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NURBN1005 Introduction To Research And Evidence-Based Practice 3

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  • Course Code: NURBN1005
  • University: Federation University Australia
  • Country: Australia

Question:

The purpose of this assessment task is to explore and critically examine a contemporary topic that impacts the practice of nurses and other health care providers. The interactive group process encourages the development of communication, leadership and team building skills. This group presentation also provides a forum for discussion of controversial nursing issues and improves student oral presentation skills.

Tpoic:

Medical marijuana mainly uses the marijuana plant as well as the chemicals in it for the treatment of different ailments and disorders. It is the same product as the recreational marijuana but mainly taken for medical purposes. The plant marijuana mainly contains 100 different chemicals such as the cannabinoids. Each of the components have different types of effects on the body with different health outcomes (White et al., 2015). The two main components of marijuana are the Delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). However, there are debates whether it should be legalized as there are many positive effects, unfortunately they are linked with various negative outcomes too. This assignment will mainly show a debate in order to establish whether marijuana should be legalized or not. 

According to Keyhani et al. (2018) opinion pain can occur at any part of the body and is described as the medical condition that has the capability of causing noticeable discomfort and pain in the individuals. Pain has debilitating effects affecting the physical abilities, leisure activities, hobbies, job opportunities, emotional state as well as the general mood and even mobility. Chronic pain can affect any individual resulting in arthritis, nerve damage, back pain, chronic migraine as well as many others. Researchers like Popova et al. (2017) have supported that traditional painkillers like oxycodone and morphine are highly effective but they also remain associated with a higher risk of addiction and even dependence. This can be highly dangerous as well as fatal when taken in inappropriate amounts; marijuana on the other hand has the capacity of benefitting individuals with similar palliative outcomes with a lesser significant risks for substance abuse and consequent health issues. The main way by which medical marijuana acts as a pain killer is the presence of the ingredient called cannabinoids that affects the brain. About 80 different cannabinoids are present out of which the most notable ones are the delta-9-tetrahydrocannabinol or THC. The main thing it does is activate the cannabinoid receptors of the body. These receptors are present in the brain and throughout the most of the organs of the body.

According to Volkow et al. (2014), medical marijuana is also found to be extremely helpful in the treatment of chronic nausea as well as loss of appetite. Often in cancer treatments as well as chemotherapy, an individual patient loses the appetite. Many of the other patients suffer from the conditions like anorexia, depression, Chron’s diseases as well as HIV. In such situations patients are seen to lose their appetite. Medical marijuana is mainly helpful for such patients helping them to eat thereby helping the body to get the nutrition the body needs. There are arguments often that marijuana causes individuals to take snacks quite often and there are a few studies to prove it. On the other hand, Azofeifa, Mattson and Grant (2016) opinion are that this drug indeed helps in the gaining of weight but only in the underweight individuals. However, it does not result in gaining of weight in normal to that of the overweight users.  Studies suggest that persistent as well as long-term caloric deficiencies may cause severe health related issues. These should include decrease in the density of the bone as well as impaired circulatory function, vitamin deficiencies and even early death that might occur due to heart failure. Therefore, in such situations, marijuana seems to be highly useful.

Emotional pain is one of the most harmful and devastating situation that are highly dangerous to patients similar to that of the physical pain. Often there are many situations, which can affect the quality of life of many individuals. Situations like anxiety, depression, chronic disorders or posttraumatic stress disorder are found to be intricately associated with the lackluster of the performance at job, poor mood, strained interpersonal relationships and even thoughts of suicides or self-harm (Donnely & Young, 2018). The medications, which are advised by doctors in such situations work at varying degrees and remain associated with various types of side effects that may harm them in other ways. Medical marijuana thereby provides relief to such patients with mood disorders as an effective alternative with lessened chances of any form of side effects. Roditis et al. (2015) stated that medicinal marijuana is found to be used safely as well as effectively in association with that of the current psychiatric medication. Many of the studies have proved that the use of the cannabis in combination with other medications is the most effective treatments.

Many of the researchers opinion is that marijuana has a chemical compound, which is highly, helpful in stopping the cancer from spreading. Cannabidiol is one of the most important chemicals that keep away cancer by turning off the important gene called ID 1. Cancer cells make more of the copies of this gene than the non-cancerous cells and this makes the cancer cells to be spread out throughout the body. When the researchers treated certain breast cancer cells in the lab with the high expression levels of the ID 1 with that of the cannabidiol (Bradford & Bradford, 2016). It was seen that after this treatment, the cells had decreased the level of expression of ID 1 and thereby became less aggressive spreaders. Again it is also stated that marijuana does not hamper the lung function but in return helps in the increase of the lung capacity. In various studies it showed that tobacco smoking resulted in the decrease of the lung function over time but marijuana users showed increase in lung capacity over time.

