Drug Wars, Drug Addiction, and Social Justice Issues


I have been reading Johann Hari’s Chasing the scream: The first and last days of the war on drugs. 

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This book provides a very detailed account of how we came to be an anti-drug and pro-prohibition nation that lead the way toward making criminals out of people who struggle with use of substances and millionaires out of people/ cartels who sell drugs on the black market. I have found the book in some aspects hard to read because the political manipulation of our global population and the injustices that have arisen from this global movement. I get angry about what has happened as I read and I have to step away for awhile.

Some key points from this text for nurses to consider:

  • The dominant medical establishment (in particularly the AMA) was initially very against “drug” prohibition, but key vocal players were forced into silence by the government.
  • Overall, 90% of people use substances we call “illicit drugs” without having addiction issues, yet we continue to think that people need to be cautious with drug use. For instance, many (not all) soldiers used heroin in Vietnam to get through the hellish experiences, yet many (not all) had no issues with heroin addiction when they returned stateside.
  • There is a clear connection between lack of social support, childhood abuse, and adverse childhood experiences (ACEs: see the CDc website for more info on this) with addiction. We need to be compassionate toward those who are suffering, because these childhood experiences literally changed how their brains function, making them very vulnerable toward addiction. Adverse childhood events impact young people across the socio-economic spectrum, and many people who came from “good families” have also experienced a lot of childhood trauma.
  • When it comes to death and illness, our two leading “drug use issues” are likely nicotine and alcohol, both legal, and both toxic and deadly. Yet, we simply put warning labels on these drugs and let folks self-determine their fate. Why are these drugs okay, but others are not? Because they are socially acceptable? Because they are “cheap”?

When we think of the opiate crisis, one of the biggest issues of course is people not having safe and affordable access to opiate medications: when people are cut off from safe supplies (ie, their pain prescriptions which the medical establishment has endorsed and prescribed, with potentially some of the cost covered by their medical insurance ), they may turn toward heroin and other “street” opiate medications. These drugs are expensive, sometimes hard to find, and in many ways they force or perhaps support people to live a life of crime in order to maintain their habits, if people have gone that far they must get help. And people overdose because they have no idea what is in the products they are obtaining.

Maybe, we have created an addiction monster in our society.

However, Portugal has found a way out of the addiction monster’s clutches. In 2001, with a growing heroin addiction problem, Portugal decriminalized all drugs and began to consider addiction to be a public and personal health issue. Drug addiction was viewed for what it is:  a chronic, debilitating illness. People caught with a 10 day supply of any drug are referred to a sociologist who helps to determine their treatment options. And what Portugal has realized is that not only is this a more humane approach, it is also far less expensive to provide adequate medical care and treatment to addicts versus incarcerating them. Portugal has experienced a 75% drop in addicted persons from the 1990’s, and their addiction rates are 5 times lower than the rest of the EU. Meanwhile, drug related HIV infections have dropped by 95%, and the stigma around addiction has lessened dramatically.

http://www.npr.org/sections/parallels/2017/04/18/524380027/in-portugal-drug-use-is-treated-as-a-medical-issue-not-a-crime

As nurses, we are concerned about social justice issues and public health issues. I would posit that nurses and politically active nursing organizations should be taking action around the opiate crisis in several ways:

  • Calling for safe injection sites and distribution of clean needles (or needle exchange centers) and free condoms.
  • Looking at prevention and early identification of at risk persons (both ending early childhood trauma through supporting parents at risk for enacting trauma and assessing for early childhood trauma both across the lifespan and across all populations to determine risks for addiction).
  • Supporting harm reduction techniques.
  • Supporting a view of addiction as a public health issue, and a chronic disease issue.
  • Considering a call toward decriminalization of drugs and ending incarceration for addicts (the Portugal Model).
  • Acting compassionately toward all addicts (even the “drug seeking” ones).

If you are interested in this topic, I do recommend reading Chasing the scream. This text provides great historical insight into how we came to where we are at with the global  “war on drugs” and the escalating issue of for-profit prisons.

We have become the nation with the greatest number of incarcerated individuals (not %, but sheer number!): though we only have 5% of the world’s population, we incarcerate 25% of the world’s total prison population (this link looks at the complexity of these numbers and supports the idea of the truth that in the land of the free, we incarcerate a much higher percentage of people due to lack of alternative ways to provide help https://www.washingtonpost.com/news/fact-checker/wp/2015/07/07/yes-u-s-locks-people-up-at-a-higher-rate-than-any-other-country/?utm_term=.1ca70c3620af).

