Medical Cannabis: The Oncology Nurse's Role in Patient Education About the Effects of Marijuana on Cancer Palliation

Cannabis Use and Disclosure in the Oncology Setting: A Cross-Sectional Survey Exploring Information Needs Among Cancer Survivors

BACKGROUND

Given the potential positive and negative impacts of cannabis use during cancer care, more information is needed to understand how changes in cannabis legalization and social norms have affected cannabis use and clinical disclosure among cancer survivors.

OBJECTIVES

The purpose of this research was to explore cannabis behaviors, disclosure, and information needs among cancer survivors.

METHODS

The study team conducted cross- sectional analyses using descriptive statistics to assess data collected via an online survey distributed through online health communities.

FINDINGS

This analysis included 719 participants, and most reported currently undergoing treatment. About one-third reported current cannabis use. Cannabis use varied across the cancer care continuum, and most of those using cannabis discussed their use with a healthcare provider and reported interest in receiving more information about cannabis.

Routes of administration, reasons for use, and approved indications of medical cannabis in oncology: a scoping review

INTRODUCTION

Some patients diagnosed with cancer use medical cannabis to self-manage undesirable symptoms, including nausea and pain. To improve patient safety and oncological care quality, the routes of administration for use of medical cannabis, patients' reasons, and prescribed indications must be better understood.

METHODS

Based on the Joanna Briggs Institute guidelines, a scoping review was conducted to map the current evidence regarding the use of medical cannabis in oncological settings based on the experiences of patients diagnosed with cancer and their healthcare providers. A search strategy was developed with a scientific librarian which included five databases (CINAHL, Web of Science, Medline, Embase, and PsycINFO) and two grey literature sources (Google Scholar and ProQuest). The inclusion criteria were: 1) population: adults aged 18 and over diagnosed with cancer; 2) phenomena of interest: reasons for cannabis use and/or the prescribed indications for medical cannabis; 3) context: oncological setting. French- or English-language primary empirical studies, knowledge syntheses, and grey literature published between 2000 and 2021 were included. Data were extracted by two independent reviewers and subjected to a thematic analysis. A narrative description approach was used to synthesize and present the findings.

RESULTS

We identified 5,283 publications, of which 163 met the eligibility criteria. Two main reasons for medical cannabis use emerged from the thematic analysis: limiting the impacts of cancer and its side effects; and staying connected to others. Our results also indicated that medical cannabis is mostly used for three approved indications: to manage refractory nausea and vomiting, to complement pain management, and to improve appetite and food intake. We highlighted 11 routes of administration for medical cannabis, with oils and oral solutions the most frequently reported.

CONCLUSION

Future studies should consider the multiple routes of administration for medical cannabis, such as inhalation and edibles. Our review highlights that learning opportunities would support the development of healthcare providers' knowledge and skills in assessing the needs and preferences of patients diagnosed with cancer who use medical cannabis.

Medical Cannabis and School: Separating Fact From Fiction

The majority of states have legalized medical marijuana (MM) despite its Federal Schedule 1 designation as an illegal substance. Public schools must comply with Drug Free Workplace laws or risk the loss of federal funding. To address the conflict between state and federal laws regulating MM, the National Association of School Nurses issued a position brief in January 2019. The accompanying article introduces the Cannabis/Marijuana Position Brief and provides guidance for school nurses who encounter a student treated with MM. Topics addressed include background implications of federal marijuana and hemp law, mechanism of action for MM, Epidiolex overview, current research regarding efficacy of MM for common qualifying conditions, and implications for school nursing practice.