Nurses and other healthcare providers should talk to patients about their cannabis use the same way they talk about other habits like smoking and drinking: routinely and without judgment.
That should happen, but too often doesn't, said Marian Wilson, registered nurse and associate professor at the Washington State University College of Nursing. She is the lead author on a paper published recently in the journal Pain Management Nursing about shared decision-making in talking about cannabis use.
"We want this paper to guide providers in how they can start opening up this conversation and normalizing it," Wilson said.
The shared decision-making model starts with either the patient or the provider bringing up the topic of cannabis use, then moving on to specifics about that patient's situation, benefits, and risks of cannabis use based on research and evidence, and finally formulating a plan.
"Central to patient-centered conversations is understanding the top priorities of patients," Wilson writes. "Researchers have suggested that clinicians should ask 'What matters to you?' as well as 'What is the matter?'"
Some studies have suggested cannabis use is beneficial to patients with chronic pain who are also using opioids, so many in that patient population are using cannabis or considering it, Wilson said. That's why it's especially important for providers working in pain management to discuss the subject, though patients may be reluctant to disclose cannabis use because they might have been penalized in the past.
Wilson says providers face real challenges in obtaining current, evidence-based information on the benefits and risks of cannabis use. The paper calls for the creation of a centralized, noncommercial, scientific repository of information, research, and best practices on cannabis use. Such a resource will become more important as cannabis legalization spreads nationwide.
"We want providers to ask people about their cannabis use and we want patients to feel comfortable talking about it, but right now many don't," Wilson said.
For more information: "Shared Decision-Making for Patients Using Cannabis for Pain Symptom Management in the United States," Marian Wilson, PhD, MPH, RN-BC; Tracy Klein, PhD, FNP, ARNP, FAANP, FRE, FAAN; Ross J. Bindler, PharmD; Louise Kaplan, PhD, ARNP, FNP-BC, FAANP, FAAN, Pain Management Nursing.
Pain Management Nursing