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Due to today’s opioid epidemic, medical marijuana should be further evaluated as an alternative treatment method for chronic illnesses. With only 34 states legalizing the use of medical marijuana, research has been difficult to attain due to the governmental policies differing at the federal and state level. Research population is limited because it is a Schedule 1 controlled substance with only legalization occurring over the past 23 years. This paper describes the research found on the efficacy of medical marijuana and its impact on patients’ quality of life. From this research, medical marijuana has been found to have a positive effect on quality of life measures related to physical and mental well-being. The benefits of medical marijuana use has been shown to decrease pain, inflammation, muscle spasms and increase mobility and mood. Adverse effects that have been associated with the use of medical marijuana include symptoms of bronchitis, decreased brain functioning and an associated increased risk for coronary artery disease. Although medical marijuana has been found to have several adverse effects, these do not compare to the magnitude of those experienced by individuals using alternative pharmacological methods. With more research, medical marijuana could potentially prove to be beneficial for improving the quality of life of individuals living with chronic pain.

Marijuana

  • Marijuana used as a natural herb dates as far back as 2900 BC.
  • It is predominately used for medical, spiritual, recreational and religious purposes in various cultures.
  • Marijuana is noted to reduce pain, modulate anti-inflammatory pathways, and offer neuroprotection, among other functions
  • Indicated uses of medical marijuana
    • Various types of chronic pain
      • Cancer, musculoskeletal, neuropathic, arthritis, fibromyalgia
    • Parkinson’s Disease
    • Irritable Bowel Syndrome
    • Diabetes
    • Glaucoma
    • Epilepsy
    • Multiple Sclerosis
    • Nausea
    • Mental health conditions

Endocannabinoid System

  • Endocannabinoid system (ECS) is a natural internal system involved in homeostasis.
  • CB1 and CB2 receptors aid in bodily functions such as: appetite, digestion, immune function, inflammation, mood, sleep, motor control, temperature regulation, and pain.

Legality Issues

  • A total of 34 states have legalized the use of medical marijuana
  • Despite the widespread legalization at the state level over the past two decades, possession and administration of medical marijuana has not been legalized at the federal level.
  • At the federal level, marijuana is currently classified as a Schedule I controlled substance stating it is not accepted for medical use and poses a high risk for abuse.
  • Although there is emerging research available on the benefits of medical marijuana, federal restrictions have made it difficult to pursue.

Opioid Crisis/Adverse Effects

  • Throughout the years 1999-2017, opioid overdose has resulted in approximately 400,000 deaths.

Is Medical Marijuana Effective in Improving the Quality of Life in Chronically Ill Adult Patients?

Stephany Caicedo, Joanne Meneses, Brianne Swanda, Jillian Swisher

Accelerated Bachelors of Science in Nursing, New Jersey City University

ABSTRACT

BACKGROUND

Is Medical Marijuana More Effective Than Opioids in Improving the Quality of Life in Chronically Ill Adult Patients?

  • Be aware of current state regulations and qualifying conditions
  • Understand how the endocannabinoid receptors affect body systems
  • Be able to distinguish common side effects associated with medical marijuana from adverse reactions
  • Be mindful of appropriate routes of administration and how they benefit various populations
  • Acknowledge safety considerations; storage and disposal
  • Stay informed on current research

Through our research related to the effectiveness of medical marijuana for chronic pain and improvement of quality of life, it can be concluded that although there is a possibility that medical marijuana can be an effective treatment option, there is still more research that needs to be done. Medical marijuana has been shown to have an impact on several factors, including the amount and frequency of alternative medications being taken, the symptoms associated with certain conditions, and patients’ overall life-satisfaction. Through the use of medical marijuana, patients have reported decreased amounts of prescription and over-the-counter medications used to treat their conditions, while achieving the same, if not better, therapeutic effect. By medical marijuana allowing patients to decrease the amount of medications that they are taking, this improves patient satisfaction. Patients experience less side effects and are more likely to have an improved quality of life through increased mobility, mood, and overall sense of well-being. Although medical marijuana has been shown to have several benefits, it has also been suspected to have an association with adverse events such as an increased risk of CVA, CHF, and CAD, increased respiratory symptoms, and can also have an effect on cognitive function.

In 2016, the American Nurse Association (ANA) revised their position statement on the therapeutic use of marijuana. The ANA recognized that due to the designation of marijuana as a Schedule I drug, clinical research is halted by the Drug Enforcement Agency. The organization recommends additional scientific research on marijuana in order to guide evidence-based practice for therapeutic use in patients. Our research coincides with the recent ANA position statement, concluding that although the use of medical marijuana for various conditions seems promising, more clinical research is needed in order to make further advancements as a therapeutic drug.

CONCLUSIONS

NURSING IMPLICATIONS

SUMMATION OF FINDINGS

REVISED PICO QUESTION

Participants were found to have an increased risk associated with CVA, CAD and CHF if medical marijuana was consumed.

Patients using medical marijuana for a period of 8 months were surveyed and were found to have improvements in the categories above.

Results depict a positive correlation between length of marijuana use and FVC measurement suggesting improved lung function.

Participants reported an increase in respiratory symptoms with chronic marijuana use.

Marijuana has been shown to decrease IQ levels which may be associated with decreased grey matter in the frontal cortex.

Katharine Kolcaba’s theory of comfort states that patient comfort exists in three forms; relief, ease and transcendence. Through the use of medical marijuana, comfort, as defined by Kolcaba, can be achieved through decreased pain, increased quality of life, and patient preference, as concluded from our research.

COMFORT THEORY

Adults age 65 and up participated in a study which showed an improvement in perceived view of their quality of life and a decrease in falls experienced during the study.

Prevalence of Cardiovascular Events in Patients With and Without Medical Marijuana Use

Association Between Length of Marijuana Exposure and FVC

Correlation Between Marijuana Use and IQ

Frequency of Respiratory Symptoms Reported During Last 30 Days of Marijuana Use

What Did Participants Like Most About Medical Marijuana?

What Did Participants Like Least About Medical Marijuana?

Mean Scores for Variables Indicating Marijuana’s Influence on Physical and Mental Health Parameters

Self-Reported Variations in Dimensions of Parkinson’s Disease

Changes Reported Among Participants Receiving Medical Marijuana to Treat Fibromyalgia

Comparison of the Quality of Life and Safety in Geriatrics Before and After Using Medical Marijuana

Approximately half of the participants reported discontinuation or a reduction in other pain medications while also reporting an improvement in their capacity to work or to return to work full-time.

Participants diagnosed with PD received a placebo, 75mg CBD, or 300mg CBD for a period of 6 weeks. Results show significant improvements in mobility, ADLs , emotional well-being, and physical discomfort.