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Replies for peers. Need ONE Response Per Each Discussion Total 8 Responses. Attached Are The Discussions And Rubric Please Follow Them. Posts Will Be A Minimum Of 100 Words, APA Format.One Reference Per Each Discussion Top of Form
Ana Barreras Lopez
 

Who are the stakeholders both in support of and in opposition to medicinal cannabis use?

           The use of cannabis as medicine results a controversial and frequent debate in all levels of society. Mostly in comparison with others legal drugs as alcohol and tobacco which have not proven health benefits. Different arguments have been posters by the pro-marijuana use: is a plant not a drug, healthy than tobacco, not everyone to takes drugs becomes an addict, is harder to overcome from alcohol abuse that marijuana use, is another crop to develop farmer industry, helps with pain, allows to “die with dignity”, also has anti inflammatory properties, antiemetic, and has been use as medicine for hundreds of years. It can be used in many ways, and not need to get high to enjoy its benefits.
           But for some legislatives, is another addictive substance, a gateway drug. Also, researches have demonstrated that affect short-term memory, impair cognitive abilities, cause lung damage, increase the risk of lung cancer. Impairs driving skills causing collisions. Is consider illegal under federal law being placed as Schedule I drug in the Controlled Substance Act same as heroin (The Debate Over the Legalization of Marijuana for Medical Use, 2021).
           Multiple and diverse interests are mixed, the drug companies saw a unique opportunity to make money, legislatives and politicians use it as campaign logo, to gain votes, and beyond planning a way to tax the sale. Others advocate the right of freedom to have a recreational not harmful activity. Economically is another way for farmers to diversify production as herb or hemp. By the other hand the use among young people can lead to other drug dependency, alter family stability, and affect scholarity. On the peak of the iceberg stands medical benefits, health professionals need to adhere to laws and best practices (Gardiner et al., 2019).

What does current medical/nursing research say regarding the increasing use of medicinal cannabis?

           The use of marijuana as a medicine date back centuries, it was even listed in the US. pharmacopeia. Unfortunately, it was very popular among the marginalized, minorities, poor class and Afro-American musicians as a recreational drug and there began the legal and social problems that favored The Marijuana Tax Act of 1937 (Mason et al., 2016). Despite the prohibition and all social issues, researches identified that health professionals support the use of medicinal cannabis, exist a lack of knowledge regarding legislative and clinical domain, and the risk of psychiatric events (Gardiner et al., 2019). The highest risk on implementing medicinal cannabis is the potential for recreational misuse. Also, exist a gap among pharmacist related to dosage, administration, side effects, and interactions that must be filed by evidence and research. Education about this topic must be provided to professionals because is a trending medicine nowadays (Abazia & Bridgeman, 2018).
           The effects of phytocannaboids can be reached by a variety of routes of administration giving a broad spectrum for medicinal use. Inhalation is the most common way having the quickest onset of action appropriate for those which requires a rapid release of symptoms with a shorter duration. Oral administration has a longer duration but slower onset of action, very effective on chronic pain. Oro mucosal is also another alternative to treat spasticity on multiple sclerosis and neuropathic pain. Rectal use is uncommon but available to treat chemotherapy nausea and emesis. Topical administration has been proven effectivity on glaucoma (Mouhamed et al., 2018).
           All of above prove the beneficial effect of medicinal marijuana, bust still exists a lack of studies analyzing benefit-harm of this alternative method of treatment. More evidence-based report is needed to plenty support this option. However, many countries including some states of the union have approved the use of medical marijuana. Worldwide 45-80% of patients are using this modality of treatment (Tawfik et al., 2019).

What is the policy, legal and future practice implications based on the current prescribed rate of cannabis?

