Summary of finding and resources of project Accessibility of Medical Marijuana

1. Group #28
How might we educate patients and providers regarding the legal accessibility of
medical marijuana?
Natalie Aspray, Shoshanah Balter, Jonathan Juca, Michelle Kelmansky, Gissel Margarin, Liza
Yelin
Abstract
Background/ Overview of Topic:
Due to the Schedule 1 class of medical marijuana, there are many limitations regarding the legal
status and use of medical marijuana. There has also been confusion and restrictions due to the
discrepancies between federal and state legality. Medical marijuana access has been highly
contested now and in the past because it is thought to be effective in managing many different
diseases and may have fewer and less severe side effects than other treatment options.
Search Strategies:
Our group utilized the The Cumulative Index to Nursing and Allied Health Literature (CINAHL)
database to search for articles using the following Boolean phrase: (Medical marijuana or
medical cannabis) AND (accessibility or access or availability). After analysis, which included
limiting the articles to those that were peer-reviewed and took place within the last 5 years, and
reading the titles and abstracts of articles to find which were relevant, our group identified 11
articles for use in our final project.
Summary/ Synthesis of Findings:
Through research, our group has discovered that many prescribers are confused regarding the
prescription practices of medical marijuana due to a lack of research (especially randomized
control trials) and differences in state policy and laws. Patients may also be unwilling to ask
their providers about the option of medical marijuana due to the stigma surrounding the subject
and a lack of education regarding what conditions can be treated by medical marijuana. Through
education of providers and patients and advocating for the change in the Schedule I status of
medical marijuana - this treatment option will become more available to patients who would
benefit from an alternative treatment option.
Ethical, Moral and Nursing Implications:
There are a variety of ethical, moral, and nursing implications regarding medical marijuana. The
nurse should advocate for the patients’ interest and federally legalized marijuana to help with
accessibility. Additionally, the nurse should act with beneficence and administer medical
marijuana, when possible, to help with chronic pain and disease. However, due to the Schedule I
drug class, a nurse may not be able to offer medical marijuana as an option to manage disease,
thus creating a moral dilemma.
Health Policy Implications:
The National Institute on Drug Abuse has the only license to grow research-grade medical
marijuana, thus limiting research on marijuana’s effects. The Schedule I class means that the
government does not recognize any accepted medical uses for medical marijuana and therefore

2. restricts production for research and availability as a treatment option. However, individual states
are able to legalize medical marijuana, thus meaning it is available to patients.

3. PRISMA
Search terms: (Medical marijuana or medical cannabis) AND (accessibility or access or
availability)
Inclusion/Exclusion Criteria Applied (1): Looked for articles that were available as full text,
were peer-reviewed, and were research took place in the United States.
Inclusion/Exclusion Criteria Applied (2): Reviewed articles that pertained to the main points of
our project, focusing on the aspects of: research disparities, public perception of medical
marijuana, state differences, patient education, and health care team communication.

4. References
Bestrashniy, J., & Winters, K. C. (2015). Variability in medical marijuana laws in the United
States. Psychology of Addictive Behaviors, 29(3), 639–642.
https://doi.org/10.1037/adb0000111
Clark, H. W. (2019). A Note on CBD: It’s All in a Name. Brown University Child & Adolescent
Psychopharmacology Update, 21(3), 5–6.
Department of Health. (2019, October). The New York State Medical Marijuana Program.
Retrieved from https://www.health.ny.gov/regulations/medical_marijuana/.
Fowler, M. D. M. (2015). Guide to the code of ethics for nurses with interpretive statements:
development, interpretation, and application (2nd ed.). Silver Spring, MD: American
Nurses Association.
Kruger, D. J., & Kruger, J. S. (2019). Medical Cannabis Users’ Comparisons between Medical
Cannabis and Mainstream Medicine. Journal of Psychoactive Drugs, 51(1), 31–36.
https://doi.org/10.1080/02791072.2018.1563314
Lenoue, S. R., Wongngamnit, N., & Thurstone, X. (2016). Practical Aspects of Discussing
Marijuana in a New Era. Journal of Psychiatric Practice, 22(6), 471–477.
https://doi.org/10.1097/PRA.0000000000000189
Pergam, S. A., Woodfield, M. C., Lee, C. M., Cheng, G.-S., Baker, K. K., Marquis, S. R., &
Fann, J. R. (2017). Cannabis use among patients at a comprehensive cancer center in
a state with legalized medicinal and recreational use. Cancer, 123(22), 4488–4497. doi:
10.1002/cncr.30879
Philipsen, N., McMullen, P. C., & Wood, C. M. (2017). Medical Marijuana: A 2014-2016
Update on Law and Policy for Nurse Practitioners. Journal for Nurse Practitioners,
13(2), 145–149. https://doi.org/10.1016/j.nurpra.2016.09.011
Richmond, M. K., Pampel, F. C., Rivera, L. S., Broderick, K. B., Reimann, B., & Fischer, L.
(2015). Frequency and Risk of Marijuana Use among Substance-Using Health Care
Patients in Colorado with and without Access to State Legalized Medical
Marijuana. Journal of Psychoactive Drugs, 47(1), 1–9.
https://doi.org/10.1080/02791072.2014.991008
Singh, V., Zarrabi, A. J., Curseen, K. A., Sniecinski, R., Welsh, J. W., McKenzie-Brown, A. M.,
… Gillespie, T. W. (2019). Concerns of Patients With Cancer on Accessing Cannabis
Products in a State With Restrictive Medical Marijuana Laws: A Survey Study. Journal
of Oncology Practice, 104, N.PAG

5. Śledziński, P., Zeyland, J., Slomski, R., & Nowak-Terpiłowska, A. (2019). The adverse effects
of marijuana use: The present state and future directions. Journal of Child & Adolescent
Substance Abuse, 28(2), 65–72. https://doi-
org.proxy.library.nyu.edu/10.1080/1067828X.2018.1561580
Weaver, M. S., White, A. R., & Robinson, J. (2019). Crossing the Line: Care of a Pediatric
Patient with Intractable Seizures and Severe Neuropathic Pain in Absence of Access to
Medical Marijuana. Journal of Palliative Medicine, 22(10), 1232–1235. doi:
10.1089/jpm.2019.0261
Wong, S. S., & Wilens, T. E. (2017). Medical Cannabinoids in Children and Adolescents: A
Systematic Review. Pediatrics, 140(5). doi: 10.1542/peds.2017-1818