a long list of side effects, some of which are deadly. In addition to an extensive list of side effects, many people report minimal effectiveness from the prescription medications. Not surprising since most pharmaceuticals are studied in white 60 year old males.
As it now stands, cannabis is a last resort for many. Only after failing multiple traditional treatments do people find their way to cannabis. I often hear “what do I have to lose?” My response- Nothing! And there is much to be gained when incorporating cannabis. Coming to cannabis can be a big ordeal for many. The stigma is very much alive and well. People fear judgement, retaliation, rejection, and/or shame for even considering cannabis as medicine. In fact, today I had a patient tell me “I can’t believe I have resorted to using this.” Sad, but it’s not the first time I have heard a patient say something of that nature.
So when someone has made the decision to use cannabis, who can they turn to for guidance? If that person is fortunate enough to live in a medical or adult use state, they can seek advice from a dispensary. Dispensaries are similar to pharmacies in that dispensaries house and dispense the medicine. The difference though, is that patients get most of their advice from the dispensary staff. When a patient enters a dispensary, they rely on the staff to provide them with appropriate cannabinoids, delivery methods and dosing. We certainly would not have this same expectation at a pharmacy. Patients do not go to their local pharmacy and ask the staff which anti-depressant or blood pressure medication is best for them. So why do we have this model at dispensaries? My guess is that dispensaries have had to fill a big need. In general, patients have not been able to talk about cannabis with their health care professionals. Physicians and nurses do not receive education on the endocannabinoid system while in school. Many of them are not equipped to discuss cannabis as medicine with their patients. So patients rely on the people selling the medicine. And since there are no standards in training or education for dispensary staff, knowledge can vary from individual to individual.
In some cases, the treatment can be pretty straightforward. Maybe someone suffers from insomnia and is looking to use cannabis. Often they don’t need too much in-depth advice. For those who are not so cut and dry, navigating through the therapeutic applications of cannabis alone can be frustrating. My experience has been that patients who are coming to cannabis for the first time have complex medical histories. Some have tried everything under the sun, with little to no relief. Others are taking a long list of medications, including over the counter and supplements. While cannabis has one of the best safety profiles, there is still potential for drug-drug interactions. There are also a group of patients who find cannabis to be so effective that they want to come off their prescription medications. Since they have not told their physicians about using cannabis, many feel lost, not knowing who to turn to for further guidance. Patients end up in limbo. This is where nurses can come in and provide a service that is severely lacking in the medical cannabis community.
Nurses can fill the gap between patients and dispensary staff. As a profession, we are trained to look at the whole picture and treat the patient holistically. We take an oath to do no harm and to advocate for the patient’s rights. Nurses are altruistic by nature and seek to relieve the suffering of others. Our training compliments cannabis medicine perfectly. The challenge comes when nurses want to help patients use cannabis medicine. Where do they get their training? Luckily, there is an American Cannabis Nurses Association (ACNA) dedicated to educating nurses and patients on the endocannabinoid system and the therapeutic applications of cannabis. Nurses still need a training program dedicated to cannabis medicine. The ACNA has a long term goal of credentialing nurses in cannabinoid therapeutics. In the meantime, many nurses are asking how they can get involved.
Personally, I would like to see a nurse in every dispensary. Patients would be followed throughout their treatment, keeping track of what worked and what did not. Nurses can help patients navigate through the ever changing, confusing world of cannabis medicine. Treatment is not a one size fits all and nurses are able to individualize the care. Nurses could make the difference between success and failure for a patient. It’s time to bring more nurses to cannabis medicine.
eloisetheisen 