           Since 1996 when California passed the Proposition 215 that allows patients to use herbal cannabis the changes on laws and policies began. During the 20th century many states approve the use of medicinal marijuana by provider prescriptions or by individual use. Regulations vary in terms according internal legislations on each state. In that aspect the dispensaries acts more or less aggressive, providers are required to be aware of policies, the form of distribution vary from states to states as well as chain of supply (National Academies of Sciences, Engineering, and Medicine et al., 2017).
           The H.R. 5657: Medical Marijuana Research Act facilitates medical marijuana research and directs the Drug Enforcement Administration to register practitioners, manufactures and distributors for that purpose (Summary of H.R. 5657: Medical Marijuana Research Act, 2021). A new classification is needed in order to reschedule this drug and move it to Schedule II or create a new one cannabis only schedule IV to accommodate all cannabis product and facilitate well designed clinical trials (Ryan et al., 2021). The use of appropriate terminology is important, a heath provider can recommend the use but this substance is still a Schedule I, so they only can prescribe the products authorized by law and according their license terms.

References

Abazia, D. T., & Bridgeman, M. B. (2018). Reefer madness or real medicine? A plea for incorporating medicinal cannabis in pharmacy curricula. Currents in Pharmacy Teaching and Learning, 10(9), 1165–1167.

Gardiner, K. M., Singleton, J. A., Sheridan, J., Kyle, G. J., & Nissen, L. M. (2019). Health professional beliefs, knowledge, and concerns surrounding medicinal cannabis – A systematic review. PLOS ONE, 14(5), e0216556.

Mason, D., Gardner, D., Hopkins, F., & O’Grady, E. (2016). Policy & Politics: in Nursing and Health Care (7th ed.). Elsevier.
Mouhamed, Y., Vishnyakov, A., Qorri, B., Sambi, M., Frank, S. S., Nowierski, C., Lamba, A., Bhatti, U., & Szewczuk, M. (2018). Therapeutic potential of medicinal marijuana: an educational primer for health care professionals. Drug, Healthcare and Patient Safety, Volume 10, 45–66.

National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Population Health and Public Health Practice, & Committee on the Health Effects of Marijuana: An Evidence Review and Research Agenda. (2017).
Ryan, J. E., McCabe, S. E., & Boyd, C. J. (2021). Medicinal Cannabis: Policy, Patients, and Providers. Policy, Politics, & Nursing Practice, 22(2), 126–133. https://doi.org/10.1177/1527154421989609
Summary of H.R. 5657: Medical Marijuana Research Act. (2021). GovTrack.Us.

The Debate Over the Legalization of Marijuana for Medical Use. (2021, January 23). Verywell Health.

The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research (1st ed.). National Academies PressTawfik, G. M., Hashan, M. R., Abdelaal, A., Tieu, T. M., & Huy, N. T. (2019). A commentary on the medicinal use of marijuana. Tropical Medicine and Health, 47(1).

