Medical marijuana legal?

prescriptionTimes change, and consequently, laws change to reflect the new opinions.  As a case study, the history of laws against alcohol show how variable public opinion can be about mind-altering substances.

Similarly, the debate surrounding marijuana has been fought for many long years.  I remember learning in the 80s to just say no to drugs, including marijuana.

It was vilified as a gateway drug, supposed to be fifty times worse than single cigarettes, and certainly something only used by the “bad” crowd.  Now, as a nurse, the drug may be something I can administer to patients.

Still, the lines are blurred.  A nurse practitioner in New Jersey recommended medical marijuana for two patients, ages four and six, who were experiencing symptoms of a wasting condition.

A complaint was filed against the nurse and disciplinary action was brought against him.  Now, he was not a very thorough practitioner, failing to perform an in-depth history and physical.

But the question remains whether or not his punishment stems from his recommendation of medical marijuana.  Nurses administer many, many medications that can cause addition and horrendous side effects.

Is marijuana any different?  If so, why?  Would you recommend medical marijuana for a patient in pain who has tried everything else?  Many nurses now have to ask themselves these questions.

Legislation Regarding Medical Marijuana

Marijuana has been legalized for medical use in Alaska, Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Maine, Massachusetts, Michigan, Montana, Nevada, New Jersey, New Mexico, Oregon, Rhode Island, Vermont, Washington, Maryland, and the District of Columbia.

A great deal has been made over the complete legalization of marijuana in Colorado and Washington, but several laws remain in effect that curtail its usage.

For instance, workers who test positive for cannabis for any reason can be fired.

Several other states have laws in place or coming through the legislature that allow for the medical use of this medication or lessen laws to criminalize it.

Indeed, the amount of arrests for marijuana possession and usage could help to decrease the amount of inmates in overcrowded prisons.

Yet we are conditioned to believe that this drug, any drug, is wrong.  How different is it from Oxycontin, Dilaudid, Morphine, and even alcohol?

A double standard seems in place regarding this medication, because the opiates are legal for medical usage.

Benefits and Risks of Marijuana as a Medication

One of the primary usages of cannabis is for pain relief, which doesn’t make it much different from our other controlled substances.  However, due to cultural taboos against the medication, studies into its usage for pain are small, not double blind, and limited in scope.

Other conditions that seem to respond well to medical marijuana include glaucoma, spasticity, Alzheimer’s, breast cancer, HIV, brain cancer, ALS, Crohn’s disease, and diabetes.  Ironically, it can also help with opioid dependency, caused by either street drugs or prescription medications.

Again, the research into these usages is spotty at best.

“Opiates and alcohol have their down sides, yet they are consumed in this country at an alarming rate.”

In fact, some make out medical marijuana to be a wonder drug against all problems, and that’s probably not scientifically true.  Until more researchers are allowed to study its usage, though, we may never know for sure.

So, there has to be a down side, right?  Not much, really.

Again, the knowledge of side effects is hampered by the lack of rigorous studies.

No known cases of marijuana overdose have ever been reported.  In some cardiovascularly impaired patients, the drug may cause infarction, either stroke or heart attack.

This may limit its use in the extremely sick patients it is often recommended for.

Another problem with cannabis is that it is smoked.  A study in 2006 in the journal Cancer Epidemiology Biomarkers & Prevention found that marijuana is not likely to cause lung, throat, or any other pharyngeal cancers.

In many cases, it seems that marijuana may be safer than the opioids we use on a daily basis, and they have some of the same effects.

Is a cultural taboo preventing patients from using an effective medicine?

Is this just a smoke screen by marijuana enthusiasts to legalize their “fun drug”?

Nurses are always advocates for their patients, and I think that the evidence for marijuana as a medical adjunct is promising enough to insist that studies are conducted.

Opiates and alcohol have their down sides, yet they are consumed in this country at an alarming rate.

Can we at least agree to allow for the testing of cannabis as a possible adjunct to pain management?

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