Impact of Legalizing Medical Marijuana in Arizona on Health
Health policies are government laws, rules, or regulations that have the power to influence and impact population health and to support the pursuit of health, a basic human right (Longest, 2010). According to the Congressional Research Service (2012), the Drug Enforcement Administration (DEA) regulates the use of controlled substances as defined by the Controlled Substances Act (CSA). Drugs in Schedule I are not accepted for medical use and are illegal to prescribe to the public. Providers registered with the DEA are only authorized to prescribe controlled substances listed in Schedule II-V. Marijuana is listed as a Schedule I drug (Congressional Research Service, 2012). Therefore, providers are not allowed to “prescribe” marijuana, they can only “certify” or “recommend” medical marijuana to qualified patients. Medical Marijuana is also not approved by the Food and Drug Administration. However, researchers interested in performing clinical trials for medical marijuana need to collaborate with the National Institute on Drug Abuse for government-approved marijuana (Food and Drug Administration, 2014).
In Arizona, it is legal for physicians to certify patients for medical marijuana. However, nurse practitioners were not included in the legislative language and cannot certify patients for medical marijuana. According to Mark Adams, author for High Times Magazine (2013), physicians in Arizona are hesitant to recommend medical marijuana. In fact, naturopathic doctors certify the majority of patients for medical marijuana in Arizona. The director of the Arizona Department of Health Services, Will Humble, states that it is possible that patients may be getting certified by “certification mills” instead of talking to their primary care providers about medical marijuana (Adams, 2013).
Medical Marijuana and the role of NPs
Nurse practitioners are capable of diagnosing, managing, and treating medical conditions that medical marijuana is approved for, such as cancer, glaucoma, HIV/AIDS, hepatitis C, amyotrophic lateral sclerosis, Crohn’s disease, agitation of Alzheimer’s disease, post-traumatic stress disorder, or a chronic/debilitating disease or treatment that causes cachexia, severe and chronic pain, severe nausea, seizures including epilepsy, and severe and persistent muscle spasms including multiple sclerosis (Arizona State Legislature, n.d.). It is recommended by the Arizona Board of Nursing to include nurse practitioners into Arizona’s Medical Marijuana Law and to be granted certifying rights (Arizona State Board of Nursing, 2011).
Role of Ethics in Decision Making Regarding NP Certifying Patients for Medical Marijuana
The American Nurses Association supports the ethical obligation of nurses to be advocates for all patients to have access to healthcare, including medical marijuana (American Nurses Association, 2008). An expansion of the law to include nurse practitioners would increase patient access to health care providers that can certify patients for medical marijuana for debilitating medical conditions. Medical marijuana can be the right drug for the right person with in-retractable nausea, vomiting, and pain, wasting disorders, seizures, and other conditions that are refractory to prescription medications and both the provider and the patient can be protected from arrest and persecution under Arizona law.
Adams, M. (2013). Arizona cracks down on medical marijuana doctors. Retrieved from http://www.hightimes.com/read/arizona-cracks-down-medical-marijuana-doctors
American Nurses Association. (2008). In support of patients’ safe access to therapeutic marijuana. Retrieved from http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Positions-and-Resolutions/ANAPositionStatements/Position-Statements-Alphabetically/In-Support-of-Patients-Safe-Access-to-Therapeutic-Marijuana.pdf
Arizona State Board of Nursing. (2011). Advanced practice committee meeting minutes. Retrieved from https://www.azbn.gov/Documents/meetings/Advanced%20Practice%20Committee/2011/Advanced%20Practice%20Committee%20Meeting.02.11.11.pdf
Arizona State Legislature. (n.d.). Retrieved from http://www.azleg.gov/FormatDocument.asp?inDoc=/ars/36/02801.htm&Title=36&DocType=ARS
Congressional Research Service. (2012). The controlled substances act: Regulatory requirements. Retrieved from http://fas.org/sgp/crs/misc/RL34635.pdf
Food and Drug Administration. (2014). FDA and marijuana: Questions and answers. Retrieved from http://www.fda.gov/NewsEvents/PublicHealthFocus/ucm421168.htm#Q2
Longest, B. (2010). Health policymaking in the United States. (5th ed.). Arlington, VA: Association of University Programs in Health Administration.