Columbia University’s CASA group has released multiple reports that link drug addiction issues to crime, incarceration, and repeat offenses. Sadly, while 65% of our prison population qualify for addiction treatment, only 11% actually receive treatment. Meanwhile, the majority of violent crimes are committed by those suffering from addiction. https://www.centeronaddiction.org/newsroom/press-releases/2010-behind-bars-II

Poverty, race, and income inequality also play a role in both addiction and incarceration, and as nurses, we are ethically obligated to advocate for change in healthcare and system wide policies that impact vulnerable populations. Raising awareness is a first step, but perhaps nursing organizations need to also start taking stances and lobbying for more humane treatment of those who struggle with addiction.

 

 

The Ethics of Nurses Being “Political”


A few weeks ago (I know, don’t tell me it feels like months!), when the 45’s “Muslim Ban” was in full swing, Pamela Cipriano, the current President of the American Nurses Association, issued a statement that reads as follows:

“Nursing is committed to both the welfare of the sick, injured, and vulnerable in society and to social justice. The ANA Code of Ethics for Nurses with Interpretive Statements establishes the ethical standard for the profession in its fervent call for all nurses and nursing organizations to advocate for the protection of human rights and social justice.Therefore, ANA opposes any action that erodes the human rights of people, and strives to protect and preserve the rights of vulnerable groups such as the poor, homeless, elderly, mentally ill, prisoners, refugees, women, children, and socially stigmatized groups.This underlying principle must be considered in light of the current Administration’s efforts to halt refugee admissions for 120 days and block citizens of seven Muslim-majority countries from entering the United States for 90 days.Any actions taken that are intended to increase the safety of our country must be clearly defined and not jeopardize human rights nor unfairly target religious groups.” (http://nursingworld.org/FunctionalMenuCategories/MediaResources/PressReleases/2017-NR/ANAPresidentResponds-ImmigrationEO.html).

Social Media Reaction 

I happened to read this on facebook, so of course I was very excited to see a nursing leader take a public stand. As I moved onto the comments section, I was concerned by what I saw, as it seems about 50% of the nurses commenting were concerned about the political nature of Dr. Cipriano’s statement, and comments were made that nurses should not be making political statements, that ANA should not be taking political stances, and that there is no room for politics in nursing.

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We still have a lot of work to do in educating nurses, both in the academic and professional settings. We need to ensure that nurses understand their ethical obligation to act as advocates for populations; and that this obligation extends beyond the bedside and workplace setting and out into the wider arena of politics.

Ethics and Political Action, Advocacy, and Activism

The Code of Ethics for Nurses With Interpretive Statements (American Nurses Association, 2015: http://nursingworld.org/DocumentVault/Ethics-1/Code-of-Ethics-for-Nurses.html) guides us in our nursing practice. In particular, nurses should be aware of the implications around the following provisions (emphasis added with italics):

  • Provision 7: The nurse in all roles and settings advances the profession through research and scholarly inquiry, professional standards development, and the generation of both nursing and health policy.
  • Provision 8: The nurse collaborates with other health professional and the public to protect human rights, promote health diplomacy, and reduce health disparities.
  • Provision 9: The profession of nursing, collectively through its professional organizations, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy.

All nurses can access this document for free online at the above link, and I would recommend particular attention be paid to provision 9.3 (integrating social justice, p. 53) and 9.4 (social justice in nursing and health policy, pg. 53-54).

I particular like how the ANA code provides a context for nurses to realize that our work does not stop at the bedside; we care for and advocate for those who do not have a strong voice, those who need support in attaining the best pathways toward good health and healing, and we care for and advocate for populations and the planet.

In this sense, when we made aware of political issues like the possible repeal of the Affordable Care Act, it becomes clear that we are ethically obligated to take action to ensure that vulnerable populations do not lose access to their healthcare, and that we be part of the conversation as new processes and policies emerge via federal and/or state mandates regarding healthcare insurance. This area may seem obvious, but we are also ethically obligated to take action when we see the health of specific populations and the health of the planet at risk. Image result for picture nurse political

One example of this might be the “extreme vetting process”, which is targeting refugees from specific war torn areas such as Syria. The atrocity of human destruction in Syria and the need for refugee re-settlement is one that nurses should be concerned about; the damage that is done to human life and the degradation of the environment and the planet in Syria is a global concern, and a nursing concern. Nurses should therefore be fulfilling our ethical obligation by questioning the new extreme vetting process and supporting a call to assist Syrian refugees. A war torn vulnerable human population requires social justice action.