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Inalvis Diaz
11/17/21, 2:55 PM
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The history of medical cannabis goes back to ancient times. Ancient physicians in many parts of the world mixed cannabis into medicines to treat pain and other ailments. In the 19th century, cannabis was introduced for therapeutic use in Western Medicine. An Irish physician, William Brooke O’Shaughnessy, is credited with introducing the therapeutic use of cannabis to Western medicine. Since then, there have been several advancements in how the drug is administered. First testing his preparations on animals, then administering them to patients to help treat muscle spasms, stomach cramps or general pain (Alison & Janet, 2000). Later in the century, researchers investigating methods of detecting cannabis intoxication discovered that smoking the drug reduced intraocular pressure (Lop, n.d.). 
Later, in the 1970s, a synthetic version of THC was produced and approved for use in the United States as the drug Marinol. Voters in eight U.S. states showed their support for cannabis prescriptions or recommendations given by physicians between 1996 and 1999.
Marijuana is becoming legal in an increasing number of states for both medical and recreational use. Considerable controversy exists regarding the public health impact of these changes. The evidence for the legitimate medical use of marijuana or cannabinoids is limited to a few indications, notably HIV/AIDS cachexia, nausea/vomiting related to chemotherapy, neuropathic pain, and spasticity in multiple sclerosis.
The public health impact of marijuana legalization remains a controversial issue. Advocates of legalization contend that this policy change will provide for more stringent regulation and safer use of marijuana, more efficient use of law enforcement resources, and possibly even a decline in the prevalence of marijuana use among adolescents and of the use of “harder” drugs (e.g., cocaine and heroin) (Project, n.d.). Those opposing legalization cite the adverse effects of marijuana and worry that legalization will lead to an increase in use, and thus an increase in health problems attributed to marijuana. The latter view is reflected in the official position statements of prominent professional medical associations such as the American Psychiatric Association, the American Society of Addiction Medicine, and the American Medical Association, which have expressed concern regarding the negative consequences of marijuana use. 
Numerous studies carried out to date confirm the potential therapeutic value of cannabinoid drugs, primarily THC, for pain relief, control of nausea and vomiting, and appetite stimulation; smoked marijuana, however, is a crude THC delivery system that also delivers harmful substances. The psychological effects of cannabinoids, such as anxiety reduction, sedation, and euphoria can influence their potential therapeutic value.  
The CSA placed cannabis in Schedule I, the most restrictive category reserved for substances that have no currently accepted medical use, alongside heroin and lysergic acid diethylamide (LSD). Each state maintains its own set of laws that regulate the supply and use of the drug. In most cases, acts involving cannabis are subject to criminal prohibition, but sanctions vary considerably by state, each of which is constitutionally entitled to establish its own criminal codes and penalties. The law generally provides an
affirmative defense for individuals using cannabis for medical purposes. Reforms at the state level continued in the waning years of the 20th century, with a handful of states passing laws to allow doctors to prescribe medical cannabis or allow for a legal defense for use of medical cannabis.
Medical cannabis laws and policies vary greatly in terms of the regulations governing supply and use. Some are more restrictive than others, limiting the access of the drug to a certain class of individuals who suffer from certain illnesses or conditions, or establishing stricter limits on the production and distribution of the substance to at-home cultivation by patients and caregivers. Some states legally protect and regulate the operation of storefronts known as dispensaries (Hanson & Garcia, n.d.).
Most researchers recognize that a growing general public acceptance of the drug for medical and recreational purposes has been encouraging the changes at the state level. It remains to be seen if cannabis will be legalized at the national level or if such public opinion will continue. In 2015, according to a Gallup tracker poll, 58 percent of Americans favored legalizing cannabis, marking the third straight year that cannabis legalization found majority support (Gallup, 2015). 
References
Alison Mack; Janet Joy (7 December 2000). Marijuana As Medicine?: The Science Beyond the Controversy. National Academies Press. pp. 15–. ISBN 978-0-309-06531-3.
Gallup,Inc.(2015,October21).InU.S.,58%BackLegalMarijuanaUse.Retrievedfrom http://www.gallup.com/poll/186260/back-legal-marijuana.aspx
HansonK.,&Garcia,A.(n.d.).Retrievedfromhttp://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx
Lop. (n.d.). Retrieved from http://www.zauberpilz.com/golden/g31-40.htm
Project,M.P.(n.d.).MarijuanaProhibitionFacts.Retrievedfromhttps://www.mpp.org/issues/legalization/marijuana-prohibition-facts/)
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Edited by Inalvis Diaz on Nov 17, 2021, 3:03:30 PM

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Joyce Rivera

Medical Application of Cannabis

The issue of cannabis use has been a contentious subject for a long time. Many institutions, especially governments, have posited that the substance is harmful and banned its use for many years. However, recent trends indicate that many countries are beginning to permit marijuana use for medicinal purposes. The application of the substance as medicine began at least 5,000 years ago in Romania and other regions. It was applied to treat different medical conditions and relieve pain. Today, increasing research continues to promote the adoption of cannabis as a treatment option. The medical utilization of cannabis is gaining traction and support from various institutions, including governments and healthcare providers, resulting in varying industry implications.

Stakeholder Support and Opposition

The adoption of cannabis for medicinal use faces support and opposition from various stakeholders. For instance, at least 36 states and four territories in the United States have passed laws permitting the use of marijuana as a medical product (National Conference of State Legislatures, 2021). Other stakeholders who support the medicinal use of cannabis are individuals running cannabis farms, dispensaries, and businesses that sell cannabis-related products. The United States Food and Drug Administration (FDA) provides limited support and approval for the use of the substance for medical purposes. The institution has only permitted one drug derived from cannabis and three cannabis-related medicines (U.S. Food and Drug Administration, 2021). However, it does not support the commercial application for the substance to treat any condition or disease. Conversely, the federal government still classifies marijuana as a schedule 1 substance, meaning that it is highly likely to become addictive and has no proven medical use.

