Medical Marijuana: A Brief Overview

About this course

Medical marijuana, also called medical cannabis therapy, refers to using the cannabis plant or its derivatives for therapeutic purposes to treat specific medical conditions and alleviate symptoms. In modern years there has been a resurgence of support for medical marijuana following anecdotal evidence and patient testimonials supporting its efficacy. Since the 1990s, several states in the United States (US) have passed legislation legalizing medical marijuana use, paving the way for further research to supplement the current limited clinical data. Still, controversy surrounds its safe administration and long-term side effects. This course discusses medical marijuana in detail, examining its active ingredients, strains, delivery methods, and differences from recreational marijuana. This course also delves into the benefits, adverse reactions, legal status, and nursing considerations of medical marijuana and cannabidiol in the US.

Learning objectives

• Review the mechanism of action of medical marijuana.
• Summarize federal vs state laws as they relate to medical marijuana use.
• Differentiate between the two species of the cannabis plant and understand their effects.
• Review medial dispensary requirements for dispensing medical marijuana.
• Understand the difference between medical marijuana and recreational marijuana.
• Understand the healthcare professional’s role in conducting a comprehensive assessment, providing patient education regarding medical marijuana use, and
• monitoring a patient’s response to medical marijuana.

Course outline

24 sections · finish in any order across devices

1. 1

   Introduction

   Medical marijuana, also called medical cannabis therapy, refers to using the cannabis plant or its derivatives for therapeutic purposes to treat specific medical conditions and alleviate symptoms.1

   4 min

2. 2

   Marijuana Description

   Marijuana is the name of the psychoactive drug from the dried flower, bud, leaves, stems, and seeds of the cannabis plant.1 These components contain over 80 known active ingredients called cannabinoids, which are responsible for causing marijuana’s mental and physical effects.4

   4 min

3. 3

   Active Ingredients in Marijuana

   The two most well-known cannabinoids and potent compounds in the cannabis plant are delta-6-tetrahydrocannabinol (THC) and cannabidiol (CBD).1,7 Delta-6-tetrahydrocannabinol (THC) is responsible for the psychoactive effects of marijuana and has potential pain-relieving properties, while cannabidiol

   4 min

4. 4

   Species and Variations

   Medical marijuana comes from two species of the cannabis plant, cannabis sativa, and cannabis indica.9 Pure Sativa species are comparatively tall, reaching as high as 12 ft, with long branches and large, narrow-bladed leaves. Marijuana made from these plants has more energizing and uplifting effects

   4 min

5. 5

   Mechanism of Action

   To understand the mechanism of action of marijuana, it is important first to understand the role of the body’s endocannabinoid system (ECS). This system assists in regulating various physiological processes and maintaining homeostasis in the body. The primary components of this system include endoca

   4 min

6. 6

   Where Marijuana is Grown

   While cannabis generally grows outdoors, it can also be grown indoors in a special soil medium under artificial light. Though this is more expensive and complex than growing outdoors, it allows for better control and faster growth. Cannabis plants can also be grown successfully indoors using hydropo

   4 min

7. 7

   Delivery Methods

   Medical marijuana can be administered using various delivery methods, each offering different pharmacokinetics and effects. Common methods include: 13

   4 min

8. 8

   Benefits of Using Medical Marijuana

   The most significant benefit of medical marijuana is its role in pain management.8

   4 min

9. 9

   Side Effects of Medical Marijuana

   Despite the advantages, medical marijuana has several disadvantages, with the most prominent beings the psychoactive effects caused by THC, which can include altered perception, impaired cognitive function, and mood changes.1

   4 min

10. 10

    Federal vs. State Laws

    At the federal level, medical marijuana is listed as a Schedule I controlled substance under the 1970 Controlled Substances Act (CSA).11 Schedule I substances are defined as having a high risk for abuse and no accepted Federl Drug Administration (FDA) approved medical use. For context, LSD, heroin,

    4 min

11. 11

    Cannabidiol (CBD)

    Cannabidiol (CBD) is a naturally occurring active chemical found in both cannabis and hemp plants, but it is non-psychoactive, meaning it does not produce a "high.” Rather, it only expresses analgesic, anti-inflammatory, anticonvulsant, anxiolytic (anti-anxiety), neuroprotective, and antioxidant pro