I am sure there will be more examples that require nurses to fulfill our ethical obligations in the forthcoming days and weeks as we look at this administration’s stances around the environment, healthcare, and even education (yes, our children are a vulnerable population away, one that needs a strong voice in support of the best educational practices).

So what can we as individual nurses do? 

Make an action plan around a singular or perhaps a few areas of political concern. Keep in mind, your actions do not need to be huge or time consuming; calling, emailing, or writing your representative on a regular basis can take just a few minutes of your time, and it can be of great impact. Don’t forget to mention you are a nurse, and always strive to share personal stories around your topic of choice. Align yourself with other like-minded nurses, and take steps to balance your work-family-advocacy-self-care efforts. Rejuvenate yourself, and find communities that you align with.

The reason why we became nurses may vary to some degree, but most of us felt a calling toward healing, toward caring, toward supporting people and populations in maximizing their health. And the world needs nurses right now to fulfill their ethical obligations in the political arena. Image result for picture nurse political

 

The Call for Community, Art, and Artists in the Resistance Movement


This week, members of the Nurse Manifest Team gathered together by the warmth of our computer screens for engaging video conference. We took the time to welcome some new members and talk about the future of the movement. I have to say for me, being with like minded #NurseResisters was so energizing (even though I have been suffering through a bout of the flu this week!) and also very comforting.

It’s important for #NurseResisters to remember we are not alone and to gather those around us during these challenging times: when change seems to be happening at a rapid pace, when social media pages are filled with what resisters might find to be concerning or bad governmental news, when there are 10 things you would like to take action on, but you can’t be on the phone all day….it can become easy to become discouraged, overwhelmed, or burned out. This is where truly being with a like minded community can lift your spirits and buoy your endurance.

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And endurance is what we will need. I know right now it sometimes feel like a sprint…get out there and get things done now, get to this march, make your signs, write your emails and postcards, get on the phone….because the administration has been creating changes at a rapid pace, the media and social media have been bumping up our energy, and we feel drawn to create change now.

The thing is, this is not a sprint and it’s not a solo race…it’s more like a team based marathon or ultra-marathon, and it is going to take teams of like minded community members to both participate in and complete the race.

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Individual Sprint

Versus

Team Marathon

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We need to carry lights, march together through the dark night with our nightingale lamps, and strive toward unity. There is no clear finish line, and no medals for winners, second, and third place. There is a beautiful planet and population of people that need caring for and this endurance test is in part about not giving up that vision of a caring, compassionate, kind, peaceful, unified, and spirit filled world.

I suggest other #NurseResisters start gathering with your communities in real life or as we did last week, in real time via video or phone conferencing. Set aside thoughtful, meaningful time to be together, to discuss future actions, and also to just support one another, to laugh together, to share your stories. Communities can rejuvenate and recharge us, and they are a must for folks who plan to run the long race.

I also did want to share that part of our discussion last week focused on the use of humor, satire, parody, art, and music to support and gather people together. Saturday Night live is becoming a great example of the power of humor, parody, and satire to help us lighten our load, to help us rejuvenate, to connect us across time and space.

 

 

While there are many older political songs we can use (Carol King just re-released One Small Voice with free download!: https://soundcloud.com/user-844282824/one-small-voice), it remains imperative that we also create new art and new music that reflects our current siutation here, now in 2017. Until then, let’s be strong together:

“One small voice speaking out in honesty
Silenced, but not for long
One small voice speaking with the values
we were taught as children
Tell the truth
You can change the world
But you’d better be strong”

(Carole King/ copyright Rockingdale Records).

 

Women, healthcare, and access issues


I have been thinking a lot lady about women’s need for healthcare and oppression of women. A lot of this thinking has been spurred on by my facebook account, which lets me know that the new administration is planning on defunding planned parenthood, cutting medicare, and possibly replace the Affordable Care Act with Health Saving’s Accounts (the last one has to be a joke…right? HSA of the average American will not pay for hospitalizations and major medical issues).

The defunding of Planned Parenthood (PP) makes little to no logical sense, as no federal money is used to support abortions (which seems to be the GOP platform reason for why PP should be de-funded). I myself used PP as a young uninsured nursing student and even when I became a nurse with no insurance. PP was in fact my primary care for many years and PP offers great care options for women.

