Brazilian Nursing Journal: Invitation Editorial on Medical Cannabis

 

Before starting O Cannabis, the only exposure I had to marijuana was what I learned through negative stereotypes: that cannabis is a gateway drug and anyone who uses it is a “stoner.” To put it mildly, I never anticipated working in the cannabis sector. It signaled loudly on my radar after 2 personally profound experiences kicked open this extraordinary professional door.

 

My mom is 72 years young. She is an avid gardener, active community member and world traveller. She also struggles with neuropathic foot pain for years. She went to her doctor not for pharmaceutical medications but for cannabis. Her doctor (surprisingly) issued her a prescription for cannabis – and yet my mom could not access her medicine. Not because she didn’t want to but because the system for accessing medical cannabis is designed to be as difficult as possible. In Canada, it’s not as simple as accessing pharmaceutical medicines where a patient takes their script and goes to the pharmacy. Instead, if a patient is fortunate enough to have access to a prescriber of medical cannabis, after they receive their script, there’s a whole ordeal that happens afterwards before the patient can acquire their medicine. Specifically, the patient has to register with a Licensed Producer (LP), which is the regulated and legal source where patients can buy their medicine.

 

For my mom, whose reported pain was 8/10 daily and who had to develop a new “normal” in order to manage her pain (read: stop whatever she was doing in order to elevate her feet and reduce the pain). After she received her script, she “fell through the cracks.”  She never heard from the company who was supposed to sell her the medicine – for over 6 months!

 

When my mom came to visit me I found this out. One night, her feet were hurting, so I gave her a foot rub with CBD medical cannabis oil and put her to bed. The next morning she excitedly shared with me that that morning was the first day that she didn’t wake up with pain.

 

Her response got my attention.

 

The other story that helped seal my Medical Cannabis Professional fate was witnessing my best friend reap the benefits of being a patient on medical cannabis.

 

My best friend is in his 50s. He was diagnosed with Rheumatoid Arthritis when he was a child and told he would be in a wheelchair by 18. Despite what the doctors said, he remained mobile but did require 2 hip surgeries, 2 knee surgeries, as well as hand, wrist, and bicep surgery - all before the age of 52. Like many patients with Rheumatoid Arthritis, he would have to put his life on pause if a storm was coming because the pain would be too much for him to leave the house. In the mornings, his hands would be so swollen that he would have to wait at least 30 minutes before he could wrap his hands around his toothbrush. Everyday, all day, he lived with pain that ranged between 6-8/10. He was prescribed Percocet PRN but due to the side effects of the medications preferred to “tough it out.” Within 2 weeks of my friend being on medical cannabis he noticed a dramatic improvement in sleep and decrease in pain. After being on medical cannabis for 5 weeks, he stopped all other medications: Tylenol, Percocet & Advil.  After 6 weeks, his pain was at 0/10 and wants me to share this with you, “living without pain has given me my life back.”

 

The lives of 2 of the people I care most about in the world were dramatically improved by medical cannabis. I explored the research and discovered that there have been over 24,000 published articles on medical cannabis – that the experiences of my loved ones were not outlier cases but rather “common” experiences of people around the world. Evidence that supports the use of medical cannabis bolstered my confidence that perhaps there was an opportunity to help more people find relief like my mom and best friend found.

 

After assessing the (then) current medical cannabis landscape, I knew I had to create something that was more patient-centric. A clinic model that made it easy for patients to access our services and a model of care that supported the patient as they journeyed through this confusing landscape while reducing the likelihood of them falling through the cracks, as my mom had.

 

The O Cannabis Clinic Model is comprised of these 4 key elements:

  • Location Free or “decentral” - this feature ensures ease of access for patients because the clinic goes to the patient rather than the patient having to go to the clinic.

  • Patient Centered Prescribing – this model of care removes health care provider biases and actions patient centered medical theory.

  • Patient Centered Follow Up – this element of O Cannabis’ unique model of care meets “patients where they are” and ensures opens patients have access to experts at every point in their medical cannabis treatment journey.  Our nursing team discusses potential drug interactions, cannabis side effects and product selections to ensure the health and safety of the patient are honored throughout their treatment.

  • Auditing & Compliance – because medical cannabis is a relatively new area of medicine, O Cannabis has put procedural structures in place to ensure exceptional medical care while simultaneously reducing the risk of patients falling through the cracks.

 

To provide a more rounded voice for this article, I interviewed a nurse-leader in the Canadian Medical Cannabis sector, O Cannabis’ lead Nurse Practitioner, Ashley Bevan, RN(EC), PHCNP

 

Q: “Did you ever think you would work in the cannabis sector?”

A: “No but I definitely want to stay in this space now.”

 

Q: “What wisdom do you have to share with nurses who want to get into the medical cannabis space?”

A: “First, I would tell them to be open minded and check their misconceptions and biases about cannabis users at the door.  The medical cannabis patient population is a vulnerable group and deserves to be treated with dignity and respect. Patients come to cannabis clinics (not because they are “druggies” or “stoners” but rather) because they have tried everything else…(as nurses who choose to work in this space) we have to meet patients where they are at and stand up (for them) rather than turning them away because we are afraid to prescribe.”

 

Q: “What educational supports/resources do you recommend to nurses curious about working in this space?”

A: “The College of Family Physicians of Canada have great resources on their site including lower risk cannabis guidelines, cannabasics and guidelines for prescribing medical cannabis for chronic pain and anxiety. Health Canada also has a wonderful document on their site that summarizes the most recent evidence for prescribing cannabis. Most importantly, it is crucial for prescribers to actively engage and seek out research in order to stay up to date in this ever evolving field.”

 

Q: “Do you have any memorable stories you want to share?”

A: “Yes! This one still makes me tear up when I think about it. A (senior) patient and her best friend used to buy cannabis behind a dumpster. They were scared of being mugged but needed to access (cannabis) somehow. They were embarrassed about their choice in medicine and didn’t have any social supports (other than each other). They didn’t know about side effects or drug interactions and just before she came to see us, her best friend overdosed and died from (street sold) fentanyl laced cannabis.”

 

In closing, my intent with sharing these stories and points of view with you has been to lift the veil on medical cannabis and give you a peak into the real lives of people who cannabis has positively effected.  Here are some final closing facts about O Cannabis:

  • O Cannabis has been open since June 2017, has over 13,000 registered patients that range between 15 months old and 98 years old.

  • We have spent thousands of hours to create a scalable and patient centered clinic model that has now become a turnkey clinic solution for countries that want to reduce the enormous learning curve required to engage in safe and compliant medical practice in this space.

  • Starting in September 2019, three countries (so far) will be offering O Cannabis university level certification courses for nurses.

  • Also launching in September 2019, O Cannabis’ book entitled, “A Nurses Guide to Medical Cannabis: Everything you need to know to be successful working in this area of medicine.”

 

For more information about O Cannabis please feel free to email me directly at morgan@ocannabisclinic.com

 

Note: all stories have been shared with explicit written permission. The people who’s stories I share want the world to know how beneficial cannabis has been for them in order to help even one person who was in a situation like them feel better.

 

 

Written by: Morgan Toombs, RN, Founder & CEO of O Cannabis Clinic

Contributor: Ashley Bevan, RN(EC), PHCNP, Lead NP of O Cannabis Clinic

 

 





 

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Online Brazilian Journal of Nursing. ISSN: 1676-4285

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