    4 min

12. 12

    Benefits of CBD Use

    Research suggests that CBD is effective for treating certain cases of severe epilepsy. It may also benefit Huntington’s disease and multiple sclerosis (MS) patients by reducing pain and muscle tightness. Other benefits for patients with multiple sclerosis include reducing tiredness, improving bladde

    4 min

13. 13

    Side Effects of CBD Use

    Cannabidiol usage may cause side effects in some patients. These effects may include low blood pressure, dry mouth, lightheadedness, dizziness, and drowsiness. There have also been occasional reports of increased suicidal thoughts or behavior and signs of liver injury with high doses of CBD.25

    4 min

14. 14

    Federal vs. State Laws

    As with medical cannabis use, there are still some discrepancies between federal and state laws regarding CBD. While some progress has been made in recent years, there is still much room for improvement.29

    4 min

15. 15

    Chemical Composition

    Medical marijuana extracts and concentrates contain higher levels of cannabinoids and terpenes than traditional herbal preparations. Pharmaceutical companies use various extraction methods to isolate and purify specific compounds within the substance, thus offering higher potency, precise dosing, an

    4 min

16. 16

    Quality Control

    Medical marijuana cultivation and distribution is subject to strict quality control and testing measures. Licensed medical marijuana producers must adhere to rigorous quality standards to ensure consistency, efficacy, and safety. This includes testing for contaminants and accurately labeling cannabi

    4 min

17. 17

    Intended Use

    Medical marijuana is specifically cultivated, processed, and dispensed for therapeutic purposes to alleviate symptoms and manage various medical conditions such as chronic pain and certain mood disorders. The primary focus of medical marijuana is on its potential medical benefits and improving patie

    4 min

18. 18

    Dispensaries

    Medical marijuana dispensaries, or medical cannabis dispensaries, are specialized retail establishments that legally sell medical marijuana and related products to qualified patients with valid medical marijuana prescriptions. These dispensaries operate in regions where medical marijuana is legal an

    4 min

19. 19

    Patients Likely to Use Medical Marijuana

    Medical marijuana is typically used by patients seeking alternative treatments for specific medical conditions that have not responded well to conventional therapies. Generally, this includes patients suffering from chronic pain conditions.1

    4 min

20. 20

    Legal and Regulatory Compliance

    Healthcare professionals must know the state and federal laws regarding medical marijuana use in their jurisdiction. As regulations vary greatly from state to state, the legality of treatment may vary if a patient travels across state lines.11,33 With a clear understanding of the legal status and re

    4 min

21. 21

    Patient Education

    Healthcare professionals must educate patients about medical marijuana, including its potential benefits, side effects, and proper use. Patients should be informed about the following:

    4 min

22. 22

    Assessment and Monitoring

    Before initiating medical marijuana treatment, healthcare professionals should conduct a comprehensive assessment, including the patient's medical history, current health status, and any contraindications for medical marijuana use. As there is the possibility of potential drug interactions between m

    4 min

23. 23

    Documentation

    Healthcare professionals should keep clear, in-depth documentation on the patient's medical history, the specific medical marijuana treatment plan, dosages, administration methods, patient response, and adverse reactions or side effects.33,34

    4 min

24. 24

    Conclusion

    Medical marijuana is a centuries-old natural remedy with a longstanding historical significance. Despite its illegal drug status at the federal level, it has reemerged as a preferred therapy for many patients with chronic conditions unresponsive to conventional therapies. As it continues to gain pop

    4 min

This course satisfies

Requirement summaries come from our state requirement records. Always confirm details with your board before you renew.

