As the healthcare professionals who often have the closest contact with patients, nurses need a voice in the medical cannabis conversation, those in the field tell Cannabis Health.
Despite being the care providers who often develop the most in-depth relationships with patients, up until recently the role that nurses play in the medical cannabis sector had been somewhat overlooked.
Launched at the end of last year, a first of its kind series of webinars has been designed to bring a deeper understanding of medicinal cannabis to the nurse and patient care pathway.
Aimed at nurses and other healthcare professionals, the series brings the multidisciplinary team (MDT) approach – which is so ingrained in other areas of care – to cannabis treatment for the first time.
The initiative was designed and spearheaded by the Nurses Arm of Cannabis Patient Advocacy & Support Services (CPASS), which is made up of practicing nurses who are keen to improve understanding of medical cannabis among others in their profession.
Sarah Higgins, an NHS nurse and sexual health lead for CPASS hopes the webinars will reduce some of the anxiety around cannabis medicines and bring nurses into the conversation.
“Our motivation is to educate nurses. We’re trying to demystify cannabis based medicines, to reduce the stigma and normalise them as just another tool in the box, the same as any other medicine,” she says.
“More often than not when anything is new, it creates some anxiety in healthcare professionals, particularly if they are not sure of the evidence around it.”
Sarah became involved with CPASS as she found many of her patients would consume cannabis illicitly to help with medical issues.
“In my area of health we talk a lot about recreational use of cannabis and when you delve a bit deeper into why people are using it, there seems to be quite a lot of therapeutic reasons given, such as around the time of their menstrual cycle,” she says.
As the healthcare professionals who have the most direct and regular contact with the patient, nurses can play an important role in opening up dialogue about cannabis, but also need to be educated in it themselves and able to practice safely.
“Nurses advocate for patients and are quite often the first port of call for them,” says Sarah.
“Typically a nurse’s bedside manner can elicit quite a lot of information from a patient that they maybe wouldn’t share with a doctor or consultant, so we develop trusting relationships with them.
“We’re able to feed back information to the rest of the team but we’re also able to support patients in a non-judgmental way in making choices around their therapies.”
She continues: “Nurses play the same role they would in any other kind of health care package, but the work CPASS is doing is to reduce some of the anxiety around this particular group of medicines and to look at ways that nurses can work safely in this area.
“We don’t want anybody working outside of the boundaries that they feel comfortable with.”
Each CPASS event is structured into two parts, the theory behind the benefits of cannabis medicines within key areas of medicine and the MDT demonstrating how the theory is put into practice.
Each MDT features a specialist consultant, nurse, GP and pharmacist, all working within the medicinal cannabis field in the UK. Their discussion will illustrate real world case studies within areas including; pain, mental health, neurology, oncology, women’s health and palliative care.
Former ICU nurse, clinical lead and co-founder of the Nurses Arm of CPASS, Sophie Hayes, left her job in the NHS to join the medical cannabis space last year.
Now lead nurse specialist at Integro Medical Clinics, she is one of the first practicing in the field.
Sophie is keen to encourage others into the field, believing the sector is currently missing a key component of person-centred care.
“The nurse is a key component of any care team. We often have the most regular contact with patients and as a result, have in depth knowledge of their health picture. This includes information regarding the patient as a whole person, not simply as a collection of diagnoses,” she says.
“This insight is invaluable when an MDT is coming together to make a decision regarding how best to move forward with the care of complex patients. A doctor might create a care plan that in theory would successfully manage the patient’s condition and the associated symptoms.
“However, it is the nurse who will be able to assess whether this fits with the patient lifestyle, and if it doesn’t work for the patient, it doesn’t work for anyone.”
Commenting on the first CPASS MDT event which took place in November, Sophie adds: “In these clinics we are often a last resort, these patients are complex and have already been reviewed by some of the countries most experienced clinicians.
“The problem solving potential of a fresh perspective of an MDT like this can be monumental for patients and the nurses role is an invaluable part of this.”
But while the cannabis sector may be lacking practicing nurses, Sarah doesn’t feel their role is undervalued.