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This year when it came to my yearly exam, instead of literally waiting 8-12 weeks for an “annual” appointment with an MD or DO, I decided to have my basic needs met through PP. They take my insurance (which I am ever so grateful for) and I could make an appointment for a few days from when I went online. I could cancel my appointment online.

When I arrived, I was pleased to see a bowl full of condoms sitting out. I was in the waiting room with one other male in his mid-20’s, it was mid-day on a Monday. When I went back to the exam room, after only waiting about 10 minutes, the MA took my weight, BP, and did a brief health history with me. An NP was with me shortly after this, and we discussed many of prohormones and my overall health concerns. She did a breast exam, gynecological exam and pap smear, discussed peri-menapause with me, and she even spent a few minutes talking with me about my tween and what the latest approaches were for sexually active teens (including answering my questions about HPV and what my daughters’ experience might be like should she come to a PP for birth control when she is a teen).

I have to admit I was more comfortable here then visiting my primary care doctor, the one who is listed on my insurance. I like getting care from NPs, I trust them and appreciate the time they devote to prevention. The routine felt comfortable and I was at ease. I left with a plan to address some of my health concerns with other healthcare professionals and with an increased knowledge base around my own health and even my daughters’ future sexual health. Although my insurance paid for this health prevention visit, I made a donation to PP on the spot before I left the building.

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I want PP to be around when my daughters’ might need them in the next few years. If you feel the same, I hope you will join me in contacting your legislative body and your local PP to see how you might be of assistance. To learn more about how to contact your representative in Washington DC, please visit: http://www.house.gov/representatives/find/

 

A Nurse’s Perspective on Cannabis (Marijuana), Legalization, and Safety.


I am a Registered Nurse with 22 years of experience, and I have had an anti-prohibition stance in regards to marijuana (cannabis) for 30 years. I was fortunate that when I moved from California to Maine 6 years ago, I was introduced to Maine’s amazing medical cannabis program. I have also been able to study and learn more about the medicinal benefits of this sacred herb through my involvement with the American Cannabis Nurses Association (I now sit on ACNA’s board of directors) and by going to cannabis clinician conferences, such as Patients Out of Time.

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Cannabis is on the ballot in 9 states this November, for either legalization for adult use or medicinal consideration. As nurses, we are often concerned with safety, so the following are my thoughts on safety issues and the end of prohibition of cannabis. If you are unfamiliar with how cannabis works in the body and why it such a safe herbal medicine, I suggest you first visit my blog posting on what nurses need to know about cannabis: https://nursemanifest.com/2015/07/14/the-endocannabinoid-system-what-nurses-need-to-know-an-introduction/.

Let’s consider the following issues:

Access: The idea of increased access for adults over age 21 is compelling on many levels. As many have stated before me, all cannabis use is medicinal due to the way the herb interacts with the body’s own endocannabinoid system. (http://thejointblog.com/all-marijuana-use-is-medicinal/;  https://halcyonorganics.com/all-cannabis-use-is-medical/). Patients who cannot access cannabis legally to support their healing because they did not have a documented qualifying condition may now have access to this safe effective herbal medicine. Sites like http://www.drugguardians.com are being created with impunity and are helping the population become informed by third parties, decentralizing the source of knowledge about drugs. As legal access increases, black market issues will likely dissipate which creates a safer environment for all citizens. Meanwhile, we know that in legalized states, teen cannabis use drops significantly, effectively decreasing access for younger folks, which is often a concern for those who are considering legalization or medicinal programs (http://www.usnews.com/news/articles/2014/08/07/pot-use-among-colorado-teens-appears-to-drop-after-legalization).th-2.jpg

Quality: In Maine, our ballot calls for testing and proper labeling of cannabis products sold at both recreational stores and recreational cafes. This is a major step forward to ensuring safe use of quality cannabis products for both patients and recreational users. Many patients now are being encouraged to start low and go slow with their dosing of their medication, and proper labeling will help to ensure that people can use cannabis with comfort knowing the relative psychoactive effects increase as THC levels of the cannabis products increase. Additionally, products will be tested for pesticides and contaminants, further ensuring the medicine and products people are accessing is safe.

