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Medical leaders explore vital role of nurses in cannabis treatment

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Nurses have a key part to play in medical cannabis treatment

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. 

Over the course of 2021, medical leaders from a multitude of disciplines will come together to provide world-class education on medicinal cannabis for UK registered nurses and healthcare professionals.

Each event, led by nurses, will be structured into two parts – the theory behind the benefits of cannabis medicines within key areas of medicine, and an MDT demonstrating how the theory is put into practice.

The second in the series, taking place on Monday 29 March, will explore the role of cannabis medicines in oncology, with registered nurses, Eleanor Owen-Jones RN DPSN MSc Clinical Research and Megan O’Rahilly RN CNS Upper GI Oncology in conversation with specialist consultants Dr Matt Brown MD (Res) FRCA FFPMRCA MRCS & Dr Charlotte Fribbens.

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 Hayes

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.”

The second webinar, Cannabis + Oncology takes place on Monday 29 March click here to register and for more information about the initiative visit www.canpass.org 

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Six big cannabis sector stories you might have missed this week

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It’s been another week of big news in the cannabis world.

At Cannabis Health, our in depth coverage of the ongoing growth of cannabis as a medical and wellness product continues

Meanwhile, over at Cannabis Wealth, we’ve been following all the big industry and policy news in a week which has seen some important developments..

Been busy and want to get caught up in a hurry?

Here are the six things you need to read to stay in the loop this week.

1. Reprieve for medical cannabis patients

The Department of Health has reached an agreement with Dutch officials to extend the supply of medical cannabis oils to existing patients in the UK until 2022.

Medical cannabis patients, living with severe, life-threatening epilepsy were left without access to medication when the UK left the EU at the end of last year.

Medical cannabis

Families, whose children are prescribed Bedrocan oils in the UK but must obtain their prescription through the Transvaal pharmacy in the Netherlands, were given two weeks notice that their medication could no longer be dispensed following the end of the Brexit transition period on 31, December 2020.

Read the full story.

2. UK largest’s medical cannabis trial reports back

The first findings from the UK’s largest medical cannabis patient study show quality of life improved by more than 50 percent.

Preliminary results from Drug Science’s Project Twenty21 study, have found medical cannabis significantly improves quality of life for people with life-limiting conditions such as chronic pain, multiple sclerosis (MS) Tourette’s syndrome and post-traumatic stress disorder (PTSD).

Published on Tuesday 11 May, the report is the first real-world data to be collected on medical cannabis in the UK.

Read more here.

3. Harrowing first-hand account of medical cannabis user
Diagnosed with a personality disorder and experiencing debilitating anxiety which left him housebound, Craig – whose name has been changed – had exhausted all treatment options and was losing all hope.
He speaks about how medical cannabis helped save his life here.

4. CBD market set to shrink

The UK’s CBD sector looks set to shrink significantly as the roll out of new regulations continues to batter the industry.

The FSA has confirmed to Cannabis Wealth it received applications for 803 different CBD products – but only 42 have been advanced to the next stage of the process so far.

More than half of all applications (445) were ‘incomplete’ and a further 41 have been withdrawn altogether.

Read the full story here.

5. CBD not linked to single doping case

CBD has not been linked to a single failed drugs test in UK sport despite fears about the undeclared levels of THC in some products.

The World Anti-Doping Agency removed the cannabinoid from its banned substances list in 2017 and since then several high profile athletes have publicly endorsed CBD products.

Even though CBD – which has no psychoactive properties – is not banned, the UK Anti-Doping (UKAD) still warns athletes to be cautious with treatments.

Read our exclusive report here.

6. School’s out for cannabis class

The first class on a pioneering university medical cannabis course have concluded their first year of studies.

The research programme at the Humboldt-Universitat zu Berlin examines the medical and nutritional uses of cannabis, production and the legal and economic frameworks of the business.

It’s the latest sign that medical cannabis is becoming a part of the mainstream education offering and a positive indication that new industry leaders will emerge in the coming years.

Full story here.

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Science finds a way for medical cannabis to relieve pain without side effects

Researchers have developed a molecule that allows THC to fight pain without the side effects.

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Medical cannabis
Many people living with chronic pain have found that cannabis can provide relief. 

Scientists may have developed a molecule which could allow medical cannabis to provide pain relief without any side effects.

Many people live with chronic pain, and in some cases, cannabis can provide relief. 

