Cannabis use in palliative care – an examination of the evidence and the implications for nurses

Green, Anita J; Vries, Kay de

doi:10.1111/j.1365-2702.2010.03274.x

Cited by 11 publications

(6 citation statements)

References 41 publications

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“…Nurses must be informed by up-to-date, pharmacological, physiological, psychological, and legal evidence regarding CTP. 6 To support NPs in providing comprehensive and safe care and patient education related to CTP, it is essential to assess their knowledge gaps, attitudes, and barriers regarding the use of CTP in clinical practice.…”

Section: Literature Reviewmentioning

confidence: 99%

A National Needs Assessment of Canadian Nurse Practitioners Regarding Cannabis for Therapeutic Purposes

Balneaves

Alraja

Ziemiański

et al. 2018

Cannabis and Cannabinoid Research

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Introduction: In Canada, the Access to Cannabis for Medical Purposes Regulations (ACMPR) has given nurse practitioners (NPs) the power to authorize cannabis for therapeutic purposes (CTP) to eligible patients. This expansion in NPs' scope of practice underscores the importance of delivering balanced, evidence-based education on cannabis to NPs. The aim of this national study was to assess NPs' knowledge and practice gaps related to CTP to inform the development of future education resources that increase NPs' clinical competence and improve patient care related to medical cannabis.Methods: This is a quantitative, descriptive exploratory design study. A national online survey of NPs was conducted from August 2013 to June 2014. NPs were recruited through email lists held by numerous Canadian nursing organizations. The survey was adapted from a previous national survey that assessed CTP educational needs among Canadian physicians. The survey assessed NPs' knowledge, experience, barriers, and attitudes related to CTP as well as preferred format for future CTP education.Results: The sample consisted of 182 NPs from across Canada. The largest knowledge gap was related to dosing and creating effective treatment plans for patients using CTP. The majority of respondents (76.3%) ranked the need for education on CTP to be either strong or very strong. Over half (57%) reported that they would be comfortable authorizing medical cannabis through the ACMPR; this number increased to 64% if they were to receive appropriate education.Conclusion: Nursing regulatory organizations, in partnership with academic institutions and government agencies, must work toward the development of educational and clinical competencies specific to CTP. Tailored education programs are needed to address the knowledge gaps held by NPs and the clinical barriers they face to including CTP as part of their care.

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Section: Literature Reviewmentioning

confidence: 99%

A National Needs Assessment of Canadian Nurse Practitioners Regarding Cannabis for Therapeutic Purposes

Balneaves

Alraja

Ziemiański

et al. 2018

Cannabis and Cannabinoid Research

View full text Add to dashboard Cite

show abstract

“…50 Microinjections of IL-10 into the ventricles also prevented memory impairment in maternally separated animals. 54 Cannabinoid Receptor Type 2 Maltreatment during early childhood is a significant predictor of cannabis dependence, [194][195][196] even after adjustment for genetic vulnerability. 197 Cannabis use by depressed individuals thus can be considered self-medication.…”

Section: Il-10mentioning

confidence: 99%

Neuroinflammation, Early-Life Adversity, and Brain Development

Andersen

2022

Harv Rev Psychiatry

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The overarching objective is to review how early exposure to adversity interacts with inflammation to alter brain maturation. Both adversity and inflammation are significant risk factors for psychopathology. Literature relevant to the effects of adversity in children and adolescents on brain development is reviewed. These studies are supported by research in animals exposed to species-relevant stressors during development. While it is known that exposure to adversity at any age increases inflammation, the effects of inflammation are exacerbated at developmental stages when the immature brain is uniquely sensitive to experiences. Microglia play a vital role in this process, as they scavenge cellular debris and prune synapses to optimize performance. In essence, microglia modify the synapse to match environmental demands, which is necessary for someone with a history of adversity. Overall, by piecing together clinical and preclinical research areas, what emerges is a picture of how adversity uniquely sculpts the brain. Microglia interactions with the inhibitory neurotransmitter GABA (specifically, the subtype expressing parvalbumin) are discussed within contexts of development and adversity. A review of inflammation markers in individuals with a history of abuse is combined with preclinical studies to describe their effects on maturation. Inconsistencies within the literature are discussed, with a call for standardizing methodologies relating to the age of assessing adversity effects, measures to quantify stress and inflammation, and more brain-based measures of biochemistry. Preclinical studies pave the way for interventions using anti-inflammation-based agents (COX-2 inhibitors, CB2 agonists, meditation/yoga) by identifying where, when, and how the developmental trajectory goes awry.

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“…Today, as a palliative treatment, we know that cannabis and its sedative properties are very effective in combating drug and treatment side effects for various medical conditions. It has been approved or is under consideration for legalization in many countries worldwide and is understood to be safe relative to opioids [15][16][17][18].…”

Section: Medical Uses Of Cannabis Sativamentioning

confidence: 99%

“The Two Sides of the Same Coin”—Medical Cannabis, Cannabinoids and Immunity: Pros and Cons Explained

Khoury

Bar‐Sela

2022

Pharmaceutics

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Cannabis, as a natural medicinal remedy, has long been used for palliative treatment to alleviate the side effects caused by diseases. Cannabis-based products isolated from plant extracts exhibit potent immunoregulatory properties, reducing chronic inflammatory processes and providing much needed pain relief. They are a proven effective solution for treatment-based side effects, easing the resulting symptoms of the disease. However, we discuss the fact that cannabis use may promote the progression of a range of malignancies, interfere with anti-cancer immunotherapy, or increase susceptibility to viral infections and transmission. Most cannabis preparations or isolated active components cause an overall potent immunosuppressive impact among users, posing a considerable hazard to patients with suppressed or compromised immune systems. In this review, current knowledge and perceptions of cannabis or cannabinoids and their impact on various immune-system components will be discussed as the “two sides of the same coin” or “double-edged sword”, referring to something that can have both favorable and unfavorable consequences. We propose that much is still unknown about adverse reactions to its use, and its integration with medical treatment should be conducted cautiously with consideration of the individual patient, effector cells, microenvironment, and the immune system.

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Cannabis use in palliative care – an examination of the evidence and the implications for nurses

Abstract: Questions and dilemmas are raised concerning the role of the nurse when caring and supporting a person making therapeutic use of cannabis.

Cited by 11 publications

References 41 publications

A National Needs Assessment of Canadian Nurse Practitioners Regarding Cannabis for Therapeutic Purposes

A National Needs Assessment of Canadian Nurse Practitioners Regarding Cannabis for Therapeutic Purposes

Neuroinflammation, Early-Life Adversity, and Brain Development

“The Two Sides of the Same Coin”—Medical Cannabis, Cannabinoids and Immunity: Pros and Cons Explained

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