Use of medical marijuana (MM) has been legalized on a state-by-state basis; however, federally, it is still illegal and is a Schedule I drug. This has led to provider confusion regarding prescription practices, a lack of randomized control trials on the use of MM for pain and symptom management, minimal access to dispensaries, and health insurance restrictions.

1. Application of Design Thinking
Accessibility of Medical Marijuana
Natalie Aspray, Shoshanah Balter, Jonathan Juca, Michelle Kelmansky, Gissel Margarin, Liza Yelin
Summary/Synthesis
of Findings
Ethical/Moral Nursing
Implications
Health Policy ImplicationsBackground/ Overview
of Topic
Group #28
Recommendations for
Practice
Empathy
• An individual who is prescribed
MM for chronic pain, but is
unable to acquire the medication
due to lack of access to
dispensaries or inability to pay
for it through insurance (due to
federal regulations).
Define
• How might we educate
patients and providers
regarding the legal
accessibility of MM?
Ideate
• 18 divergent ideas
• 1 convergent idea
Prototype
• An app which serves as
a cumulative database
for information patients
may need after getting a
prescription for MM.
Test
• We may have to look
into the feasibility of how
this app will be
funded/how we will fund
the individuals who run
the live chat.
Use of medical
marijuana (MM) has
been legalized on a
state-by-state basis;
however, federally, it
is still illegal and is a
Schedule I drug. This
has led to provider
confusion regarding
prescription practices,
a lack of randomized
control trials on the
use of MM for pain
and symptom
management,
minimal access to
dispensaries, and
health insurance
restrictions.
 There is only one license in the US given for growing research-grade
MM, which is controlled by the Drug Enforcement Agency. This license
was given to the National Institute on Drug Abuse, whose focus is
fighting drug addiction (Philipsen et al., 2017).
 Misconceptions by both patients & practitioners concerning safety and
evidence-based indications for MM can often complicate treatment
planning and outcomes (Lenoue et al., 2016).
 State differences in policy and laws may affect patients through
differences in distribution; thus affecting the quality of MM. State policy
would benefit from clearer definitions regarding distribution and retail
programs of MM (Singh et al., 2019).
 As a result of differences amongst state laws, prescribers have to be
aware of the policies within their state. State differences may include:
where MM is available (through dispensaries or growth allowed at
home); the presence of a patient registration system; and the variety
and strains or routes that are permitted. In addition, NPs may not be
able to prescribe MM in some states because it requires physician
authorization (Philipsen et al., 2017).
 Since MM is still listed as a Schedule I drug, further research on the
efficacy of MM in pediatric palliative care settings is necessary (Weaver
et al., 2019).
 States have different policies regarding what conditions can receive MM.
Some conditions that are widely covered amongst states include:
multiple sclerosis, cancer, HIV, AIDs, and glaucoma (Bestrashniy et al.,
2015).
 Legalization plays a major role in patient’s decisions to use cannabis as
more than half of patients were more inclined to use MM after education
(Pergam et al., 2017).
 Beneficence: MM can help with
chronic pain and disease
symptoms
 Moral dilemma/distress: The nurse
wants to be able to help the
patient with chronic pain/life-
threatening illnesses, but some
states do not legalize MM and
therefore the nurse cannot treat all
patients equally
 ANA 2.1 (Primacy of the Patient’s
Interests): The nurse has to
advocate for the patient's interests
and supply information for their
benefit to help guide them in
regards to MM
 ANA 8.3 (Obligation to Advance
Health and Human Rights and
Reduce Disparities): Advocating
for federally legalized marijuana
would reduce incarceration rates
in regards to marijuana
possession and assist in reducing
this disparity amongst a variety of
groups (Fowler, 2015).
 The only license to grow research-
grade MM is held by the National
Institute on Drug Abuse, thus
opportunities for research are limited as
a result of policy (Philipsen et al., 2017).
 Marijuana is considered a Schedule I
drug, meaning the government does
not recognize any accepted medical
use for the substance, thus restricting
its production for research and
availability as a treatment option
(Weaver et al., 2019).
 In spite of the federal policy, individual
states are able to legalize MM,
therefore making it available for
patients (Philipsen et al., 2017).
 Educate the public on availability of MM
and provide resources to guide them
through the registration process and
encourage them to follow proper MM
use protocols.
 Educate providers on prescription
practices of MM and its uses.
 Decrease the stigma regarding MM.
 Advocate for removal of MM from the
Schedule I status.