• Lisa Hedin

Why Cannabis Nursing Will Become an In-Demand Skill

Updated: Jan 26

Within the past decade, cannabis has surged in popularity. Now, 68% of Americans support legalization – the highest percentage ever reported.

Considering how 38 states have medical marijuana programs while 15 allow adult-use, the paradigm around cannabis is evolving towards mainstream acceptance. And as it changes and grows, having medical professionals like nurses knowledgeable about cannabis and its implications is not only realistic – it is essential.

The Growing State of Cannabis

All five states with legalization on their 2020 ballots voted yes, including Mississippi, South Dakota, New Jersey, Arizona, and Montana. Only three states have yet to update their cannabis laws as the cannabis industry projects $35 billion in legal sales by 2025.

But despite demands for legal cannabis, it ironically remains federally illegal as a Schedule 1 controlled substance – meaning the government officially considers it to have “little to no therapeutic value.” This restriction makes the large scale, clinical, and randomized trials the medical community need to verify cannabis’ potential complicated to conduct.

As a result of this lack of data, the National Council of State Board of Nursing (NCSBN) stated in their 2018 Nursing Guidelines for Medical Marijuana that “cannabis remains a complementary and alternative medicine – a drug of last resort, or a salvage therapy.”

However, a lot has changed since 2018. In light of these changes, the NCSBN will likely update this phrase to accommodate the evolving paradigm around cannabis and cannabis use.

Upcoming Legislative Changes

Last November, in addition to the legalization of five new states, the House of Representatives passed a groundbreaking piece of legislation called the Marijuana Opportunity Reinvestment and Expungement Act (MORE). In addition to providing a framework for social equity, the most notable aspect of MORE is that it decriminalizes and de-schedules marijuana from its restrictive Schedule 1 status.

Under MORE, states can create their cannabis laws without having to worry about federal interference. While the Act does not provide a framework for federal legalization, it does represent a step in that direction. And now that the Senate majority has switched to the Democrats – the party traditionally more accepting of cannabis reform – the chances of MORE passing through the Senate and becoming law is much more promising.

Furthermore, only one week after the House passed the MORE Act, the Senate passed the Cannabidiol and Marihuana Research and Expansion Act. Introduced in 2019, the Act, amongst other things, streamlines the application process for research, requires federal research and safety parameters from the FDA, and allows physicians to discuss cannabis with their patients.

Of course, all of this progress doesn’t underestimate the amount of work still needed to conduct research, pass equitable legislation, and educate people, patients, physicians, and nurses alike on safe, responsible cannabis use. Until these things happen, let’s take a look at current medical marijuana programs.

Who Benefits from Medical Marijuana?

Many CBD brands and recreational dispensaries will claim that anyone can benefit from cannabis in some way– be it for inflammation or relaxation. But cannabis nurses know it’s not that simple until there is acceptable evidence.

In the NCSBN guidelines, there is a list of qualifying conditions supported with clinical evidence and qualifying conditions without evidence, but who share symptoms with another evidence-based qualifying condition. For the complete list of qualifying conditions, see the NCSBN guidelines pages S9-S12.

In addition to these qualifying conditions, aspiring cannabis nurses and advocates alike may find the following points useful in debate against opposing viewpoints on the efficacy and good will of cannabis:

  • Cannabis treats nausea in cancer and HIV patients. Interestingly, the HIV positive community in California jumpstarted medical marijuana programs back in the 90s and 2000s.

  • CBD can help alleviate seizures in epileptic children. In fact, CBD made headlines for this reason, starting with Charlotte Figi, the inspiration behind the CBD brand Charlotte’s Web, and resulting in the FDA-approved CBD medication, Epidiolex, by G.W. Pharmaceuticals.

  • Medical marijuana can treat opiate addiction. Evidence shows how in states where cannabis is legal, both opiate and alcohol rates go down, suggesting that cannabis may be an ‘exit drug’ instead of a ‘gateway drug,’ claimed by misleading marijuana myths.

There is also growing evidence of its more widespread benefits, like anxiety and depression, of which 40 million Americans suffer. NCSBN even acknowledges how the euphoria and appetite stimulation from THC “may contribute to a subjective sense of well-being for the patient’s quality of life.”

Despite its benefits, many people still don’t know how cannabis works. The answers lies in the Endocannabinoid System, which, as the name suggests, has a direct relationship with cannabis.

The Importance of the Endocannabinoid System

The Endocannabinoid System, or ECS, was only discovered by scientists in the late 1980s, despite being one of our bodies oldest systems. Present in all mammals, it serves as the communication circuit board between the Central Nervous System, Peripheral Nervous System, Endocrine System, and Immune System.

The ECS’s job is to read incoming signals from these other systems and respond accordingly by reestablishing balance or homeostasis.

The E.C.S. reads signals through its two primary receptors, CB1 and CB2, located throughout the body. They communicate with each other by continually releasing molecules called endocannabinoids in a negative feedback loop, which are later broken down by enzymes. These endocannabinoids, like 2-AG and anandamide, execute the necessary action to fix imbalances.

For example, the CB2 receptors in the skin can sense inflammation caused by a wound and send endocannabinoids to the area to tell the Immune System to dial back its inflammation response to alleviate pain and start healing.

However, more evidence is suggesting that even our ‘master regulator’ can fall out of balance. Since plant-based cannabinoids like THC and CBD mimic our endocannabinoids and can stimulate our ECS back into gear, many researchers wonder if dysfunction in the ECS is the root cause of countless other diseases and conditions. If this is the case, then future application of cannabinoid medicine is endless.

What Nurses Need to Know About Medical Marijuana

With quickly changing laws and an industry growing exponentially, nurses well-versed in cannabis will become an in-demand skill in states with and without medical marijuana programs. Still, without scientifically rigorous and statistically reputable evidence, cannabis nurses will face challenges assisting medical marijuana patients and the large population of Americans who self-administer.

To help those navigate the changing landscape, the NCSBN has outlined six main points of practical information cannabis nurses will need to know:

  1. Understand the current state of legalization, both medical and recreational.

  2. Understand medical marijuana jurisdictions, as each one has a vastly different set of rules, laws, and regulations that are subject to frequent change. Nurses can check out State Departments of Health for resources.

  3. Understand of the Endocannabinoid System and all its components. Remember, the ECS is the backbone of scientific validation.

  4. Understand of cannabis pharmacology and associated research, including adverse effects, routes of administration, and dosing principles. This research must be derived from credible sources using randomized, placebo-controlled studies.

  5. Identify safety considerations, like storage, disposal, and administration.

  6. Approach all patients without judgment of their preferred type of medicine or their views on cannabis.

Cannabis nurses are not required to be experts in all of these subjects, but should at least have a working knowledge of them and a commitment to staying updated on new changes and developments. If nurses are interested in becoming an expert cannabis consultant, there are educational programs to coach you in becoming a nurse entrepreneur.

How to Become a Cannabis Nurse

The medical community has a lot of catching up to do to the industry and mainstream use. Taking nursing experience and personality and applying it to cannabis will help patients and physicians alike make the best decisions for the patients’ health.

As Lisa Hedin, Owner and Founder of the Training Academy for Medical Cannabis, says,

“Nurses are the most trusted profession, and all nurses have an amazing opportunity to band together with the cannabis advocates that have been pushing the agenda forward. I see us working together to give this plant the respect it deserves – and, more importantly – giving patients a choice to choose how to treat their health.”

If you are interested in becoming a cannabis nurse with formal education, register for our Cannabis Nurse Certificate Course.

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