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'Are nurses ready to manage patient expectations of cannabis-based products?'

Ian Hamilton

Rarely does policy change so quickly. The home secretary Sajid Javid announced a review into the potential health benefits of cannabis in June and then, true to his word, he acted on the findings opening up access to cannabis products from the beginning of November 2018. 

Nurses and doctors will be the first point of contact for patients who will either want access to cannabis products provided by the NHS or want more information.

An indication of the likely demand was provided by a recent poll which found that 13% of respondents said they would be asking their healthcare provider about medicinal cannabis.

The same poll found that 76% of respondents would be willing to try medicinal cannabis. So it looks as though demand for information could be significant, in part fuelled by some far-fetched claims about the benefits that cannabis offers, everything from shrinking tumours to curing hangovers.

“What is needed is a reliable and easily accessible resource that can be used in busy clinical settings”

It will be a year before the National Institute for Health and Care Excellence (NICE) produce clinical guidance. In the meantime, nurses and patients will have to source information independently. That will be challenging for many nurses who won’t necessarily have the time needed to carry out searches of research databases.

What is needed is a reliable and easily accessible resource that can be used in busy clinical settings, such as an app that provides evidence-based information about the specific health problem and whether there is potential for a cannabis product to help.

Managing patient’s expectations will be left in part to nurses, as patients will look for advice and support in their quest for access to cannabis-based products.

It will also be some time before agreement is reached on defining a cannabis-based medicinal product. The Home Office asked its scientific advisors, the Advisory Council on the Misuse of Drugs (ACMD) to help draw up a definition.

The ACMD responded by raising concerns about the interim definition proposed by the Home Office, as it does not include safety or quality standards. This means cannabis-based products might bypass the regulatory scrutiny that other medicines have to go through before they are provided by the NHS.

But this is just one of many issues that this new policy raises – for example, it can be difficult to differentiate between recreational and medicinal use of cannabis. Cannabis is used by many people to relax or as a way of feeling pleasure, which they would not otherwise experience.

For some people using cannabis, it can be a risk rather than a benefit to health, particularly mental health problems such as psychosis. The problem is that we aren’t able to accurately predict who will be helped and who will be hampered when using cannabis.

So while the home secretary is to be applauded for recognising the potential of cannabis for health, careful evaluation of this policy will be needed. Some nurses might be concerned that this new policy will result in patients taking advantage of a more liberal policy towards cannabis.

“Nurses should be offered training and education about cannabis-based medicinal products”

In some American states, where access to medicinal cannabis has been permitted for some time doctors can collude with patients who falsely claim they have medical conditions to get access to cannabis products. This is unlikely to happen in the UK as the process of accessing medicinal cannabis will not be an attractive one when most people can secure cannabis via the unregulated market.

Nurses should be offered training and education about cannabis-based medicinal products, but at a time when continuing professional development funding has been drastically cut, I fear that nurses will be left to try and locate the information for themselves.

Match this with high expectations and potentially false hope given to patients, this situation needs urgent attention and investment in nurses who will be crucial to facilitating appropriate access to cannabis-based products.


Readers' comments (2)

  • In Israel there is a process of medicalization and unfortunately the director of the medical cannabis unit decided that only doctors and pharmacists should be trained to treat cannabis. Together with another nurse, we founded a non-profit organization called The Israel Medical Cannabis Nursing Association (IMCNA). I am the chairperson of the association and in charge of a special nurse's medical cannabis course, counseling for the treatment of medical cannabis, in order to make the knowledge accessible and to provide optimal treatment for patients. Already 80 nurses have taken this course and we continue!

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  • Many thanks Irit for sharing this it sounds like a really useful and important project you have developed. Would be great to meet up if you are ever in the UK.

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