References and resources

• Bridgeman, M. B., & Abazia, D. T. (2017). Medicinal Cannabis: History, Pharmacology, And Implications for the Acute Care Setting. P & T : A Peer-Reviewed Journal for Formulary Management, 42(3), 180–188. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5312634/
• ProCon.org. (2019). Historical Timeline - Medical Marijuana - ProCon.org. Medical Marijuana. https://medicalmarijuana.procon.org/historical-timeline/
• Crane, M. (2000). Dangers of Marijuana: Long-Term Effects on the Brain and Body. American Addiction Centers. https://americanaddictioncenters.org/marijuana-rehab/long-term-effects
• FDA and Cannabis: Research and Drug Approval Process. (2019). U.S. Food and Drug Administration. https://www.fda.gov/news-events/public-health-focus/fda-and-cannabis-research-and-drug-approval-process
• World Health Organization. (2022). Cannabis. Www.who.int. https://www.who.int/teams/mental-health-and-substance-use/alcohol-drugs-and-addictive-behaviours/drugs-psychoactive/cannabis
• 2021 NSDUH Annual National Report | CBHSQ Data. (2023, January 4). Www.samhsa.gov. https://www.samhsa.gov/data/report/2021-nsduh-annual-national-report
• Cannabis and Cannabinoids. (2016). National Cancer Institute; Cancer.gov. https://www.cancer.gov/about-cancer/treatment/cam/hp/cannabis-pdq
• National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, & Board on Population Health and Public Health Practice. (2017, January 12). Therapeutic Effects of Cannabis and Cannabinoids. Nih.gov; National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK425767/
• McPartland, J. M. (2018). Cannabis Systematics at the Levels of Family, Genus, and Species. Cannabis and Cannabinoid Research, 3(1), 203–212. https://doi.org/10.1089/can.2018.0039
• Chandra, S., Lata, H., & ElSohly, M. A. (2020). Propagation of Cannabis for Clinical Research: An Approach Towards a Modern Herbal Medicinal Products Development. Frontiers in Plant Science, 11. https://doi.org/10.3389/fpls.2020.00958
• National Conference of State Legislatures. (2022, September 12). State Medical Cannabis Laws. Www.ncsl.org. https://www.ncsl.org/health/state-medical-cannabis-laws
• Wadsworth, E., Schauer, G. L., & Hammond, D. (2022). Home cannabis cultivation in the United States and differences by state-level policy, 2019-2020. American Journal of Drug and Alcohol Abuse, 48(6), 701–711. https://doi.org/10.1080/00952990.2022.2132507
• Stella, B., Baratta, F., Della Pepa, C., Arpicco, S., Gastaldi, D., & Dosio, F. (2021). Cannabinoid Formulations and Delivery Systems: Current and Future Options to Treat Pain. Drugs, 81(13), 1513–1557. https://doi.org/10.1007/s40265-021-01579-x
• ‌Cash, M. C., Cunnane, K., Fan, C., & Romero-Sandoval, E. A. (2020). Mapping cannabis potency in medical and recreational programs in the United States. PLOS ONE, 15(3), e0230167. https://doi.org/10.1371/journal.pone.0230167
• Boehnke, K. F., Litinas, E., & Clauw, D. J. (2016). Medical Cannabis Use Is Associated With Decreased Opiate Medication Use in a Retrospective Cross-Sectional Survey of Patients With Chronic Pain. The Journal of Pain, 17(6), 739–744. https://doi.org/10.1016/j.jpain.2016.03.002
• Anil, S. M., Peeri, H., & Koltai, H. (2022). Medical Cannabis Activity Against Inflammation: Active Compounds and Modes of Action. Frontiers in Pharmacology, 13. https://doi.org/10.3389/fphar.2022.908198
• Smith, L. A., Azariah, F., Lavender, V. T., Stoner, N. S., & Bettiol, S. (2015). Cannabinoids for nausea and vomiting in adults with cancer receiving chemotherapy. Cochrane Database of Systematic Reviews, 11. https://doi.org/10.1002/14651858.cd009464.pub2
• Pinto, J. S., & Martel, F. (2022). Effects of Cannabidiol on Appetite and Body Weight: A Systematic Review. Clinical Drug Investigation. https://doi.org/10.1007/s40261-022-01205-y
• Joshi, M., Joshi, A., & Bartter, T. (2014). Marijuana and lung diseases. Current Opinion in Pulmonary Medicine, 20(2), 173–179. https://doi.org/10.1097/mcp.0000000000000026
