FOR IMMEDIATE RELEASE
The American Cannabis Nurses Association (ACNA) is writing in response to Alex Berenson’s recent opinion in the New York Times on January 4, 2019. The ACNA is a national nursing organization dedicated advancing excellence in cannabis nursing practice through advocacy, collaboration, education, research, and policy development. After reading Mr. Berenson’s opinion, ACNA felt it was within our mission to publicly comment on our concerns with the misinformation represented in his opinion piece. Mr. Berenson claims that the push for legalization is largely due to lobbyist and for-profit cannabis companies, but the process of ending prohibition of the plant has been ongoing for decades. This response offers another perspective from a non-profit nursing organization.
Unfortunately, Mr. Berenson focuses on only one component of the cannabis plant known as tetrahydrocannabiniol (THC), which has been associated with euphoria and impairing effects. What Mr. Berenson failed to recognize is the other 99+ potentially beneficial cannabinoids in the plant, as well as how the human Endocannabinoid System (ECS) interacts with the over 400 potentially therapeutic compounds found in cannabis. Cannabis science is an emerging scientific field, and research supports that many components of the plant, including THC, have therapeutic properties. In fact, activation of the human endocannabinoid receptors 1 and 2 (CB1 and CB2) have been shown to mediate stress and anxiety,1 decrease pain and inflammation, 2 and palliate many symptoms, or support healing, related to: multiple sclerosis, 3,4, 17 neurodegenerative disorders,5 post traumatic stress,6 depression,7 intestinal inflammation,8 blood pressure,9 Inflammation,10,11 neuroprotection(especially in Alzheimer's disease),12 Parkinson’s disease,13,14 Huntington's disease,15,16 a7 addiction and drug-seeking behaviors,18 depression,19 bipolar disorder,20 schizophrenia,21,22 alcoholism,23 and eating disorders24. Many of the sources listed here contradict Berenson’s claims that cannabis causes psychosis and schizophrenia, increases opioid use, and negatively impacts mental health issues that might lead to violent crimes. In fact, Berenson has attempted to correlate legalization of cannabis in Alaska, Colorado, Oregon and Washington with an increase in violent crimes, such as murder, in those states. There are too many other confounding variables to conclude that cannabis is solely responsible for the increase in murder and aggravated assaults, and we are concerned about how he presented this confabulation of data.
The ACNA urges the NYT’s and its readership to review Mr. Berenson’s opinion, which is not completely based in scientific fact, and consider that of a professional nursing organization that understands the difference between low quality and moderate to high quality research. As patient’s acceptance and interest in cannabis grows, it is imperative that healthcare professionals take a stand against misinformation that potentially impacts patients’ access to herbal medicine. For the past 17 years, nurses have remained the most trusted of all professionals25.
Additionally, nursing organizations have started to develop guidelines around caring for the patient using cannabis. The National Council for State Boards of Nursing (NCSBN) has issued recommendations26 that all nurses become educated in the following areas
- The nurse shall have a working knowledge of the current state of legalization of medical and adult-use cannabis.
- The nurse shall have a working knowledge of the jurisdiction’s medical cannabis program.
- The nurse shall have an understanding of the endocannabinoid system, the receptors, ligands, enzymes, and the interactions among them.
- The nurse shall have an understanding of cannabis pharmacology and the research associated with the medical use of cannabis.
- The nurse shall be able to identify the safety considerations for patient use of cannabis. The nurse shall be able to identify the safety considerations for patient use of cannabis.
- The nurse shall approach the patient without judgment regarding the patient’s choice of treatment or preferences in managing pain and other distressing symptoms.
The NCSBN went on to state “Nurses need practical information to care for the increasing number of patients who utilize cannabis...and who self-administer cannabis as a treatment for various symptomatology or for recreational purposes. Individuals are using cannabis and nurses will care for these patients.”
It would be remiss for us to state that cannabis is not without side effects or risks. As the research and science around cannabis evolves, it behooves us all to stay neutral to the research and let the science speak for itself. We are ethically obligated to advocate for our patients and populations who are experiencing great benefits when they use cannabis effectively, safely, and responsibly and we encourage all of the NYT readers to consider the growing scientific basis that supports cannabis as an effective, healing plant medicine.
Eloise Theisen, MSN, AGPCNP-BC, President Elect American Cannabis Nurses Association
Carey S. Clark, PhD, RN, AHN-BC, President American Cannabis Nurses Association
12.Ramírez, B. G., Blázquez, C., Gómez del Pulgar, T., Guzmán, M., and de Ceballos, M. L. (2005).
Prevention of Alzheimer's disease pathology by cannabinoids: neuroprotection mediated by blockade of microglial activation. J. Neurosci. 25, 1904–1913. doi: 10.1523/JNEUROSCI.4540-04.2005
14. Price, D. A., Martinez, A. A., Seillier, A., Koek, W., Acosta, Y., Fernandez, E., et al. (2009). WIN55, 212–2, a cannabinoid receptor agonist, protects against nigrostriatal cell loss in the MPTP mouse model of Parkinson's disease. Eur. J. Neuroscience. 29, 2177–2186. doi: 10.1111/j.1460-9568.2009.06764.x
15. Palazuelos, J., Davoust, N., Julien, B., Hatterer, E., Aguado, T., Mechoulam, R., et al. (2008). The CB2 cannabinoid receptor controls myeloid progenitor trafficking: involvement in the pathogenesis of an animal model of multiple sclerosis. J. Biol.Chem. 283, 13320–13329. doi: 10.1074/jbc.M707960200via
16 Sagredo, O., González, S., Aroyo, I., Pazos, M. R., Benito, C., Lastres-Becker, I., et al. (2009). Cannabinoid CB2 receptoragonists protect the striatum against malonate toxicity: relevance for Huntington's disease. Glia 57, 1154–1167. doi:10.1002/glia.20838 via https://www.frontiersin.org/articles/10.3389/fnins.2016.00321/full#B43
17. Palazuelos, J., Davoust, N., Julien, B., Hatterer, E., Aguado, T., Mechoulam, R., et al. (2008). The CB2 cannabinoid receptor controls myeloid progenitor trafficking: involvement in the pathogenesis of an animal model of multiple sclerosis. J. Biol.Chem. 283, 13320–13329. doi: 10.1074/jbc.M707960200 via https://www.frontiersin.org/articles/10.3389/fnins.2016.00321/full#B43