nurse guidelines for cbd oil

Medical Cannabis

As of October 17, 2018, cannabis was made legal in Canada for both recreational and medicinal purposes, and governed under the Cannabis Act. Part 14 of the Cannabis Regulations specifically addresses access to cannabis for medical purposes and replaces the Access to Cannabis for Medical Purposes Regulations (made under the Controlled Drugs and Substances Act), which is no longer in force.

What is the nurses’ authority with respect to medical cannabis?

The Cannabis Regulations provides nurses with the legal authority to:

  • Distribute or sell to a patient a cannabis product [1] , other than cannabis plants or cannabis seeds, upon receipt of a medical document or written order.

In the Cannabis Act, “distribute” is generally defined as “administering, giving, transferring, transporting, sending, delivering, providing or otherwise making available in any manner, whether directly or indirectly, and offering to distribute.” The Act also specifies that distribution differs depending on the practice setting. For example, in public settings such as in the community or home care, nurses providing assistance may not transport, send or deliver cannabis.

It is important to note that each employer can make specific determinations about access to medical cannabis. Nurses are only authorized to distribute or sell medical cannabis if employer policy permits and supports this activity. Nurses are accountable for understanding employer policies that relate to the distribution or sale of medical cannabis.

According to the Cannabis Regulations, nurses are authorized to distribute medical cannabis in a hospital, but not send the product to the patient [2] .

What should nurses consider when providing nursing care to patients who are prescribed medical cannabis?

Nurses must consider whether they have the knowledge, skill and judgment and the authority required to care for a patient taking medical cannabis. These accountabilities are outlined within the Decisions about Procedures and Authority practice standard.

It is important for nurses to understand relevant employer policy related to medical cannabis. If no policies exist, nurses are encouraged to advocate for and work with their employer to develop policies that support safe patient care.

When distributing any medication to patients, nurses are accountable for adhering to the CNO’s Medication practice standard. Nurses must ensure they can distribute the medication safely, competently and manage the potential outcomes of administering it. CNO’s Medication decision tool can assist nurses when faced with decisions about their medication practices.

The Nurse’s Guide to CBD

CBD (cannabidiol) oil is a popular cure-all that you may have seen hyped or scrutinized by the media. But what exactly is it, is it safe, and how is it different from the use of medical marijuana?

THC, CBD, and Hemp

Marijuana comes from the leaves of the Cannabis plant, which produces a variety of active chemical compounds referred to as cannabinoids. There are dozens of cannabinoids; THC ( tetrahydrocannabinol ) and CBD are two of the more widely studied. THC is the psychoactive compound in marijuana that causes intoxication, or a high, by activating the brain’s reward and pleasure center, causing the release of dopamine. By contrast, CBD is not psychoactive and therefore does not cause a high. It is also not believed to be addictive.

Hemp also derives from Cannabis , but generally refers to plants cultivated for non-drug use. Hemp also contains much higher concentrations of CBD and a much lower concentration of THC (<0.3%). Historically, hemp has been used to make rope, fabrics, or textiles.

Medical Marijuana

Medical marijuana is now legal in 33 states and the District of Columbia. For recreational use, marijuana is legal in 10 US states and in DC. In recent years, the number of patients who are turning to Cannabis for medical treatment is increasing. Marijuana has been a therapeutic treatment for cancer patients; it has been shown to treat pain, nausea, and cachexia. Marijuana is also now used as a treatment for Alzheimer’s disease, chronic pain, Crohn’s disease, and many other conditions.

CBD is generally sold formulated into an oil and has been touted as a solution to pain, insomnia, anxiety, and a wide range of other medical conditions. CBD oil is expected to become a billion-dollar industry in coming years. It is important to note, however, that despite the oil’s growing popularity, it remains largely unstudied and unregulated.

CBD is readily available for purchase online, but it has varying levels of legality in the United States. Although several US states have specific laws regarding CBD, it remains a controlled substance by the Drug Enforcement Agency, and is classified as a Schedule I drug. This designation remains despite the passage of the 2018 Farm Bill (which legalized the broad cultivation of hemp, under outlined restrictions).

There is a lack of high-quality, large-population studies on CBD use in humans. Large-scale, randomized clinical trials are needed, but it has been proposed as a potential therapy for a range of conditions, including anxiety, Parkinson’s, chronic pain, schizophrenia, and multiple sclerosis. Many users anecdotally claim it has pain-relieving benefits and use it as a treatment for muscle aches, inflammation, and pain. Other people use it to ease anxiety and insomnia.

There currently exists only one FDA approved medication that contains CBD: a seizure medication called Epidiolex, which is used to treat two particularly severe seizure disorders in children.

CBD is most commonly available in the form of an oil or drops. It may also be formulated into a balm, patch, or topical. There are also edible formulations, such as chewing gum, gummies, cookies, and brownies.

Nursing Considerations

It is not likely that a patient will mention the use of CBD oil during a medication reconciliation, so it is important to ask patients about all products they use, including herbs, supplements, and oils. Patients should know that CBD oil may interact with other medications (such as blood thinners), and it could potentially increase the level of certain drugs in the bloodstream. Although side effects are anecdotally infrequent, it may cause sedation, fatigue, or nausea or diarrhea.