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Cannabis Information for Healthcare Professionals

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Patients expect evidence-based practice from their healthcare professionals, which includes providing drug/medication information that is accurate and science based. Our biennial conference series was designed to meet the educational needs of healthcare professionals by ensuring they were accredited for continuing education credits. Although we don’t include sections specific to professionals such as pharmacists or social workers, much of this information will be useful in these fields as well as medicine and nursing.

Physicians

Physicians are in a legal/ethical quandary: Science shows that cannabis is a safe and effective medication yet the federal government has phys img 1 patientdocplaced it in Schedule I of the Controlled Substances making it illegal for them to prescribe. In the historic rescheduling petition of NORML and ACT vs the DEA, the DEA’s Administrative Law Judge, Francis Young, concluded in 1988 that cannabis must be removed from Schedule I. After reading all of the evidence, pro and con, he noted that cannabis was “one of the safest therapeutic substances known to man.” If this herbal medicine is so safe, surely physicians should be able to prescribe it to their patients.

Patients Out of Time strongly believes that physicians must educate themselves on the science of medicinal cannabis and the endocannabinoid system. Once educated, physicians must be proactive and work towards ending the cannabis prohibition. It is not OK to simply shy away from or ignore this issue. Cannabis has the potential to improve the quality of life for countless patients. They need and expect your support.

Recent Events of Interest to Physicians

November, 2009 – American Medical Association changes position on medical marijuana, recommending more research and possible changing of the federal scheduling of marijuana.

April, 2009 – Dr. Frank Lucido, Dr. David Bearman, other MDs and researchers form the American Academy of Cannabis Medicine to establish board certification for physicians recommending Medical Cannabis, to provide clinical expertise and legal assistance.

May, 2009 – The University of California’s School of Medicine at San Fransisco announces Continuing Medical Education Accreditation for Patients Out of Time’s series of Clinical Medical Conferences on Cannabis Therapeutics, beginning with on-line video presentations from the 2008 conference in Pacific Grove, CA.

May, 2008 – The National Clinical Advisory Board of the National Multiple Sclerosis Society issued an “Expert Opinion Paper – Treatment Recommendations for Physicians” , which recognizes the healing properties of Cannabinoids and Cannabis (marijuana), specific to the pain and muscle spasticity of MS. The MS Society also calls for research into the neuroprotective aspects of Cannabinoids, following evidence that the progression of the disease can be slowed or halted by these remarkable therapeutic agents. The Society also recognized that close to one half of MS patients in America report using Cannabis as their medicine of choice.

Headline: Feb.16.2008 – Ease Up on Marijuana, Doctors Group Tells FedsAmerican College of Physicians, representing 124,000 MDs, the largest group of internal medicine doctors in America, has endorsed using Cannabis for medical purposes and is urging the U.S. Congress to remove it from Schedule One (which stipulates a drug as having no medical use) of the Controlled Substances Act. The ACP Position Paper (PDF) also calls for protection for doctors and patients in the twelve U.S. states that have legalized medical marijuana, now suffering raids and intimidation at the hands of the federal government.phys img 2 lucido08

Doctors & Medical Cannabis, Dr. Frank Lucido, April, 2008 – At Fifth National Clinical Conference on Cannabis Therapeutics, held in Pacific Grove, CA, April, 2008, Dr. Frank Lucido has a message for physicians new to the field of Medical Cannabis.

Nurses

img 1 docpatientTime and again nurses rank #1 as the most trusted profession in Gallup’s annual survey of professions for their honesty and ethical standards. Nurses are the “bedside” healthcare providers who strive to promote health, prevent illness and alleviate suffering. The fundamental principles of nursing are compassion and respect for the individual patient. A key role of the nurse is to act as a patient advocate. Nurses are there for patients when it comes to the issue of medicinal cannabis. The Virginia Nurses Association was the first state nurses association to pass a formal resolution calling for patient access to therapeutic cannabis back in 1994. More states followed and in 2003 the American Nurses Association overwhelmingly passed a strong resolution supporting patient access to cannabis as well as the education of registered nurses on evidence-based research on the efficacy of cannabis as medicine, and have reaffirmed their position in a 2008 position paper.

With the discovery of the endocannabinoid system, it is becoming more apparent as to why cannabis has so much therapeutic potential and yet has a remarkably wide margin of safety. The endocannabinoid system affects how humans eat, sleep, relax, protect and forget. This system is essential to life and cannabis is the only natural plant that has endocannabinoid-like chemicals called phyto-cannabinoids or simply cannabinoids. While cannabis remains in Schedule I under federal law, more and more states are acknowledging its medicinal value. For those nurses who work in states with medical marijuana/cannabis laws, it is essential that you understand the risks and benefits of cannabis and cannabinoids. For those nurses who work in states where it is illegal it is time for you to become educated on its efficacy and work towards changing the law in your state. For all nurses it is an ethical responsibility to patients to help them gain the option to use cannabis as medicine and thus work towards educating your legislators and policy makers about this safe and effective medicine.

