HJBR Jul/Aug 2024

HEALTHCARE JOURNAL OF BATON ROUGE I  JUL / AUG 2024 51 Karen C. Lyon, PhD, MBA, APRN-CNS, NEA Chief Executive Officer Louisiana State Board of Nursing 2. NCSBN “National Nursing Guidelines for Medical Marijuana,” including APRN recommendation statutes and recommendations for the nursing care of patients using medical mari- juana. 6 3. Knowledge of Louisiana jurisdiction of the state medical marijuana pro- gram designated caregiver provi- sions. While the NCSBN guidelines are help- ful, they were published in 2018 and must be supplemented by all known changes in both federal and state law. Related re- sources can be found in the references sec- tion below, including a helpful graphic to identify the risks of marijuana use for both licensees and their patients. 7 n REFERENCES 1 Transformative Health Center. “A brief history of medical marijuana in Louisiana.” Accessed May 31, 2024. https://transformativehealthcenter. com/history/ 2 Louisiana Board of Pharmacy. “Authorized Clinicians – Therapeutic Marijuana Guidance.” Accessed May 31, 2024. 3 Schoonmaker, M.S.; Johnson, E.A.; Thompson, A.R. “President Biden Signs Law Expanding Research on Cannabis.” The National Law Review 14, N0. 152 (Dec. 2, 2022). https://natlawreview. com/article/president-biden-signs-law- expanding-research-cannabis 4 Schedules of Controlled Substances, 21 U.S. Code 812. 5 Congressional Research Service. “Legal Consequences of Rescheduling Marijuana.” Legal Sidebar, updated May 1, 2024. https://crsreports. congress.gov/product/pdf/LSB/LSB11105 6 National Council of State Boards of Nursing. (2018) National Nursing Guidelines for Medical Marijuana. Guidelines for Medical Marijuana | NCSBN. https://www.ncsbn.org/public-files/ The_NCSBN_National_Nursing_Guidelines_for_ Medical_Marijuana_JNR_July_2018.pdf 7 Substance Abuse and Mental Health Services Administration. “Marijuana: The Risks are Real.” Accessed May 31, 2024. https://www.samhsa . gov/sites/default/files/marijuana-infographic- risks-are-real.pdf H.R.8454, the Medical Marijuana and Can- nabidiol Research Expansion Act, which became Public Law 117-215. This act was aimed at providing greater federal support for cannabis research and its potential health benefits. It is the first stand-alone cannabis reform legislation in the United States. The act does three things: 1. Provides a mechanism for the scien- tific study of cannabidiol and canna- bis for medical purposes. 2. Arranges a pathway for the Food and Drug Administration to approve the commercial production of drugs con- taining or derived from cannabis. 3. Protects doctors who may now dis- cuss the harms and benefits of using cannabis and cannabis derivatives. 3 Right touch regulation LSBN believes that all complaints in- volving cannabis receive the same due process considerations as all complaints of violations of our “Nurse Practice Act” and rules and regulations. That said, ex- cept for the medical use of marijuana as recommended by an authorized provider, LSBN still follows the federal regulation of marijuana as a Schedule I controlled sub- stance. Schedule I substances are described as those that have all the following findings: 1. The drug or other substance has a high potential for abuse. 2. The drug or other substance has no currently accepted medical use in treatment in the United States. 3. There is a lack of accepted safety for use of the drug or other substance under medical supervision. 4 On April 30, 2024, it was reported that the Drug Enforcement Administration (DEA) planned to reschedule marijuana from a Schedule I to a Schedule III drug under the Controlled Substances Act, fol- lowing a 2023 recommendation from the U.S. Department of Health and Human Services. Any change to the status of mar- ijuana would have to be made through DEA rulemaking procedures and would not take effect immediately. Current legal status of marijuana can be found in the Congressional Research Services report “Legal Sidebar”titled “Legal Consequences of Rescheduling Marijuana.” 5 The mission of LSBN and all other nurs- ing regulatory jurisdictions is to protect the public, meaning we must weigh the risk of what we are regulating to produce rules and regulations that are consistent, targeted, and transparent. Three types of complaints come to the board regarding our licensees and the use of cannabis: 1. A licensee that tests positive for tet- rahydrocannabinol (THC), the active psychoactive ingredient in marijuana. 2. An APRN licensee’s improper recom- mendation of medical marijuana un- der Louisiana law. 3. A licensee’s administration of canna- bis to a patient outside of caregiver provisions of the Louisiana medical marijuana program. Each of these complaints requires knowledge of our current state of legaliza- tion of medical marijuana and includes the following: 1. Knowledge of standards and lim- itations of current testing related to marijuana use.