Many of the researchers like van Amsterdam et al. (2015) opinion is that there is another important ingredient in marijuana that is called the tetrahydrocannabinol that is successful in the treatment and control of the seizures. This is mainly done by binding of the ingredient to the brain cells that are responsible for the controlling of the excitability and regulating the relaxation. Many of the healthcare professionals opinion is that cannabidiol in the plant is mainly seem to interact with the cells of the brains and thereby helps in excessive activity in the brain that causes these seizures.

However, a large number of negative outcomes are also associated with excessive and continued use of marijuana among the people whom medical marijuana is prescribed. Although, it is believed that it increases the lung capacity but there are also studies which state that smoked cannabis cause irritation of the delicate lining of the respiratory tract. The main cause is the damage to the cells in the lining of the bronchial passage. Pacher et al. (2018) had opinion that this damage has the capacity of impairing the ability of the respiratory system to clear the toxins and therefore they cannot fight off any types of microorganism. Users of marijuana suffer from both the risks of acute and chronic bronchitis. Inflammation in the lungs show many symptoms like that of the increase of the phlegm, cough, wheezing, and shortness of breath.

Although many of the researchers have stated that marijuana is useful in the prevention of cancer by stopping the production of the ID 1 gene and preventing the spread of the cells containing such gene, many other studies have also opposed to this view. Smoking marijuana is believed to carry a risk of cancer mainly lung cancer as well as cancer in the head and the neck. Wilkinson et al. (2016) states that heavy marijuana may result in making biochemical as well as genetic alterations in the respiratory tract that are mainly the markers of the precancerous change. Many of the studies also suggest that the smoke of the marijuana has carcinogenic hydrocarbons that have the capability of using lung cancer. Marijuana seems to increase the heart rate and along with that, it increases the blood pressure. Both of the situations combine and produce additive effects on the heart making the heart to work more strenuously. These effects are not seen in individuals who has a healthy heart. Studies have shown that marijuana might have severe effects on individuals who have pre-existing heart disorders (Ford et al., 2017).

There are different types of short-term effects that might occur on power of cognition. Marijuana intoxication results in the alteration of the short term memory as well as sense of time, sensory perception and even attention span. This also affects the problem solving ability as well as verbal fluency and reaction time along with psychomotor control. Although some of the writers associate this with euphoria as well as the relaxation but others, particularly naïve users are seen to report anxiety as well as paranoia and panic reactions (Camchong, Lim, & Kurma, 2017). There are also high levels of accidents that are taken place because of the negative effects of marijuana on the attention, eye coordination with the hand as well as tracking behaviors and reaction times. Long-term effects on the brain are mainly seen to be associated with extended use of cannabis. The long-term effects mainly remain associated with cerebral blood flow, glucose metabolism and electrophysiology, and structural anatomy. Functional imaging has shown less activity in the regions of the brains in individuals who are chronic users of marijuana.

Goldenberg et al. (2017) have shown medical marijuana causes fluctuations in the mood and increase in the anxiety as well as depressive disorders among frequent marijuana users. This is completely opposite to the papers that have found positive outcomes with people suffering from mood disorders. Again, studies have also found that shows increase of the use of marijuana to be associated with depression and anxiety. One paper also stated that marijuana can even cause psychosis in individuals (Cooper, 2016). Marijuana can also cause masking of the symptoms of those individuals who have vulnerability towards schizophrenia. Many of the instances are which shows poor educational attainment, poor quality performance at job and many personal issues associated with individuals who have misused medical marijuana,. Many of the patients are also seen to suffer from insomnia. It is the inability to sleep as well as chronic sleeplessness (Kollins et al., 2015).