Learn more:

Patients Out of Time provides an accredited biennial conference series on the therapeutic value of cannabis that is especially designed to educate healthcare professionals about this issue as we bring together researchers from around the world to present their current findings.

Nurses in all areas of practice are encouraged to attend the next conference in this series.

Nurses can also earn CEUs and learn online by watching presentations from previous conferences that are available on the UCSF School of Medicine’s Continuing Education website.

Nursing Perspectives from our Conference Faculty Presentation

img 2 martin06The California Nurses Association, co-sponsors of our April, 2006 Clinical Conference on Cannabis Therapeutics held in Santa Barbara, sent a representative, Bonnie Martin, RN, to speak about the ethics and goals of patient advocacy by the CNA, which stipulate that “Patients should not be forced to suffer pain and suffering…and must be free to seek all therapeutic options”

Nurse Martin goes on, “Unfortunately, one of these therapeutic measures is denied to us as a result of the social stigma and legal environment that has developed around the medical use of marijuana. We must work together to find a solution to this moral/legal conflict, so that neither patients nor providers are criminalized when their only goal is just to make someone’s life just livable”. Video – CNA Nurses Support Medical Cannabis, Bonnie Martin, RN.

img 3 glick06aAt the same 2006 conference, a registered nurse from Oregon, Ed Glick, RN, tells of his efforts to make Oregon’s medical marijuana program accessible to more people in need, especially mental health conditions like Post Traumatic Stress. Ed has tried to bridge the healthcare gap for many patients whose doctors are hesitant to recommend medical cannabis. Video – PTS(d), Psychiatric Patients need Cannabis, Ed Glick, RN.

img 4 mathrie04Author of Cannabis in Medical Practice and an addiction specialist, Mary Lynn Mathre brings the nurse’s perspective to the medical marijuana issue at 2004 Cannabis Therapeutics Conference. Declaring that enough research has been done on Cannabis as medicine to warrant immediate access for patients, Mary Lynn shares the poignant story of Barbra and Kenny Jenks, AIDS victims who were arrested and convicted for medical marijuana. Video – Cannabis – Challenge to Unlearn the Lies, M.L.Mathre, RN, MSN.

Cannabis in Medical Practice

img 5 cannabisinmedicalA Legal, Historical, and Pharmacological Overview of the Therapeutic Use of Marijuana – Edited by Mary Lynn Mathre, RN

This book is the collaborative effort of 17 experts from the countries of Brazil, Jamaica, The Netherlands and the United States who tell the story of medical marijuana in layman’s language based on facts, scientific inquiry, common sense and compassion. Included are hundreds of references for those who wish to explore the subject of therapeutic Cannabis to a greater depth.

Medical Ethics

Patients Out of Time strongly believes that the greatest risk to patients who use cannabis is its prohibition. With the prohibition there is no quality control of cannabis and patients do not receive education about the risks and benefits or the appropriate dose and route of administration. Physicians are intimidated by the law and fear the consequences of a patient using a potentially contaminated unregulated product. Nurses are expected to educate their patients about the safe use of their medications and here too, some nurses may be concerned with the lack of quality control for this prohibited medicine. Healthcare professionals are encouraged to explore and consider the ethical issues involved in this unjust medicinal cannabis prohibition.

Faculty Presentations on Medical Ethics

img 1bonnie04Medical Ethics and Cannabis Prohibition, by Richard Bonnie, JD – Professor Richard J. Bonnie, University of Virginia Law School; Institute of Medicine of the National Academy of Sciences, addresses the 2004 Cannabis Therapeutics Conference on medical ethics and public policy, postulating “What is the right thing to do?” for physicians and officials.

img 2 mamas04aSurely compassion is a crucial aspect of ethical behavior and we at Patients Out of Time can think of no other who more embodied compassion than Mae Nutt, one of our founding directors, who we affectionately called “Grandma Marijuana”. At first adverse to the idea of medical marijuana, Mae became an advocate for medical cannabis and patients’ rights, after seeing that marijuana helped her son Keith endure cancer treatment. He died in 1979, on the day that Michigan passed a Medical Cannabis law, after testimony by her family in Senate hearings.

Mae championed the cause of compassion for over 25 years, speaking at several conferences on Cannabis Therapeutics, including this one in Charlottesville, VA in May, 2004, hosted by Patients Out of Time. Video – Grandma Marijuana – Mae Nutt tells her Story of Compassion

Cannabis Providers

As long as cannabis remains in Schedule I, most patients will need to find a safe and reliable cannabis supplier. In the states that have passed medical marijuana/cannabis laws compassion clubs have opened up to provide this medicine to patients. Cannabis growers/providers need to ensure that the cannabis is grown and harvested under safe and responsible conditions.

Supporting Organizations

This is an ever-growing list of organizations that have taken action to formally support patient access to therapeutic cannabis. Healthcare professionals are strongly encouraged to take action within their specialty organizations by urging and assisting them in formally supporting patient access to cannabis through a resolution or position paper. Please contact Patients Out of Time for assistance if needed and notify us of any organization that passes a supportive paper. As the list continues to grow, politicians and policy makers will have the necessary support to change the laws and end the cannabis prohibition.

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