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The purpose of this integrative literature review was to understand the effects of medical cannabis for chronic pain management in adults. Anecdotal reports suggest the use of medical marijuana as a pain management therapy could be an alternative to opioids and other medications which have long term consequences. Potential uses span the health care continuum, from prescribed outpatient symptom management, to acute care, extended care, home care, and hospice treatment settings. The methodology included a review and synthesis of relevant research articles from 2012 to 2018, written in the English language. The findings suggest medical cannabis has the potential of effectively managing chronic pain in older adults. Adverse effects, if present, are mild and resolve without intervention. Lower doses of medical cannabis were reported to be more effective in treating chronic pain compared to higher doses. Inconsistencies in the efficacy of THC were noted compared to CBD for managing neuropathic pain. Implication for nursing practice, policy, education, and recommendation for future research were discussed along with study limitations.

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The legalization of medical marijuana has been a complicated and confusing process. The drug is used for medical purposes yet is only semi-legal and not approved by the federal government. This piece will observe the legal medical history of this drug in the United States. It will analyze the growth of the medical marijuana movement up to the present with a special emphasis to the importance of federal, state and local supremacy. It will observe important court cases that have been decisive in defining the reach of federal power under the Commerce Clause and the 1970 Controlled Substance Act. This analysis will look at the current legal standing of medical marijuana as well as the legal hurdles to achieve full legal status and medical recognition from state federal and local levels of government. A special focus will be given to the state of California because it has the largest medical marijuana market and has taken center stage in the movement to legalize marijuana as a medicine. This paper will also cover the growth of the state condoned medical marijuana black market and the complications that arise from taxing, and licensing semi-legal businesses. This paper will assess the monetary and personal costs of this movement and the political elements of resisting the medical development and scientific understanding of this drug. It will seek to suggest a solution to the current impasse and explain why medical marijuana in this instance has been bad medicine and dangerous policy.

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Marijuana is the most common illicit drug that is abused by pregnant women, and recently many states have adopted various levels of relaxed marijuana policies. The purpose of this study was to evaluate a potential association between residing in a state that allows medical marijuana use and maternal marijuana usage. Grounded in the theory of planned behavior, this study evaluated the prevalence and extent of maternal marijuana use in states that allow and states that do not allow medical marijuana use using the National Survey of Drug Use and Health (NSDUH). It was anticipated that more lenient subjective norms toward marijuana use and increased availability would support an increase of maternal marijuana use. The 2014 NSDUH was queried and analyzed using chi-square and logistic regression. The study revealed an increase of maternal marijuana use in states where medical marijuana was allowed, but the increase was not statistically significant. An increase of heavy users was observed in states where medical marijuana was allowed (54% versus 37%). Consistent with other research findings, this study revealed that young (OR = 3.56; 95% CI: 1.379, 9.213; p = 0.009) and unmarried (OR = 6.81; 95% CI: 2.485, 18.661; p < 0.001) pregnant woman were at higher risk for past month maternal marijuana use and had similar results for past year use. The unintended consequences of increased in utero marijuana exposure and its subsequent negative public health effects have been missing from the discussion of the relaxation of statewide marijuana policies. This study will provide policy makers responsible for changing marijuana policy with useful evidence on the unintended consequences of increased maternal marijuana use in areas where medical marijuana is allowed.

Kronisk smärta är ett utbrett problem och konventionell farmakologisk smärtbehandling upplevs otillräcklig av många patienter. Medicinsk cannabis (MC) diskuteras idag som ett smärtlindringsalternativ, men mer forskning rekommenderas inom området för att fastställa riskerna förenade med kort- och långtidsbehandling. Syftet med litteraturstudien var att undersöka patienters upplevelse av MC som smärtlindrande behandling vid kronisk smärta. En induktiv ansats valdes, varav tre artiklar med kvalitativ ansats, sju artiklar med kvantitativ ansats samt en mixad-metod artikel, inkluderades i resultatet. En analys av materialet genomfördes och teman med tillhörande subteman utformades. I resultatet redovisas olika aspekter, som påverkar upplevelsen av behandling med MC. Stigmatisering kring MC upplevdes förekomma från både omgivning och hälso- och sjukvårdspersonal. Reducerad smärtpåverkan, upplevd ökad livskvalitet och reducering av andra läkemedel var andra aspekter som redovisades, men även oönskade effekter av läkemedlet visade sig förekomma. Litteraturstudien visar att sjuksköterskor bör erhålla kunskap om läkemedlet, samt upplevelsen av det, för att kunna bemöta och informera patienter som efterfrågar denna behandling mot kronisk smärta. Sjuksköterskor behöver samtidigt vara medvetna om risker förenade med läkemedlet och arbeta proaktivt för att undvika att det hanteras fel och missbrukas. / Chronic pain is a widespread issue and conventional analgesic treatment is insufficient for many patients. Medical cannabis (MC) is discussed today as a pain management alternative but more research is recommended in the field to determine the risks associated with short-term and long-term treatment. The aim of this literature-based study was to explore patient´s experiences of MC as an analgesic treatment in chronic pain. An inductive approach was chosen, of which three articles with a qualitative approach, seven articles with a quantitative approach and a mixed-method article were included in the result. An analysis of the content was conducted and themes with associated subthemes were designed. The result presents different aspects that affect the experience of MC as a treatment. Stigmatization related to MC was found to occur from both the surrounding sphere and healthcare staff. Reduced pain-intensity, increased quality of life and reduction of other drugs were reported. The literature study shows that nurses should acquire knowledge about the drug as well as the experience of it, in order to respond to and inform patients who request this treatment for chronic pain. Nurses also need to be aware of the potential risks of the drug with, for example, adverse effects and risk of further abuse, and work proactively to avoid this.