But the drug also can significantly impact memory and other cognitive functions. 

Now, researchers have developed a peptide that, in mice, allowed THC to fight pain without the side effects.

According to the US Centres for Disease Control and Prevention (CDC) around 20 percent of adults in the states experienced chronic pain in 2019. 

In some studies, medical cannabis has been helpful in relieving pain from migraines, neuropathy, cancer and other conditions, but the side effects can present hurdles for widespread therapeutic use.

Previously, researchers identified two peptides [molecules which are made up of amino acids] that disrupt an interaction between a receptor that is the target of THC and another that binds serotonin, a neurotransmitter that regulates learning, memory and other cognitive functions. 

When the researchers injected the peptides into the brains of mice, the mice had fewer memory problems caused by THC. 

Now, this team, led by Rafael Maldonado, David Andreu and colleagues, has gone one step further to improve these peptides to make them smaller, more stable, orally active and able to cross the blood-brain barrier.

Based on data from molecular dynamic simulations, the researchers designed two peptides that were less than half the length of the original ones but preserved their receptor binding and other functions. 

They also optimised the peptide sequences for improved cell entry, stability and ability to cross the blood-brain barrier. 

Then, the researchers gave the most promising peptide to mice orally, along with a THC injection, and tested the mice’s pain threshold and memory. 

Mice treated with both THC and the optimised peptide reaped the pain-relieving benefits of THC and also showed improved memory compared with mice treated with THC alone. 

Importantly, multiple treatments with the peptide did not evoke an immune response. 

Reporting in the American Chemical Society’s Journal of Medicinal Chemistry, researchers say that these findings suggest the optimised peptide is an ideal drug candidate for reducing cognitive side effects from cannabis-based pain management.

The abstract that accompanies this paper can be viewed here.

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Dutch Government to supply medical cannabis for UK patients until 2022

The Department of Health has reached an agreement to continue the supply of Bedrocan oils

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The Dutch Government will supply medical cannabis to UK patients until 2022

The Department of Health has reached an agreement with Dutch officials to extend the supply of medical cannabis oils to existing patients in the UK until 2022.

Medical cannabis patients, living with severe, life-threatening epilepsy were left without access to medication when the UK left the EU at the end of last year. 

Families, whose children are prescribed Bedrocan oils in the UK but must obtain their prescription through the Transvaal pharmacy in the Netherlands, were given two weeks notice that their medication could no longer be dispensed following the end of the Brexit transition period on 31, December 2020. 

After outrage from campaigners, the Dutch government agreed to continue supplying the life-saving products until 1 July, 2021 while a more permanent solution was reached.

This waiver period has now been extended until 1 January, 2022.

Health ministers promised to work with officials in the Netherlands to find a “long-term” solution, but according to those at the forefront of the campaign, there is still “some way to go”.

Hannah Deacon and son Alfie Dingley

Hannah Deacon’s son Alfie Dingley, who is prescribed Bedrocan products for a rare form of epilepsy, recently celebrated one year seizure-free.

In a letter to Deacon on Thursday 13 May, the DofH said it was working with the Dutch government, Bedrocan and the Transvaal pharmacy to proceed as “quickly as possible” with the UK production of these medicines.

It added that domestic production is “complex” and that manufacturing “unlicensed herbal medicines” comes with “significant challenges”. 

Deacon said that the UK production of Bedrocan products was the “only solution”.

While other cannabis-based medicines are available in the UK, experts have warned that there is ‘significant variation’ from one product to the next and switching an epilepsy patient’s treatment could be ‘life-threatening’.

“With the 1 July deadline for Bedrolite supply to cease from the Netherlands looming ever closer, we made it clear we wanted an extension to the agreement to stop the situation becoming dangerous for Alfie and the other patients receiving this vital medicine,” commented Deacon.

“The long term solution of Bedrocan products being made in the UK still has some way to go, but it can be the only solution and we thank everyone who is working very hard to achieve this. 

“This is still a long way off from being okay, but for now we have the pressure taken off on the supply issue.”

With limited access to medical cannabis on the NHS, families are still calling for the Government to help fund their children’s prescriptions, which can cost thousands of pounds each month.

Deacon added: “The ever-pressing issue of financial burden on the many families and patients wishing to use medical cannabis in the UK remains and this is a huge issue which needs dealing with.

“There are many ways in which the Government could step in and help access for very vulnerable people and we will continue working as hard as we can to make things better for all.”

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