Ridad and McKaig Discuss Oncology Nurse Perceptions on Medical Cannabis

Most oncology nurses who work at UCLA Health indicated that medical cannabis helped their patients manage anxiety and insomnia, according to findings of a survey presented at the 48th Annual Oncology Nursing Society (ONS) Congress.¹

In an interview with Oncology Nursing News®, study author Alyssa Ridad BSN-RN, OCN, explained that in California, “Ryan’s Law,” or Senate Bill (CA SB) 311, has mandated that health care facilities allow medical cannabis use for patients who are terminally ill. Ridad, and her co-investigator, Amanda McKaig, BSN, RN, OCN, sought to understand nurses’ comfortability in managing medical cannabis use in the inpatient, medical-surgical oncology population.

Findings from a literature suggest that research strongly supports the use of medical cannabis in the management of chronic pain, including nausea, vomiting, and anorexia.^2-6 Moreover, research has demonstrated that delta-9-tetrahydrocannabinol/cannabidiol (THC/CBD), in combination with standard anti-emetic regimens, can be effective in reducing chemotherapy-induced nausea and vomiting. Additionally, there is emerging evidence that THC/CBD may be effective in managing chemotherapy-induced peripheral neuropathy and sleep disorders.

In accordance with Ryan’s Law, the institution updated their policy to allow for the interdisciplinary collaboration between nursing and pharmacy. The process is as follows:¹

• MD recognizes that a patient meets the criteria for inpatient cannabis use.
• The patient provides a supply of their own cannabis products.
• The pharmacy provides patients with a personal lockbox to store their cannabis products.
• The patient can self-administer their products as needed.
• Nurses document each administration into the Medication Administration Record (MAR).

Ridad and McKaig created a survey, which was sent to all nurses who care for a patient who successfully oversaw cannabis use after the implementation of Ryan’s Law. This survey measured nurse comfort and their perception of the cannabis’ efficacy on symptom management. They queried participants to rate their responses to following questions:

I feel comfortable implementing Ryan’s Law into my practice.

• One respondent shared that they strongly agreed with this statement, 3 somewhat agreed, and 1 neither agreed nor disagreed.

I feel that Ryan’s Law helped my patients with their symptoms on reassessment.

• Three respondents shared that they strongly agreed with this statement, 3 somewhat agreed, and 1 neither agreed nor disagreed.

I feel that Ryan’s Law had a positive impact on my patient stay.

• Three respondents shared that they strongly agreed with this statement, 3 somewhat agreed, and 1 neither agreed nor disagreed.

Moreover, nurses responded that sleep and anxiety were the symptoms most likely to prompt their patients to use their cannabis products.

References

1. McKaig A, Ridad A. Nurses’ perspectives on compassionate access to medical cannabis. Poster presented at: 48th Annual Oncology Nursing Society Congress; April 26-30, 2023; San Antonio, TX. Accessed May 25, 2023. https://ons.confex.com/ons/2023/meetingapp.cgi/Paper/12684
2. Banerjee S, McCormack S. Medical cannabis for the treatment of chronic pain: a review of clinical effectiveness and guidelines. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2019.
3. Bodine M, Kemp AK. Medical cannabis use in oncology. StatPearls. Updated October 25, 2022. Accessed May 25, 2023. https://www.ncbi.nlm.nih.gov/books/NBK572067/
4. Finn DP, Haroutounian S, Hohmann AG, Krane E, Soliman N, Rice ASC. Cannabinoids, the endocannabinoid system, and pain: a review of preclinical studies. Pain. 2021;162(suppl 1):S5-S25. doi:10.1097/j.pain.0000000000002268
5. Kleckner AS, Kleckner IR, Kamen CS, et al. Opportunities for cannabis in supportive care in cancer. Ther Adv Med Oncol. 2019;11:1758835919866362. doi:10.1177/1758835919866362
6. McDonagh MS, Morasco BJ, Wagner J, et al. Cannabis-based products for chronic pain: a systematic review. Ann Intern Med. 2022;175(8):1143-1153. doi:10.7326/M21-4520