Smoking: I often hear that medical providers are very concerned with the idea that smoking cannabis may be harmful to the person. While there may be some minimal changes to lung structures, there is no strong correlation with COPD and lung cancer in cannabis smokers (http://www.ncbi.nlm.nih.gov/pubmed/23802821; http://www.ncbi.nlm.nih.gov/pubmed/21859273). However, there are many ways to ingest cannabis, and vaporizing cannabis is a way to inhale the medicine without having contact with some of the combustive byproducts that are related to any perceived risk of smoking cannabis. For more therapeutic effects, regular users of cannabis and those seeking its healing properties are generally encouraged to use edibles and tinctures, as they target whole body homeostasis more effectively.

OUI/ DUI: Driving under the influence of any psychoactive medication is obviously an issue. However, levels of THC in the body do not directly equate to impaired driving in the same way that alcohol does, secondary to the way THC is metabolized in the body and how it remains in the body due to it being a fat soluble substance (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3456923/). “Stoned drivers” do not pose the same risk to the public’s well-being as “drunken drivers” do; indeed “stoned” drivers tend to drive more slowly. Researchers from UCLA have called for more efforts to be made around lowering acceptable blood alcohol levels to truly curb issues around impaired driving (http://www.nytimes.com/2014/02/18/health/driving-under-the-influence-of-marijuana.html?_r=0), as being at .08 BAL leads to an eleven fold increase in the risk for being in a car accident, while driving under the influence of cannabis leads to a two-fold increase of being in an accident (texting while driving has a two fold increase and talking on the phone while driving has a 3 fold increase in risk for car accidents) (http://www.huffingtonpost.com/sam-tracy/putting-marijuana-dui-in-_b_6023136.html). Driving or operating machinery while under the influence of cannabis is unacceptable and indicates a risk, however in Colorado since legalization of recreational use of cannabis was initiated, DUI fatalities have decreased (https://www.washingtonpost.com/news/the-watch/wp/2014/08/05/since-marijuana-legalization-highway-fatalities-in-colorado-are-at-near-historic-lows/?utm_term=.64fa02a0cc5e). It should be noted that Colorado made a concerted effort to promote safer driving conditions and decreasing driving while intoxicated once they ended cannabis prohibition. all states should be making efforts to combat intoxicated and unsafe driving practices.

Children: When cannabis was made recreationally available in Colorado, it appeared that more children were being accidentally exposed to cannabis (http://www.usatoday.com/story/news/nation/2014/04/02/marijuana-pot-edibles-colorado/7154651/). I would posit however that once the plant became legal, more parents were willing to seek medical attention if their child had accidentally ingested cannabis infused edibles or other cannabis products. Additionally, the relative number of cannabis ingestion issues versus other toxic substances truly remains quite low in Colorado at 6.4% of all “poisoning” cases treated within the pediatric population (http://www.cnn.com/2016/07/27/health/colorado-marijuana-children/index.html). There has not been a single reported death from a child (or any person) ingesting cannabis (unlike other ingested toxins, such as laundry pods: http://www.cnn.com/2014/11/10/health/laundry-pod-poisonings/index.html). So while we will need to educate consumers about the risks of pediatric access and ingestion of cannabis, the risks remain relatively low. In most cases, children recover quickly from cannabis intoxication, with hospitalization for supportive care only, which generally lasts 1-2 days and generally leads to no lasting side effects (http://health.usnews.com/health-news/news/articles/2013/05/27/kids-poisoned-by-medical-marijuana-study-finds
). Both the states and the individual companies who will be selling cannabis should be responsible for educating the public around ensuring pediatric safety should a state chose to legalize. Ideally some of the tax dollars generated from cannabis sales would be geared toward education of the public on safe cannabis consumption and storage.

Teen Use: Teen cannabis use has actually declined as more states legalize or become medicinal cannabis states (https://www.washingtonpost.com/news/wonk/wp/2014/12/16/teen-marijuana-use-falls-as-more-states-legalize/). This in part may be due to tougher regulations making it harder for teens to access cannabis, and a decrease in black market availability of cannabis.

Pregnancy: Dr. Melanie Dreher, the Former Dean of Rush University school of nursing, is a nurse who researched the Ganga culture in Jamaica for over ten years, and determined that there were no adverse outcomes to the fetuses who were exposed to cannabis (https://www.youtube.com/watch?v=K9WorIM0RhA; https://www.youtube.com/watch?v=RDV5HhmP4UI). A recent study also reported that cannabis use is safe during pregnancy (though caution may still be advised)(http://www.scienceworldreport.com/articles/47194/20160910/marijuana-safe-during-pregnancy-experts-encourage.htm) and breast feeding while using cannabis also appears to have minimal risks (http://cannabisclinicians.org/breastfeeding-and-cannabis/).

