STORIES

A Major Nursing Journal Throws Shade at Prohibition

By David Jenison on August 22, 2017

Dr. Lisa Sheldon, Editor of the Clinical Journal of Oncology Nursing, wrote "Cannabis Guidelines" in the August 2017 edition of the publication, and the second line starts, "Cannabis has been used for centuries in the treatment of medical conditions. Cannabis has been recommended for appetite, anxiety, depression, sleep, and migraines." Dr. Sheldon, who also serves as the chief clinical officer at the Oncology Nursing Society, then describes the federal government's stance in the most cold and sterile way possible. 

"The U.S. Drug Enforcement Agency (DEA) maintains that marijuana is a schedule I controlled substance—the same class as LSD, heroin, and ecstasy. In August 2016, the DEA again declined (for the sixth time) to change the status of marijuana. To date, the U.S. Food and Drug Administration has not approved cannabis for treatment for cancer or any other medical condition. "

In contrast, Dr. Sheldon talks about how a majority of states legalized medical cannabis and some crafted specific indications for medical use. She painted the states in a positive light compared to the federal government while noting that "ethical issues arise related to inequities in access to cannabis for the treatment of medical conditions." 

The Clinical Journal of Oncology Nursing editor treated medical cannabis as an established fact, but she argues that doctors and nurses do not know the best way to administer the medicine because "desperately needed" clinical trials are still needed to establish guidelines for safety, dosing and indications. She then blames the federal government for the lack of trials: "Research studies are limited because only one site in the United States, the University of Mississippi, has approval to use research-grade cannabis for studies."

Absent these evidence-based guidelines, Dr. Sheldon described the current norm as a "low and slow approach" by which patients self-administer smaller doses to start and then gradually increase them. She also pointed to the American Cannabis Nurses Association as a source for information and advocacy. In the meantime, she encouraged all nurses to demand extensive research on how to administer cannabis and the need for increased access to it. 

Dr. Sheldon concluded, "Oncology nurses need further education about the indications and effects of cannabis. We need to promote research to develop dosing guidelines that promote the safe use of cannabis in oncology care. Nurses need to advocate at the policy level so that patients have access to the appropriate cannabinoid for their symptom or condition.
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In 2014, WebMD published a survey that asked doctors about the medical value of cannabis, and a clear majority reaffirmed its value. However, the strongest support came from oncology doctors, with 82 percent saying medical cannabis provides real benefits and should be a treatment option. Oncology nurses apparently feel the exact same way. 


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