Medical Research on Medical Use of Marijuana

Current medical research on the application of marijuana as a medicinal substance has shown both the positive and negative outcomes of using the substances. According to Bridgeman and Abazia (2017), even though the drug’s widespread use and its related products treat some conditions and suppress some symptoms, their effectiveness in alleviating specific conditions is unclear. Presently, many individuals undergoing chemotherapy for cancer treatment use cannabis to prevent nausea (Smith, Azariah, Lavender, Stoner., & Bettiol, 2015). Moreover, there is limited evidence on the application of cannabis in managing neurological conditions, including Parkinson’s disease, epilepsy, and multiple sclerosis. However, the American Academy of Neurology developed a summary showing various systematic reviews proving that oral administration of marijuana may manage painful spasms or central pain for multiple sclerosis patients. Thus, the existing medical research on the use of cannabis to treat various diseases and symptoms is still very limited.

Regulatory and Policy Implications

The current application of cannabis in medical use presents various regulatory and policy implications. For instance, the federal government still prohibits using the substance for any purpose, including medical. Thus, physicians have no legal ground to prescribe the drug to patients (Bridgeman &Abazia, 2017). However, in the states where medicinal use has been approved, the physicians are permitted to recommend or certify their use for treatment. The classification of cannabis as a Schedule 1 drug limits access to the substance for research. Consequently, research on the efficacy or implications of using cannabis as a treatment option remains limited.

Conclusion

As many stakeholders support the adoption of cannabis as a medical substance, various legal and policy implications arise. Many states in the United States have approved the use of the substance to treat disorders and conditions. Moreover, other stakeholders, including farmers and sellers, support the classification of the drug as a possible medicine. Conversely, through the Drug Enforcement Agency and FDA, the federal government still prohibits the use of marijuana for any purpose. Thus, many medical researchers cannot access the substance leading to limit research on the topic. Future projections indicate increased adoption of cannabis as a medicinal plant.

References

Bridgeman, M. B., & Abazia, D. T. (2017). Medicinal cannabis: History, pharmacology, and implications for the acute care setting. Pharmacy and Therapeutics, 42(3), 180–188. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5312634/
National Conference of State Legislatures. ( 2021, August 23). State Medical Marijuana Laws. Retrieve from https://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx.
Smith, L. A., Azariah, F., Lavender, V. T., Stoner, N. S., & Bettiol, S. (2015). Cannabinoids for nausea and vomiting in adults with cancer receiving chemotherapy. Cochrane Database of Systematic Reviews, (11). https://doi.org/10.1002/14651858.CD009464.pub2.
U.S. Food and Drug Administration. (2021). FDA Regulation of Cannabis and Cannabis-Derived Products: Q&A. U.S. Food and Drug Administration. Retrieved from https://www.fda.gov/news-events/public-health-focus/fda-regulation-cannabis-and-cannabis-derived-products-including-cannabidiol-cbd.
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Edited by Joyce Rivera Garcia on Nov 22, 2021, 4:26:30 PM

Aymee Morales Aranegui

 Stakeholders both in support of and in opposition to medicinal cannabis use
The U.S. Food and Drug Administration (FDA) and American Academy of Neurology (AAN) approve cannabis and cannabis-derived compounds for the clinical use. FDA has approved THC and CBD-based medication for the nausea treatment for cancer patients and severe cases of childhood epilepsy, respectively. However, the U.S. Drug Enforcement Agency has categorized cannabis under the Schedule I Substances Act meaning that it is a controlled substance because of the increased potential for the abuse and dependency. The World Health Organization (WHO) has classified marijuana as a highly addictive drug (Vedelago et al., 2020). These are some of the bodies that support and oppose the use of medicinal cannabis.

