5 Things You Need to Know When Treating a Patient Who Uses Cannabis

Cannabis can provide needed relief for many patients. It can even help to manage chronic pain without opioids. However, like any medicine, cannabis alters a patient’s needs.

For one, cannabis users may require a higher dosage of pain medication in surgery to feel its effects. And, they’re at a higher risk for adverse reactions to medications such as sedatives.

"Periop providers may not be ready for the risks that cannabis users could experience during surgery." That's according to Barbara Nalley, MSN, RN, NP-C, ANP-BC, CNOR, RNFA.

With cannabis legal for medicinal use in 37 states and permissible for any reason in 24 states, it’s increasingly likely that your next surgical patient could have cannabis in their system.

Nalley wants to help periop nurses be ready for these patients’ safe care. That's why she's sharing comprehensive education on the subject at AORN’s upcoming annual conference.

Ahead of her session, Nalley shared these tips to help nurses ensure safer surgery for patients taking cannabis.

1. Identify if Cannabis is in the Patient’s System

This is crucial. Like cigarette smoke, cannabis can cause hyperactive airway.

Patients who frequently use cannabis may require up to three times more anesthetic and pain medication. And that even applies to simple procedures (think endoscopies) to achieve adequate numbing or relaxation.

2. Understand How Cannabis Affects the Body

Cannabis comes in many forms for both recreational and medicinal users and can have lasting and varied effects, she explains. "Consider a patient who uses CBD-infused skin cream for pain relief. They may have a lower level of the drug in their system compared to a patient who smokes cannabis.”

3. Look for Drug Interactions with Cannabis

There are many adverse risks of cannabis when mixed with other medications, such as sedatives. Here are some common symptoms of a cannabis interaction that Nalley says to watch for:

• Drowsiness
• Dizziness
• Anxiety
• Hypotension
• Headache

4. Know What Your Patient on Cannabis Needs

Every member of the perioperative team needs to understand that cannabis can impair cognition. That means a cannabis patient may not be able to make decisions about care or sign a consent for treatment.

Withdrawal is also a danger to plan for, especially if a chronic cannabis user needs to be hospitalized after surgery, she cautions.

5. Follow the Evidence on Cannabis

When a state legalizes cannabis, it becomes easier to expand research for the drug in that state. This is needed, she stresses, as we continue to identify the potential complications for the perioperative patient population. She encourages nurses to keep up with this research to address unique needs in healthcare.

Nally also believes periop nurses play an important role in adding to this literature. “Leading research and improvement projects on cannabis users and safety gives nurses the power to standardize care. It also helps them increase awareness for cannabis users’ needs during their surgical experience.”

Don’t miss Nalley’s presentation on “Cannabis and Your Perioperative Patient” at AORN Global Surgical Conference & Expo, March 9–12, in Nashville.