• Curran, H. V., Freeman, T. P., Mokrysz, C., Lewis, D. A., Morgan, C. J. A., & Parsons, L. H. (2016). Keep off the grass? Cannabis, cognition and addiction. Nature Reviews. Neuroscience, 17(5), 293–306. https://doi.org/10.1038/nrn.2016.28
• Barber, P. A., Roberts, S., Spriggs, D. A., & Anderson, N. E. (2014). Adverse Cardiovascular, Cerebrovascular, and Peripheral Vascular Effects of Marijuana: What Cardiologists Need to Know. The American Journal of Cardiology, 113(6), 1086. https://doi.org/10.1016/j.amjcard.2014.01.400
• Barber, P. A., Pridmore, H. M., Krishnamurthy, V., Roberts, S., Spriggs, D. A., Carter, K. N., & Anderson, N. E. (2013). Cannabis, Ischemic Stroke, and Transient Ischemic Attack. Stroke, 44(8), 2327–2329. https://doi.org/10.1161/strokeaha.113.001562
• Blanco, C., Hasin, D. S., Wall, M. M., Flórez-Salamanca, L., Hoertel, N., Wang, S., Kerridge, B. T., & Olfson, M. (2016). Cannabis Use and Risk of Psychiatric Disorders. JAMA Psychiatry, 73(4), 388. https://doi.org/10.1001/jamapsychiatry.2015.3229
• de Graaf, R., Radovanovic, M., van Laar, M., Fairman, B., Degenhardt, L., Aguilar-Gaxiola, S., Bruffaerts, R., de Girolamo, G., Fayyad, J., Gureje, O., Haro, J. M., Huang, Y., Kostychenko, S., Lepine, J.-P. ., Matschinger, H., Mora, M. E. M., Neumark, Y., Ormel, J., Posada-Villa, J., & Stein, D. J. (2010). Early Cannabis Use and Estimated Risk of Later Onset of Depression Spells: Epidemiologic Evidence From the Population-based World Health Organization World Mental Health Survey Initiative. American Journal of Epidemiology, 172(2), 149–159. https://doi.org/10.1093/aje/kwq096
• Silva, M. H. (2023). Neurotoxic or protective cannabis components: Delta-9-Tetrahydrocannabinol (THC) and Cannabidol (CBD). Journal of Exploratory Research in Pharmacology. https://doi.org/10.14218/jerp.2023.00017
• Zhornitsky, S., & Potvin, S. (2012). Cannabidiol in Humans—The Quest for Therapeutic Targets. Pharmaceuticals, 5(5), 529–552. https://doi.org/10.3390/ph5050529
• Office of the Commissioner. (2018, June 25). FDA approves first drug comprised of an active ingredient derived from marijuana to treat rare, severe forms of epilepsy. U.S. Food and Drug Administration. https://www.fda.gov/news-events/press-announcements/fda-approves-first-drug-comprised-active-ingredient-derived-marijuana-treat-rare-severe-forms
• CBD Oil May Worsen Glaucoma. (2019, February 5). American Academy of Ophthalmology. https://www.aao.org/eye-health/news/cbd-oil-may-worsen-glaucoma
• A Cannabis Conflict of Law: Federal vs. State Law. (n.d.). Www.americanbar.org. https://www.americanbar.org/groups/business_law/resources/business-law-today/2022-april/a-cannabis-conflict-of-law-federal-vs-state-law/
• Medical Cannabis Dispensary Regulations | DOR. (n.d.). Www.dor.ms.gov. Retrieved August 8, 2023, from https://www.dor.ms.gov/medical-cannabis-dispensary-regulations
• Ruheel, M. A., Gomes, Z., Usman, S., Homayouni, P., & Ng, J. Y. (2021). Facilitators and barriers to the regulation of medical cannabis: a scoping review of the peer-reviewed literature. Harm Reduction Journal, 18(1). https://doi.org/10.1186/s12954-021-00547-8
• Chadi, N., Minato, C., & Stanwick, R. (2020). Cannabis vaping: Understanding the health risks of a rapidly emerging trend. Paediatrics & Child Health, 25(Supplement_1), S16–S20. https://doi.org/10.1093/pch/pxaa016
• Ruheel, M. A., Gomes, Z., Usman, S., Homayouni, P., & Ng, J. Y. (2021). Facilitators and barriers to the regulation of medical cannabis: a scoping review of the peer-reviewed literature. Harm Reduction Journal, 18(1). https://doi.org/10.1186/s12954-021-00547-8
• Buxton, J. A., Haden, M., & Mathias, R. G. (2008, January 1). The Control and Regulation of Currently Illegal Drugs (H. K. (Kris) Heggenhougen, Ed.). ScienceDirect; Academic Press.https://www.sciencedirect.com/science/article/abs/pii/B9780123739605003567?via%3Dihub

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