What current medical/nursing research say regarding the increasing use of medicinal cannabis
The use of medicinal cannabis is increasing due to its therapeutic effects for terminally ill patients in alleviating symptoms and side effects of the treatment. Nurses should encounter patients who may benefit from the medicinal marijuana as the use of this treatment option grows. Palace and Reingold (2019) states that despite the known advantages and validation of medical cannabis in the healthcare system, nurses are not taught about medical marijuana in nursing school. There is a need for standard regulations through the formulation of prescribing guidelines that include indications for the usage, exact doses, and means of administration, predicted outcomes, possible negative effects, and indicators for discontinuing the treatment.
 
Policy, legal and future practice implications based on the current prescribed rate of cannabis
Given the increased use of medical marijuana, there is a need for a shift in the policy and legal practice implications for this treatment approach. According to national surveys, 1 to 2 percent of US individuals have used medical cannabis in 2020 and 9% to 12% of adults in the United States use cannabis with recreational purposes (Han et al., 2018). However, there are no known prescription and dosage regulations on the use of medical marijuana. Medical marijuana is legal in about 35 states, with an estimated 3.6 million state-legal medical cannabis patients (Han et al., 2018). Marijuana’s status should be revised from a federal Schedule I controlled substance to a federal Schedule II controlled substance. Nursing practitioners should be immune from the criminal indictment, civil liability, and professional sanctions. Nurses should be facilitated to administer medical marijuana in accordance with the professional ethics and state legislations.

References
Han, B., Compton, W. M., Blanco, C., & Jones, C. M. (2018). Trends in and correlates of medical marijuana use among adults in the United States. Drug and Alcohol Dependence, 186, 120–129. https://doi.org/10.1016/j.drugalcdep.2018.01.022
Palace, Z. J., & Reingold, D. A. (2019). Medical cannabis in the skilled nursing facility: A Novel approach to improving symptom management and quality of life. Journal of the American Medical Directors Association, 20(1), 94–98. https://doi.org/10.1016/j.jamda.2018.11.013

Vedelago, L., Metrik, J., & Amlung, M. (2020). Differentiating medicinal and recreational cannabis users via cannabis use motives. Cannabis, 3(1), 52–63. https://doi.org/10.26828/cannabis.2020.01.006

Villelixe Soto

           More recent research regarding the use and benefits of cannabis and its therapeutic effects for various medical disorders has allowed more people to think about its use and has become more widely accepted (Rosenthal & Irina, 2017). Many healthcare facilities, stakeholders, and health businesses are actually considering initiating the use of medical cannabis with their patients. Those who favor the practice believe that the legalization of cannabis could help stem the opiate/heroin epidemic in the United States. Medicinal cannabis can be used to treat chronic pain instead of opioids, which are much more dangerous. There has also been incredible opposition from other healthcare segments. 
           Some stakeholders who oppose the use of medical cannabis is the pediatric community. The American Academy of Pediatrics believes that “any change in the legal status of marijuana, even if limited to adults, could affect the prevalence of use among adolescents” (American Nurses Association, 2017, p. 18). While it supports scientific research on the possible medical use of cannabinoids as opposed to smoked marijuana, it opposes the legalization and use of marijuana for minors.
           Historically speaking, current and ongoing research on medicinal cannabis include studies that examine its use or potential use for treatment of alcohol abuse; Alzheimer disease; and anxiety, depression, and psychosis (Rosenthal & Irina, 2017). The proapoptotic effect of cannabis along with its ability to inhibit AGF makes it particularly interesting to researchers and clinicians who treat patients with cancer. Its anti-inflammatory effect has drawn the attention of those involved in researching and treating autoimmune diseases as well.
           One of the first concerns that many nurse practitioners may have is what support would they have in their practice with regard to the use of medicinal cannabis. Nurses whose patients are using medicinal cannabis may find it comforting to know that the American Nurses Association provides a supportive position statement highlighted in this excerpt below:
“Professional nursing organizations need to advocate for all nurses and to advance change to improve health and healthcare.” The ANA strongly supports:
ReferencesAmerican Nurses Association (2017). Advocacy, solutions, and position statements: Medical cannabis. http://nursingworld.org/MainMenuCategories/Policy-Advocacy/Positions-and-Resolutions/ANAPositionStatements/Position-Statements-Alphabetically/Therapeutic-Use-of-Marijuana-and-Related-Cannabinoids.pdf.

