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C4. Cannabis and CBD: using evidencebased research to guide clinical practice

C4. Cannabis and CBD: using evidencebased research to guide clinical practice

 

Learner category:

  • Beginning Level
  • Novice Level
  • Intermediate Level
  • Expert Level

Learning objectives:

  • Participants will review how cannabis affects the brain
  • Participants will be able to explore the differences between CBD that is sourced from cannabis vs hemp
  • Participants will explore how to talk with patients about potency levels of THC in marijuana products, including CBD
  • Participants will have an understanding of the medical/psychological effects of cannabis and CBD, as presented in peer-reviewed, evidence-based publications
  • Participants will recognize the importance of being able to talk with your patients about the pros and cons of using cannabis and CBD
  • Describe current treatment approaches in working with clients with problematic cannabis use or Cannabis Use Disorder

Abstract:

Cannabis has begun to become widely legalized for medical and/or recreational use in both the United States and Canada. Regulations regarding the study of cannabis have been loosened, allowing easier access to conduct research evaluating the medical and psychological effects of cannabis use. There are many limitations in conducting this research; validity and reliability must be considered as much of the published research is sponsored by the cannabis industry. In addition, THC content of plant-based cannabis and cannabis concentrates vary significantly and there is little regulation regarding how plants are grown and how products are brought to market. Cannabidiol (CBD) has been touted as a “miracle” drug, curing a wide variety of medical and psychological diseases. As with cannabis, there is a wide variety of products, some containing THC at various concentrations and others being hemp-based. The research regarding CBD is only just emerging and much of the research is funded by the cannabis industry. This presentation will explore the evidence-based research related to cannabis and CBD and provide strategies about how to more effectively talk with patients about use of these products.

Author(s):

Bari K Platter, MS, RN, PMHCNS-BC, FIAAN
Center for Dependency, Addiction and Rehabilitation, A division of UCHealth, Colorado, USA

Bari K Platter, MS, RN, PMHCNS-BC, FIAAN is a Psychiatric/Mental Health Clinical Nurse Specialist with over thirty years
of experience working in a variety of mental health settings. Ms. Platter is a Dialectical Behavior Therapy (DBT) trainer.
Additional areas of expertise include Solution Focused Therapy, Motivational Interviewing, Cultural Competency and Case Management. She is an internationally recognized speaker/ trainer and is published in the areas of addiction,
cultural competency and mental health nursing.

Comments (28)

  1. Shari Hardy

    I really appreciated this presentation – it was helpful to see so much of the data together in one place. This is an important topic. Thank you for doing this!

    1. Bari Platter

      Thank you so much for the feedback. Cannabis use disorder has become a significant problem in addiction treatment in Colorado and I expect that it is beginning to be the same across the US and beyond.

      1. Shari Harding

        I am in Massachusetts so your experience in Colorado really resonated!

  2. suzannealunni@yahoo.com

    As Always Great Presentation Bari!!!

    1. Bari Platter

      Thanks Suzanne!

  3. Dennis Hagarty

    Thank you good presentation.

    1. Bari Platter

      Thank you Dennis!

  4. Kimberly Dion

    Thank you for this information. I was surprised by the responses of the “bud tenders” and wondered if you knew what kind of training these individuals receive at the dispensary and if anything is required by the state.

    1. Bari Platter

      Hi Kimberly,
      Great question! There currently isn’t any training that is mandated by the state of Colorado for individuals who work in dispensaries. They typically get their information from other budtenders or from publications that are sent to them from the cannabis industry or from recreational cannabis advocates. It’s troubling, because when a health care provider recommends the use of medical marijuana, there’s no telling what their patient will be told about what strain to use, delivery method and doses.

  5. Rachel Shuster

    Always interesting and educational to hear your experiences in Colorado, Bari. Thank you! I hope that the US can federally change the scheduling of cannabis as a controlled substance so we may better research it to inform evidence-based practice.

    1. Bari Platter

      Hi Rachel, The rules about researching cannabis have loosened up a bit, but the challenge that exists is that we can’t compare outcomes of participants using different strains/strengths of cannabis. We already have observed that higher levels of THC produce more medical and psychiatric side effects. You’re right- if it is scheduled then we can do better research. Bari

  6. Sufyan Abu Subaih

    Thanx for your fantastic and evidence based information

    1. Bari Platter

      Thank you for the feedback!

  7. Lauren Carpenter, RN, CARN

    Wonderful presentation! This is a topic I am not 100% comfortable talking with my patient’s about, for many reasons. One being my lack of knowledge regarding evidenced based data, so this was very helpful and gives me studies to look into more! Thank you!

    1. Bari Platter

      Thanks- I do hope that the information is helpful for your clinical practice. Bari

  8. Oluremi Adejumo

    Very nice presentation. Just like other substances of misuse and dependence, recovery from cannabis is possible with a sustained abstinence.

    1. Bari Platter

      Yes! The data shows that recovery from cannabis use disorder is typically longer lasting than other substances of abuse, such as alcohol or opiates.

  9. Oluremi Adejumo

    Very nice presentation. Just like other substances of misuse and dependence, recovery from cannabis is possible with sustained abstinence.

    1. Bari Platter

      Thank you for commenting- yes, the data actually look good regarding recovery from cannabis use disorder. The challenge is that there are so many clinicians who miss the diagnosis and don’t provide education, screening, brief intervention and referral to treatment.

  10. Dr Shirley Sunn

    Bari, thank you for your very informative presentation. I live in Los Angeles where it is legal. I see lines at the dispensary in my neighborhood and then during the day we treat all the drug-induced psychosis, depression and results of habitual use in our emergency room. As others stated in previous comments, let us hope it becomes a controlled substance again.
    I liked your clear demarcation between between sativa and indica. You can tell on which side of the fence I stand.

    1. Bari Platter

      I’m right there with you! For those 1 in 10 individuals that are vulnerable to developing a substance use disorder, cannabis is incredibly dangerous to use. I hope that public health information catches up with cannabis industry information so that younger adults can make better decisions about cannabis use.

  11. Laura Hagarty

    Thank you for your presentation, it answered many questions that were lurking around in my head!

    1. Bari Platter

      Thank you!

  12. Virginia Singer

    Thank you

  13. Michelle Labossiere-Tekpoh

    Thank you for your wonderful presentation 🙂

  14. Suesan Tracy

    Thank you for this literature review and presentation! Great job!

  15. Frank Campbell

    Wonderful as always!

  16. Shannon Rondeau

    Thank you for the informative session! I had heard some of those responses by the “budtenders” and it’s scary to hear that is happening. It’s up to all of us to provide education and awareness to our patients and the general population. I hope we will see more rigorous research with medical cannabis and CBD products in the near future.

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