Harm Reduction: Cannabis has been studied as a harm reduction tool, particularly when it comes to addiction and treating folks for pain related issues. Physicians have called for neuropathic pain to be treated with cannabis instead of opioids (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3295721/). We also know that cannabis can decrease the need for escalating doses of opioids, and assist people who are opioid dependent in either decreasing thier doses of opiates or completely overcoming their addiction (http://nationalaccesscannabis.com/press-release/opiate-study-press-release/).
For an overview of the body’s endocannabinoid system and the issue of biological harm reduction, please see here: http://harmreductionjournal.biomedcentral.com/articles/10.1186/1477-7517-2-17

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Overdoses with opioids have fallen in states where medicinal and legal cannabis are available (http://www.nytimes.com/roomfordebate/2016/04/26/is-marijuana-a-gateway-drug/overdoses-fell-with-medical-marijuana-legalization; and https://www.drugabuse.gov/news-events/nida-notes/2016/05/study-links-medical-marijuana-dispensaries-to-reduced-mortality-opioid-overdose). With high rates of opioid addiction plaguing our country, it makes sense to legalize cannabis now to help address this issue.

Self-Medicating: People self-medicate with substances on a daily basis; from alcohol to caffeine to tobacco. People self-medicate with herbs as well from turmeric to Echinacea, to vitamins and mineral supplements. With legalization and regulation, people have a better chance of using safe, monitored, quality herbal cannabis medicine. For most of our recorded human history, cannabis was used as a healing herb. This came to a halt when cannabis prohibition became a global stance. Additionally, legalization opens the door for more open discussions between healthcare providers and patients. Healthcare providers such as nurses and doctors must become educated around the body’s endocannabinoid system and the therapeutic use of cannabis to create homeostasis and support healing.

Pathways for New Healing Products: Currently, many new cannabis products that are available in legal states are not available to medicinal patients in states where only medicinal cannabis is legal. For instance, various teas, salves, edibles and patches that are available in Colorado, Washington, or Oregon are not yet always available for medicinal patients in other states. Once states have a legalized cannabis regulation processes in place, it may be that people can access items such as a topical sub-dermal patches to deliver cannabis medicine or specific cannabinoids. A person may be able to use a CBD (a non-psychoactive cannabinoid) only patch during the day to help with issues like, pain, anxiety, nausea, and depression, and a CBN patch (another non-psychoactive cannabinoid) at night to help with sleep. In this example, the person would have minimal if any exposure to the psychoactive effects of THC in cannabis, and yet they may experience a greater quality of life. From a justice perspective, people deserve to make choice around the medicines they would like to utilize for their own healing, particularly when the medicines are safe.

Social Justice Issues and Policing: Recently, the chiefs of police in Maine came out against the yes on 1 ballot initiative to legalize marijuana in Maine. It is interesting to me that this organization stated they are “unprepared to address legalization issues,” when certainly looking at the legalization issues in Colorado and Washington should provide plenty of data and solutions to common issues. I would posit that there would be fewer marijuana trafficking issues and convictions, and the police could turn greater attention to bigger and more harmful issues in Maine, such as the opioid crisis and OUI related to alcohol ingestion. Additionally, cannabis legalization is a step toward social justice given the illogical, irrational, and unsuccessful war on drugs (http://www.sfgate.com/opinion/article/Marijuana-legalization-a-step-toward-social-5848468.php, http://theweek.com/articles/542678/why-pot-legalization-also-fight-social-justice). Legalizing cannabis should free up our law enforcement agencies to fight crimes that cause greater damage, even as it lowers the need for them to be addressing black market cannabis issues.

I would like to close with my final thought:

All cannabis is medicinal. Our bodies have our own endocannabinoid systems; we make our own endogenous cannabinoids. However when we become deficient in these cannabinoids, we may become ill and need to seek exogenous sources of cannabinoids, or support our own bodies in creating more endocannabinoids. Cannabis is a safe effective medicine with a low rate of addiction and minimal if any withdrawal symptoms, similar to caffeine. Ingestion of cannabis itself has never lead to a death (unlike many prescription and OTC drugs, alcohol, and nicotine products), and it is time we begin to move beyond the government’s ineffective “prohibition of marijuana” stance and take steps toward effective access for all adults.

In the states where cannabis is a ballot initiative, I urge us as nurses and other healthcare providers to explore the data around cannabis as a medicine and consider our roles as  advocates for patient access to the healing support this medicine can provide.

 

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