M edical Marijuana: Use, Misuse and Addiction



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edical Marijuana: Use, Misuse and Addiction


Jassin M. Jouria, MD

Dr. Jassin M. Jouria is a medical doctor, professor of academic medicine, and medical author. He graduated from Ross University School of Medicine and has completed his clinical clerkship training in various teaching hospitals throughout New York, including King’s County Hospital Center and Brookdale Medical Center, among others. Dr. Jouria has passed all USMLE medical board exams, and has served as a test prep tutor and instructor for Kaplan. He has developed several medical courses and curricula for a variety of educational institutions. Dr. Jouria has also served on multiple levels in the academic field including faculty member and Department Chair. Dr. Jouria continues to serve as a Subject Matter Expert for several continuing education organizations covering multiple basic medical sciences. He has also developed several continuing medical education courses covering various topics in clinical medicine. Recently, Dr. Jouria has been contracted by the University of Miami/Jackson Memorial Hospital’s Department of Surgery to develop an e-module training series for trauma patient management. Dr. Jouria is currently authoring an academic textbook on Human Anatomy & Physiology.

Abstract

Cannabis species and subspecies have been used medicinally for over 5,000 years. In the United States, the regulation of cannabis as a Schedule I drug has hampered the study of cannabis and its medicinal uses. The 1996 legalization of marijuana in California was followed by more states including the District of Columbia. Consequently, recent reviews and studies related to medicinal marijuana have been done, specifically on whether cannabis is effective for medicinal purposes, such as the treatment of nausea and vomiting, appetite stimulation in chronic diseases and pain, as well as other health conditions reviewed in this course.


Policy Statement

This activity has been planned and implemented in accordance with the policies of NurseCe4Less.com and the continuing nursing education requirements of the American Nurses Credentialing Center's Commission on Accreditation for registered nurses. It is the policy of NurseCe4Less.com to ensure objectivity, transparency, and best practice in clinical education for all continuing nursing education (CNE) activities.



Continuing Education Credit Designation

This educational activity is credited for 3 hours. Nurses may only claim credit commensurate with the credit awarded for completion of this course activity. Pharmacology content is 1 hour.



Statement of Learning Need

Health clinicians need to know how cannabis works on the human body, its physiological effects, its efficacy related to various human diseases and conditions, and its side effects. Additionally, an awareness of state laws regulating the use of cannabis for medicinal purposes is important for licensed clinicians able to prescribe it for patients.

Course Purpose

To provide learning for clinicians interested in how cannabis in controlled trials and medical studies may effectively be used by patients diagnosed with various diseases and conditions.



Target Audience

Advanced Practice Registered Nurses and Registered Nurses (Interdisciplinary Health Team Members, including Vocational Nurses and Medical Assistants may obtain a Certificate of Completion)


Course Author & Planning Team Conflict of Interest Disclosures

Jassin M. Jouria, MD, William S. Cook, PhD, Douglas Lawrence, MA,

Susan DePasquale, MSN, FPMHNP-BC – all have no disclosures


Acknowledgement of Commercial Support

There is no commercial support for this course.



Please take time to complete a self-assessment of knowledge, on page 4, sample questions before reading the article.

Opportunity to complete a self-assessment of knowledge learned will be provided at the end of the course.

  1. __________________ is a plant species, variety known as hemp.




  1. Cannabis sativa Linnaeus

  2. Cannabis sativa

  3. Cannabis indica

  4. Cannabis Lemark




  1. The major psychoactive compound found in cannabis is an anandamide agonist known as




  1. cannabinol (CBN).

  2. aminoalkylindole.

  3. cannabidiol (CBD).

  4. Δ-9-tetrahydrocannabinol (Δ9-THC or THC).




  1. Hemp cultivation in the European Union and Canada require _________ THC.




  1. less than 3%

  2. less than 0.3%

  3. less than 0.9%

  4. no trace of




  1. Tetrahydrocannabinol is an aromatic ______________ with low water solubility.




  1. terpenoid

  2. protein

  3. sterol

  4. membrane




  1. True or False: Because of its medicinal applications, cannabis has now been removed from the Drug Enforcement Administration’s Schedule I list of drugs.




  1. True

  2. False

Introduction

Cannabis species and subspecies have been used medicinally for over 5,000 years, though cultivation may reach as far back as 10,000 years.1 In the United States, the regulation of cannabis as a Schedule I drug has hampered the study of cannabis and its medicinal uses. Since California became the first state to legalize medical marijuana in 1996, almost 30 states and the District of Columbia have followed, and more states are expected to legalize medical marijuana. As a result, there have been recent reviews and studies related to medicinal marijuana. The inquiry made by older and more recent studies is whether cannabis is effective to treat nausea and vomiting due to chemotherapy, stimulating the appetite of patients with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), chronic pain, seizures, and other conditions or diseases. The results are mixed but in certain instances there is encouraging evidence that cannabis may provide relief for certain conditions. A brief overview of the history of cannabis species and subspecies is covered in the following first sections1 prior to a more in depth discussion of the botanical chemistry and physiological effects of cannabis in controlled trials and medical studies that focused on its effects related to various human diseases and conditions.





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