Rosenthal, K. & Irina, E. (2017). Medicinal cannabis: Policy and research. Journal of Contemporary Nursing; 7(5):464–470.
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Gioconda A. Orellana

 Medicinal Marijuana

Who are the stakeholders both in support of and in opposition to medicinal cannabis use?

Stakeholders who support the use of cannabis are the Food and Drug Administration and the American Academy of Neurology. On the other hand, the World Health Organization recognizes the high burden of cannabis abuse globally; thus, it opposes the use it for medicinal purposes (Mason et al, 2016). The U.S Drug Enforcement Agency has also categorized marijuana under schedule I. Therefore, it is categorized as a controlled substance because it can easily be abused.

What does current medical/nursing research say regarding the increasing use of medicinal cannabis?

           The cultivation, distribution, as well as regulation of medicinal cannabis, are complicated. Even though some states have cultivated the use of the drug in medicinal treatments, the federal government has never given the medicinal value of cannabis any priority. On the other hand, the research by Ryan and Sharts-Hopko (2017) has shown the clinical significance of cannabis. For example, the authors demonstrated that marijuana can help in relieving symptoms of HIV/AIDS, cancer, glaucoma, and multiple sclerosis (Ryan & Sharts-Hopko, 2017). However, the increased risk for abuse especially among the youth is the main hindrance in the utilization of the drug for medical purposes.

What are the policy, legal, and future practice implications based on the current prescribed rate of cannabis?

Currently, 35 states have legalized medical marijuana, and the number of legal medical cannabis patients is estimated to be 3.6 million. In addition, the recreational use of this drug is accepted in 16 states. However, the practice may give the rise to more young and school-going children abusing the drug. In addition, it might lead to an increase in the crime rate and traffic accidents. Thus, the development of legislation focused on the prevention of delivering cannabis to underage children is necessary. The legislation must also address the quantity of marijuana that is considered illegal for medical purposes (National Conference of State Legislatures, 2021). In addition, guidelines on the correct prescription and follow-ups of marijuana medical use are necessary. Therefore, legislation and guidelines will help in reducing the drug abuse rate.

References

Mason, D.J., Gardner, D. B., Hopkins, F.O., O’Grady, E.T. (2016). Policy and politics in nursing and health care (7th ed.). Elsevier.
National Conference of State Legislatures. (2021, August 23). State medical marijuana laws.

Ryan, J., & Sharts-Hopko, N. (2017). The experiences of medical marijuana patients: A scoping review of the qualitative literature. The Journal of Neuroscience Nursing, 49(3), 185–190.

 
Adelisa Bencomo
11/17/21, 12:09 AM 

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The increased use of medicinal cannabis or marijuana is one of the therapeutic interventions that have raised concerns worldwide. There have been many controversies revolving around the ethical, legal, and societal implications associated with packaging, safe administration, dispensing, and the various adverse health consequences attributed to cannabis intoxication. According to the World Health organization, cannabis is the most commonly trafficked, cultivated and abused drug globally. However, it is essential to note that there has been extensive experimentation of various policies that promote the liberalization of marijuana. For instance, more than 26 states in America have legalized the use of cannabis, while another 16 states were adopting the illicit drug as cannabidiol used as a medicinal value (Pacula & Smarrt, 2019). On the other hand, the opposition to the legalization and the use of cannabis has been largely based on moral grounds by religious leaders and groups. Cannabis use has significantly resulted in increased disorders among young adults, escalation of road traffic deaths and cannabis potency.
The clinical research regarding the medicinal value of cannabis and its therapeutic benefits indicates that the illicit drug is a highly safe and most effective medication in various chronic conditions. There is a piece of substantial evidence that establishes the relative safety of cannabis as a medication. However, its efficacy has been established as there has been an enormous …

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