“It’s a very new, emerging area of medicine and I would expect it to be doctor-led – lots of areas of medicine are doctor-led and and nurse-delivered, it’s just about making sure that information trickles down to everybody,” she says, encouraging nurses to ask questions and be open about their understanding of cannabis medicines.
“I would like nurses to look at cannabis based medicines as they would opioids, to try to reset any kind of previous views or opinions that they’ve held about it.
“It’s important to remember that we’re not discussing it in terms of something that has been bought on the street, we’re talking about something that is regulated and prescribed through a pharmacy.”
“But I’d also urge them not to feel embarrassed about the questions they have,” she adds.
“It’s important that we discuss our concerns or fears and address the barriers – I don’t think there is a silly question when it comes to cannabis.”
For more information on the next webinars and to join or support this initiative contact email@example.com and visit www.canpass.org
Charlotte’s Web announces long-term study into effects of CBD
The company behind renowned CBD brand Charlotte’s Web has teamed up with leading scientific researchers to examine the cannabinoid’s effects on physical and mental health.
Charlotte’s Web Labs (CWL), the research arm of the renowned CBD producer, has announced a long-term scientific collaboration with McLean Hospital, a Harvard Medical School affiliate.
Two distinct clinical trials will investigate the efficacy of a custom-formulated, hemp-derived high-CBD product, with results to be published in 2022.
The trials will be overseen by lead researcher Dr Staci A Gruber, Ph.D, associate professor of psychiatry at Harvard Medical School and director of the MIND program at McLean Hospital in Belmont, Mass.
Dr Gruber’s Marijuana Investigations for Neuroscientific Discovery (MIND) Program, established in 2014, is the first of its kind, and is dedicated to studying the long-term impact of cannabis and cannabinoids for medical and adult use which utilises various clinical and cognitive tools as well as multimodal neuroimaging techniques.
MIND utilises valid, robust research models and supports numerous projects designed to address the impact of medical cannabis on important variables such as cognition, brain structure and function, mood, conventional medication use, quality of life, pain, sleep, and other health-related measures.
Through observational longitudinal investigations, survey studies, and clinical trials of custom-formulated cannabinoid products, MIND aims to examine the unique effects of cannabis and its constituents to determine the efficacy of cannabinoids for specific conditions and diseases and to clarify the overall impact of cannabinoid-based treatments on physical and mental health.
Dr Gruber is also conducting a number of other studies, including a longitudinal observational study of veterans who use Charlotte’s Web products.
Charlotte’s Web is the number one CBD brand in the USA and distributed through more than 22,000 retail locations, select distributors and online.
CWL is the research and development division of Charlotte’s Web, with an aim of advancing science around hemp-derived phytocannabinoids, terpenes and flavonoid compounds.
“We are honoured to be working with Dr. Gruber, Harvard Medical School and McLean Hospital on these important clinical trials,” said Tim Orr, president of Charlotte’s Web’s CW Labs division.
“Charlotte’s Web remains dedicated to supporting third-party research on hemp CBD investigated by some of the country’s top scientists.”
What is fibromyalgia – and can cannabis help?
With around one in 20 people in the UK and an estimated three to six per cent of the world’s population diagnosed, fibromyalgia is one of the most common pain conditions in the world.
Anyone can develop fibromyalgia – it affects around seven times as many women as men but can develop in either gender at any age – though its wide-ranging symptoms can make it a difficult condition to diagnose.
Alongside chronic pain, those affected may suffer with extreme tiredness, muscle stiffness, headaches, irritable bowel syndrome and problems with mental processes such as memory and concentration – all of which can be attributed to a number of other ailments.
While the exact cause of the condition is unknown, it’s thought to be related to abnormal levels of certain chemicals in the brain and changes in the way the central nervous system processes pain messages carried around the body. In many cases, it can be triggered by a physically or emotionally stressful event such as injury, giving birth or the death of a loved one.
Unfortunately, there is no known cure for fibromyalgia and no remedy to get rid of pain entirely. Instead, patients search for methods to alleviate symptoms, with many opting for a combination of treatments.