From the above discussion, it can be seen that a huge number of papers has found positive outcomes from the use of marijuana. Somehow, there are arguments stating both positive and negative sides from the use of medical marijuana on the patients. Both randomized controlled trails have conducted to find out the positive and negative outcomes and most of them were successful. Therefore as a nursing professional, reaching to a conclusion is difficult. There had been continuous ceaseless battles of the different clashing opinions among the journalists as well as the police departments, attorneys, medical doctors and even social activists and different legislators. In the debate it stated that people who stand to get benefits from the use of the medical marijuana or who suffer from serious health conditions are never given the chance to make informed decisions based on facts and evidences. This makes me feel that the medical marijuana is helpful in overcoming many illness and situations helping individuals to live better quality lives. Some of the limitations noticed in some of the studies were that they were conducted by selection of participants who were biased and had their own-view points. Very less were on randomized trials by taking people randomly. Many of the tests were done on rats and mice and therefore they need to be conducted on humans like those of cancer cell tests. Therefore, effective outcomes for helping patients with cancer cannot be considered true on patients until conducted on them. Giving the people, the chances to utilize the medical marijuana are in turn associated with a number of issues.  The use of medical marijuana associated with the feeling of relaxation and euphoria can make the individuals addicted without making them aware that they are abusing medical marijuana. Once such situation affects individuals, they would get vulnerable to different side effects of the disorders. Not all patients might have the self-power, confidence and strictness for them to leave using medical marijuana when the courses are over. Once the individuals get affected, the negative affects might affect him to an extent making him lead to a poor quality lifestyle. Social issues, crimes, accidents, theft and many others might also get associated with it. One should always remember that for patients who require marijuana, they can be treated with other medications. However, once individuals get addicted, the negative outcomes of marijuana may affect their lives and it would become very difficult for them to lead healthy lives once again. They may misuse the drug and can get involved in crimes and accidents if legalization takes place. Therefore, personally I do not support the legalization of medical marijuana for patients.   

Should the use of medicinal marijuana be legalized?

 

Answer:

From the overall arguments made regarding legalization of marijuana, it can be concluded that marijuana should be legalized because of its benefit in reducing inappropriate medical prescribing for pain relief. The opioid crisis or the overdose of opioid for pain relief is one of the major public health crisis and Vyas, LeBaron and Gilson (2018) gave the indication that by using cannabis or medical marijuana as an alternative therapy for pain management, the problem of prescription opioid medication (POM) can be resolved. This was proved by the examination of state cannabis use laws and policies in US and reviewing its impact on POM use and associated harm. The systematic review of research literature revealed that cannabis law and policy was associated with decreased POM use. The analysis of the cannabis related law also revealed that cannabis law was associated with reduced admissions for opioid overdose and overdose related deaths. Hence, the evidence provided give rationalize the need to legalize cannabis and use it as a useful substitution for addressing the opioid crisis in health care setting.

Despite the above justification for legalization of marijuana, one of the challenges is that it might lead to issues related to addiction and misuse of the drug. It may have implications on the substance abuse related burden in health care. Once marijuana is legally available, it might increase availability and social acceptance of marijuana among adolescents (Cerdá et al., 2015). However, appropriate implementation of harm reduction strategies such as educating patients about medical marijuana may help to obtain more benefit rather than harm from treatment. Hopfer (2014) argues that the legalizing marijuana would create additional challenges, however this can be addressed by taking proper approach to address perceptions related to the use of marijuana. The role of physicians will be important in this regard as they can play a role in screening adults and providing clear message regarding the medical use and adverse effect of marijuana. In addition, a well-developed and coordinated public health policy response will also be necessary so that claims of medicinal benefits of marijuana are clearly disseminated among target audience.

Hence, it can be concluded that legalization of marijuana should come up with appropriate policy related to effective use of the drug too. This is necessary to eliminate the problem of substance abuse because of overuse of marijuana among adolescents. Salomonsen-Sautel et al. (2012) gave idea regarding the increase in medical marijuana use among adolescents by investigating about the frequency of marijuana use among adolescents in substance abuse treatment. The study revealed that 74% adolescents had used someone else’s medical marijuana. The study also revealed the possibility of diversion of medical marijuana. This issue gives the implication to implement appropriate drug monitoring programs.  Physicians can be encourage to provide proper education regarding the addictive and deleterious properties of marijuana before prescribing it to patients. Best practice strategies like assessing for possible risk of diversion and discussing with patients regarding the serious ill-effect of diversion can be done to address challenges associated with legalization of marijuana.

 

References:

Cerdá, M., Wall, M., Keyes, K. M., Galea, S., & Hasin, D. (2012). Medical marijuana laws in 50 states: investigating the relationship between state legalization of medical marijuana and marijuana use, abuse and dependence. Drug and alcohol dependence, 120(1), 22-27.

Hopfer, C. (2014). Implications of Marijuana Legalization for Adolescent Substance Use. Substance Abuse?: Official Publication of the Association for Medical Education and Research in Substance Abuse, 35(4), 331–335. https://doi.org/10.1080/08897077.2014.943386

Salomonsen-Sautel, S., Sakai, J. T., Thurstone, C., Corley, R., & Hopfer, C. (2012). Medical Marijuana Use among Adolescents in Substance Abuse Treatment. Journal of the American Academy of Child and Adolescent Psychiatry, 51(7), 694–702. https://doi.org/10.1016/j.jaac.2012.04.004

Vyas, M. B., LeBaron, V. T., & Gilson, A. M. (2018). The use of cannabis in response to the opioid crisis: A review of the literature. Nursing outlook, 66(1), 56-65. 

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