“I want to help people.” This was a desire I held even as a young child. I can remember looking through books that taught about human diseases and genetic mutations. I felt empathy for the people and wished I could help them. In high school, Biology and Human Anatomy were subjects I found fascinating. When choosing a profession, nursing was an obvious choice. I always thought I was doing everything I could to help my patients, until recently. In November 2016, the people of Arkansas passed the Medical Marijuana Act. I never had any prior knowledge of how marijuana, which I now only refer to as cannabis, could be beneficial in the human body. I was determined to find answers that would persuade me to argue either for or against the use of medicinal cannabis. My journey had just begun.
To lay a foundation of my educational background, I began my college experience at Arkansas State University, obtained my RN diploma at Baptist Health Schools, and finished with my BSN at Arkansas Tech University. Sadly, throughout all of my high school and college biology and nursing courses and countless hours of continuing education, I never learned about the endocannabinoid system (ECS). How can this be? This is part of our bodies that has been completely overlooked for centuries. Now that it has been discovered, shouldn’t it be taught in colleges and universities? Until the ECS is added to our educational curriculum, we, as individuals, must take the initiative to learn all that we can and educate one another.
My cannabis education process began by tagging along with my husband, who holds a doctorate in chemistry, to a few Arkansas Cannabis Industry Association (ACIA) seminars and patient forums. Kyle, my husband, was attending these meetings to further his own career and to promote his abilities in cannabis analytical testing. ACIA has been very instrumental in educating the public about the medicinal uses of cannabis. Via ACIA, I have heard many inspirational speakers. One individual that spoke at a CE course I attended was Marcie Cooper, MSN. Marcie taught about the history of cannabis, the ECS, and the connection between the two. At a patient forum, I heard Dr. Uma Dhanabalan and Coltyn Turner speak. Dr. Uma impressed upon me the safety in the use of cannabis as a medicine. She has been successfully practicing medicine without prescribing narcotics for over 7 years. That single fact impressed me greatly. Coltyn, now 17 years old, provided his story of living with Crohn’s disease and how cannabis has assisted him in finding remission of his symptoms that had not been possible with multiple different prescription medications. These individuals furthered my curiosity into the world of medicinal cannabis.
I was interested, but also very confused. My previous thoughts and ideas of cannabis were perplexing me. It had never been a part of my life and I naively thought since it was illegal, it had to be bad for you. In addition, my religious beliefs were in conflict. The belief that one shouldn’t use mind-altering drugs versus my knowledge that all things were created for our use was spinning around in my head. Is this plant as dangerous as I had been taught? Or are we overlooking a gift that was created to treat the sick? In an attempt to clear up more of my questions, I attended the Cannabis Science Conference in Portland, Oregon. This conference hosted Marcie, Dr. Uma, Heather Manus, Julie Monteiro, a panel of pediatric cannabis patients’ parents, and many more. These individuals, with the content they discussed and the testimonies they gave, provided the answers I had been looking for. That cannabis IS a medicine and patients, young and old, desperately need it in their lives.
Now that I had made an educated decision that medicinal cannabis is beneficial, I knew I had to be motivated to learn. I sought out, bought, and read books about the topic. Among these were, “The Cannabis Pharmacy” and the “Cannabis Health Index”. I quizzed everyone around me that had any level of understanding. I learned that the women that spoke at the Portland conference made up an organization called the Cannabis Nurses’ Network (CNN). The CNN held an educational conference in Las Vegas, Nevada that I was able to attend. Jennie Stormes, RN, MSN and author of the book, “Cannabis Education for Nurses”, utilized her book to create the curriculum that was taught at the conference. My confidence and comprehension greatly increased. I learned that the ECS is a system in the bodies of mammals. The ECS “communicates” with other body systems to maintain homeostasis via CB1 and CB2 receptors. Like our lungs need air to survive, our ECS needs cannabinoids to maintain good health. If the ECS is lacking cannabinoids, it will have an impact on other body systems. This is where cannabis becomes significant. Cannabis contains phytocannabinoids that our ECS uses to function. Due to the interaction of the ECS with all body systems, cannabis can be utilized in many medical diagnoses, in most, if not all systems.
Now understanding the physiology of cannabis in the body, I have to familiarize myself with what is being purchased by patients. I felt the best way to accomplish this was to go to a dispensary and ask questions similar to a patient. Patients have many options when selecting products and administration methods. Inhalation, via smoking or vaping, oral consumption of edibles, capsules, tinctures, topical creams or salves, transdermal patches, and vaginal or rectal suppositories are some of the choices that patients have depending upon their need. Assisting patients find the best route and type of cannabis to use is where I believe that healthcare professionals such as: nurses, pharmacists, and physicians will need to be able to assist. If we don’t understand the medication, we cannot help them. Some patients will try one type of medication and if it doesn’t work the first time, or they have an unpleasant experience, they won’t try anything else. It is imperative that we teach them correctly the first time they try the medication. Will we get the correct medication on the first attempt every time? The answer is probably no. Journaling is an important part of a beginning medicinal cannabis user’s routine.
Along with educating the patients, our communities need to be instructed as well. In order for the “Woodstock” stigma to be torn down, our citizens need to be taught that medicinal cannabis may not even include the psychoactive part of the plant (THC). The non-psychoactive part of the plant (CBD) may be sufficient to treat some. If THC is needed, small percentages of it can be gradually added to CBD until a therapeutic level is achieved. For the individuals that obtain their medicinal cannabis license, it is important to use your medication responsibly. You can either add to the negative stigma or help tear it down. Dispensaries must also work to rebuild the public’s views of this industry.
I have visited a few different dispensaries and they ranged in ability to educate their patients. One dispensary, the bud tender stated he obtained his knowledge about cannabis because he was a “stoner”. As a nurse, I was greatly disappointed in his statement. I will encourage my patients to shop at dispensaries that care enough about the patients to train their bud tenders or have educational support readily available. The nicest dispensary I have visited to this point is Oregon’s Finest. The bud tender was very knowledgeable, patient with me as I asked questions, and stated that their business requires that new hires read “The Cannabis Pharmacy” and pass a verbal examination. Other considerations that patients need to be aware of is to chose a dispensary that is clean, has enough business to circulate product, provides adequate safety and privacy while discussing the products, are respectful and are forthcoming with laboratory testing information. If this is a new venture for the patient, they need to visit a few different dispensaries to find the one that suits their needs. Once the dispensary licenses are awarded, I will visit many of them in order to be able to judge for myself which dispensaries I feel are best.
In nursing, we are taught that it is acceptable if we do not know the answer to every question. What isn’t acceptable is if we don’t know where to go to find the answers. I have been blessed to come in contact with some fantastic, supportive individuals. As I dive into this new area of nursing, I am sure that I will have to turn to these and other resources to continue my learning process. The most important thing I have encountered in this field is encouraging, knowledgeable individuals. I believe that cannabis nurses are aware of the mountain ahead of us, that there are numerous individuals that must be educated for medicinal cannabis to be successful and become available for all that need it. Corey Hunt, Courtney Boze, Marcie Cooper, Heather Manus, and Jennie Stormes patiently answered my questions during my educational growth. Thank you all so much and I hope that you understand that I now can help others because you helped me.
Love the Lord your God with all your heart and with all your soul and with all your mind. This is the first and greatest commandment. And the second is like it: Love your neighbor as yourself. Matthew 22:37-39