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Medical Marijuana for Chronic Pain Management

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Medical cannabis for chronic pain has been shown to be an extremely effective treatment and much safer than opioids. Patients suffering from pain related to the nervous system have specially found immense improvement in symptoms, whether they smoke marijuana, consume it, use it in an oral spray,or taking it through a joint. With an alarmingly high number of people dying due to an epidemic of opioid overdoses, marijuana is becoming a popular alternative for people who suffer from pain on a regular basis. In many cases, marijuana has been shown to not only decrease the side effects that result from taking opioids and other medications, but also improve the quality of life for many patients.

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According to a Harvard-led review of 28 studies of cannabinoids to treat medical and pain issues published in the Journal of the American Medical Association, the use of marijuana for chronic pain is supported by quality evidence.

A study from the University of Michigan from March 2016 and published in the Journal of Pain showed that marijuana helped in improving quality of life, reducing opioid usage and decreasing side effects of other medications.

Although its advantages over opioids are known, still it is not quite prevalent in use. So, in order to implement the usage of marijuana we need to follow certain steps, which can be grouped under the headings of: Information, Persusasion, Decision, Implementation and Verification based on cohort epidemiological studies.

These steps are in accordance with the Roger’s diffusion of innovation theory.

We will look into how the transition may be implemented in accordance with the theory and keeping in mind the effectiveness, time and monetary constraints.

First comes information. The personnel involved in health and nursing management need to know regarding the benefits of marijuana and why its use should be encouraged. This would require discussions, seminars and forums by eminent faculties who can guide others. This can be carried out in the hospital premises itself, on a small scale.

Second is persuasion. After gathering information, there will be discussions and debates amongst themselves, following which people will seek information regarding this and will lead to an inquisiteness in them.

Third is decision. The only way to reject or accept something is through knowledge regarding the matter. Following the enlightenment, they will be better informed regarding acceptance or denial of the proposition. Owing to the established benefits this has, there will optimistically be unanimous agreement,

Fourthly, there is Implementation. Health care providers will start administering marijuana medically to their patients. However, the most important aspect in this is vigilance. They should carefully monitor their patients.

Lastly, is Verification, i.e. to actually establish if this is effective through personal practice. For this proper documentation is required. A cohort epidemiological study may be performed. This is a progressive study where over a specified period of time, in this case for almost a year, the patient’s condition is recorded. For example, if they are on opioids, marijuana or both. To record the duration for which they have been taking it, the route, duration of the pain, the disease, the benefits noticed in comparison to the earlier drug, if they were on any. Thus, a comprehensive study is performed and based on this the validity of its use is verified. Positive outcome in this will give physicians the confidence to recommend it to patients suffering from common pain.

This completes our steps for implementation.

Coming to other factors that need to be kept in notice is legal barricades. Not all countries allow medical marijuana. For example, in India this is still under research and development. Next is the fear of abuse. People might practice marijuana abuse, which has been noted earlier. In this case however, we do not require any consent from the patient, however what is required is informing the patients what we are prescribing them. Although, this is not binding on a physician, but we should inform them regarding its implications. Implementing this has no time constraints. We can start prescribing it if it’s legal and available.

The monetary factor if considered, the cost of marijuana is different in different places, and it’s not very high.

Human power may initially be required, for documentation of cases, and maybe as many as 5-10 people, depending upon the case load to follow-up. They will need training regarding the relevant questions to ask, respecting the privacy of the patients. No elaborate instruments are required as such. The plan is quite feasible, as the costs that will be incurred are those of the computer required to document the data , the travel charges for the staff to visit the patient’s house and the stationary charges. These are nominal charges and will probably be funded by the institution.

The challenges that can be faced in this matter, is mostly legal or ethical regarding marijuana abuse. Legal implications if exist, example if ban on medical marijuana use exists, it needs to be overcome through the legal route. For example, by filing a petition or taking the measures as possible in that legal system.

After implementation, if we find that the results are same as with other drugs, we may discontinue it. If the results are adverse, the drug should be stopped immediately. If results are not satisfactory, we may try altering the dose, and if they are, we should continue with the same dose.

Thus, with the above measures we can successfully try implementing the plan.

Research by Boehnke et al. (2016) demonstrated that patients with chronic pain who used medical marijuana reported a substantial decrease in opioid use. So, we may also try using it and hopefully results will be surreal!

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