One which is growing significantly in terms of both research and usage is cannabis.
The remedy has long been associated with pain relief and as evidence of its benefits mounts, many fibromyalgia patients are choosing to give products such as gels and capsules a try.
In 2019, a study of 367 patients found that pain intensity decreased when treated with CBD. This was supported by Chaves, Bittencourt and Pelegrini in 2020, with the team finding that phytocannabinoids can serve as an ‘affordable yet well-tolerated therapy’ for symptom relief and quality of life improvements.
As usage rises, professionals are coming round to the idea of CBD as a prescribed treatment in fibromyalgia, and in 2018 Carly Barton of Brighton became the UK’s first fibromyalgia patient to receive a prescription for medical cannabis. Prior to that, she, along with thousands of others, had been paying up to £2,500 for three months’ treatment.
Despite many sufferers being reluctant to exercise for fear of aggravating symptoms, it’s another effective way to alleviate pain. Aerobic, resistance and stretching exercises have all been known to relieve pain and stiffness, increase strength and improve mobility in patients, while relaxation exercises such as yoga and t’ai chi can help with difficulty sleeping.
Research has repeatedly backed up these claims and shown that regular aerobic exercise can improve pain, function and overall quality of life, with a 2017 study stating that “aerobic and muscle strengthening exercises are the most effective way of reducing pain and improving global wellbeing in people with fibromyalgia and that stretching and aerobic exercises increase health-related quality of life”.
While regular painkillers may provide some benefits to fibromyalgia symptoms, one of the most commonly prescribed medications for the condition is antidepressants. The medication is known to boost the levels of certain chemicals (neurotransmitters) that carry messages to and from the brain, and with low levels of neurotransmitters thought to be a factor in fibromyalgia, it’s believed that this boost may ease the widespread pain associated with the condition.
Many professionals also believe that talking therapies, such as cognitive behavioural therapy (CBT) and counselling, are an effective way to manage symptoms and improve low mood associated with fibromyalgia.
How you can take part in a worldwide survey on cannabis and endometriosis
Do you have endometriosis and use cannabis to manage your symptoms? Here’s how you could take part in new research.
Researchers from Western Sydney University and the University of New South Wales are keen to find out more about the potential use of cannabis to manage endometriosis pain.
They are looking for participants from across the world, who have been told by their doctor they have the condition and who consume cannabis – either through a prescription or illegally – to manage symptoms.
Results of this survey will help design an upcoming clinical trial to explore the effectiveness of medicinal cannabis for endometriosis.
Endometriosis is the second most common gynecological condition in the UK, affecting around one in 10 UK women – although frequent misdiagnosis and a lack of understanding means this figure may be higher.
Despite its prevalence, according to Endometriosis UK, it takes an average of seven and a half years from onset of symptoms to get a diagnosis.
It happens when tissue similar to the lining of the womb starting to grow in other places, such as the ovaries and fallopian tubes, causing inflammation, pain and the formation of scar tissue. A wide range of debilitating symptoms include pain in the lower abdomen and back, nausea and intense fatigue.
There is currently no cure for the chronic condition and treatment is limited to painkillers, hormonal contraception, or surgery.
However, there is a growing amount of anecdotal evidence for the efficacy of cannabis in managing some symptoms such as pain and nausea, with some early suggesting cannabinoids can help with stopping the endometrial cells from multiplying, regulate nerve growth and reduce inflammation.
Researchers in Australia hope to continue to increase the information on cannabis use for endometriosis, and to plan a clinical trial to investigate the safety, tolerability, and effectiveness of a standardised and quality assured medicinal cannabis product for pain and associated symptoms.
This survey is open to patients worldwide who must fulfil the following criteria:
- Aged between 18-55 years of age
- Been told by your medical doctor that you have endometriosis
- And you must have used cannabis or cannabinoid-based products (eg CBD, cannabis oils, dried bud (flower) with known levels of THC and/or CBD, or non-legal cannabis) in the past three months specifically for the purpose of managing your endometriosis pain or related symptoms.
The survey expires on 31 March 2021, find out more here
Click here to participate
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