Introduction
For the management of pain among patients released from healthcare facilities, prescription drugs are often used to ensure that individuals can engage in effective self-management. However, research suggests that overdoses of prescription drugs are the leading cause of accidental death in the United States (Reiman, Welty, & Solomon, 2017). Specifically, according to the report made by the Centers for Disease Control and Prevention (CDC) (2022), the drug overdose epidemic, particularly regarding the use of opioids, continues to worsen in the country. Moreover, for every drug overdose from opioids that results in death, there are several more non-fatal overdoses that adversely affect individuals’ emotional and physical health and economic stability. Notably, the
Looking to alternative solutions to opioids can help address this issue while also determining the effectiveness of newer methods. Specifically, cannabis has been cited as one of such alternatives that can help effectively treat pain among patients while reducing the risks of both dependence and fatal overdose as compared to opioid-based medication (Reiman et al., 2017). Bachhuber et al. (2014) found that states that have laws for medical cannabis have significantly lower state-level opioid overdose rates for mortality. The practice issue has the potential to be explored through the PICOT approach to identify whether marijuana could be a viable pain relief alternative to prescription opioids. The PICOT question for the identified health care issue is the following: in a patient population requiring pain relief (P), does marijuana represent a viable alternative medication (I) as compared to opioid-based prescription drugs (C) for alleviating the burden of pain the population (O) over a six-month period (T)? If the proposed intervention turns out to be successful, then it will be possible to help patients experiencing pain relieve it without the use of harmful and potentially addictive opioid-based medication.
Sources of Evidence
In answering a PICOT question involving the outcomes of marijuana use for pain relief as compared to opioid-based medication, multiple sources of evidence can be potentially effective. Most of the evidence is expected to come from research articles published in journal articles because it will be based on empirical findings from studies involving actual participants within a specific healthcare setting. PubMed is among the prominent databases containing multiple journal articles on the use of marijuana as an alternative to opioid prescription medication. It is important that the findings are based on evidence-based practice (EBP) because it allows for providing the most effective care solutions that are available, with the purpose of improving health outcomes among patients (Boswell & Cannon, 2018). When applied to the nursing practice, EBP enables professionals to evaluate relevant research so that they acknowledge the risks and efficacy of treatments and diagnostic tests. Findings from research suggest that the implementation of EBP can be facilitated by the promotion of their belief in such practice (Abu-Baker et al., 2021). Thus, the stronger nurses’ beliefs regarding EBP, the more likely they are to implement it in their practice.
Findings
Over the recent several years, medicinal cannabis has increasingly become a topic of study among researchers regarding its part in alleviating both chronic pain symptoms. Even though marijuana is not an FDA-approved medication, licensed practitioners can prescribe them to patients (Bains & Mukhdomi, 2022). Nevertheless, patients who suffer from pain continue using opioids to address chronic pain even though they have limited long-term efficacy. Researchers found that long-term opioid therapy was associated with several risks, including opioid use disorder, overdose, and death. Used separately or in combination with opioid pain medication, cannabis can lower side effects, cravings, and the severity of withdrawals while also enhancing the analgesic effect.
One of the challenges that scientists encountered when researching the use of cannabis for chronic pain management was the Schedule I status of cannabis, making it difficult to carry out large-scale clinical studies on its efficacy. However, among studies that could research cannabis use for relieving pain symptoms, marijuana did show a degree of effectiveness. For instance, in their research, Reiman et al. (2017) found that patients reported successfully using cannabis along with or as a substitute for opioid medication. The patients in the study revealed that when using marijuana, they were able to use fewer opioids and that cannabis presented less unwanted side effects compared to opioid-based medication. Besides, 80% of patients reported that cannabis alone was more effective than their opioids (Reiman et al., 2017). This suggests that for individuals who substitute marijuana for opioid-based pain medication can have better outcomes with fewer undesirable side effects compared to other drugs.
The findings of the study suggested that patients involved in it overwhelmingly supported the idea that they could be more likely to use marijuana as a way of treating pain if it was more available and less stigmatized. Even though there are populations that can truly benefit from cannabis as alternative pain medicine, some people do not consider it because of social stigma and the legal limitations associated with its use. Because the prescription of opioids has not been curbed or addressed in the United States despite the growing rate of fatal overdoses and increasing dependence, cannabis should be seen as an alternative. Giving patients the option of cannabis for pain relief together or separately with the opioids option has the potential of assisting with pain relief symptoms in a safer way that causes fewer risks to health among the population.
Relevance of Findings
The findings of the studies on the effects of cannabis on relieving pain symptoms are relevant to the current PICOT question because they illustrate that marijuana use for pain relief has been widely overlooked despite the benefits it brings to patients. As the country’s legislation regulating marijuana changes and opens up more opportunities for alternative treatment, cannabis has great potential to be used for therapeutic purposes. In addition, the findings point to the need to conduct more research on this topic because the existing regulations on marijuana use limited previous studies. New findings will support the evidence-based practice and enhance it through the use of alternative pain relief methods.
Conclusion
This PICOT question paper explored the topic of alternative methods of relieving pain medication symptoms among patients with an emphasis placed on marijuana use. The consistent use of opioid-based medication as a pain relief method leads to adverse outcomes, including death from overdose. Therefore, the subject being studied is highly promising in terms of offering a new option for both scholars and practitioners to consider when dealing with patients who require assistance in relieving pain on a regular basis. Answering the PICOT question will allow for providing a basis for future studies as well as an evidence-based practice.
References
Abu-Baker, N. N., AbuAlrub, S., Obeidat, R. F., & Assmairan, K. (2021). Evidence-based practice beliefs and implementations: A cross-sectional study among undergraduate nursing students. BMC Nursing, 20(13).
Bachhuber, M. A., Saloner, B., Cunningham, C. O., & Barry, C. L. (2014). Medical cannabis laws and opioid analgesic overdose mortality in the United States, 1999-2010. JAMA Internal Medicine, 174(10), 1668–1673.
Bains, S., & Mukhdomi, T. (2022). Medicinal cannabis for treatment of chronic pain. StatPearls.
Boswell, C., & Cannon, S. (2018). Introduction to nursing research (5th ed.). Jones & Bartlett Learning
CDC. (2022). Understanding drug overdoses and deaths.
Reiman, A., Welty, M., & Solomon, P. (2017). Cannabis as a substitute for opioid-based pain medication: Patient self-report. Cannabis and Cannabinoid Research, 2(1), 160–166.