Introduction
The use of medical marijuana is still debatable across the USA, although it was legalized in many states. As far as Minnesota is concerned, the Medical Cannabis Therapeutic Use Act (developed by Governor Dayton) was signed into law in 2014 (Minnesota Department of Health, 2017b). Since then, thousands of residents of the state have used this type of treatment and reported its positive effects. For instance, 90% of the participants of a survey implemented by the Minnesota Department of Health mentioned the positive effects of the treatment (Collins, 2016).
Minnesota Medical Cannabis Program was one of the results of the new law. The program implied the provision of certain treatment (prescriptions of medical cannabis) to certain groups of patients (Minnesota Department of Health, 2017b). However, there are still many opponents who consider the use of medical cannabis to be harmful to patients as well as the overall public health. This paper includes a brief analysis of the program and the reform strategy associated with it.
Policy Strategy
As has been mentioned above, the program was launched in 2014 when the corresponding legislature was introduced. The program is accessible to patients suffering from certain chronic conditions that are certified by their physician and registered with this program (Minnesota Department of Health, 2017b). The chronic conditions include cancer, HIV/AIDS, glaucoma, seizures, intractable pain, a terminal illness with an estimated life expectancy of one year or less, and some other.
The strategy under analysis implies the inclusion of other health issues (for example, post-traumatic stress disorder) on the list. It is noteworthy that the patients diagnosed with PTSD are planned to be included in August 2017.
It has been found that cannabis has an obvious positive effect on such patients’ health conditions as their sleep improves significantly, which leads to the effective management of other symptoms of the disorder (Bonn-Miller, Babson, & Vandrey, 2014). Considerable attention is also paid to the use of marijuana in pain management. Shah, Craner, and Cunningham (2017) report about the positive effects of the use of cannabis among patients suffering from chronic pain.
Another characteristic feature of the strategy is its focus on funding. It becomes apparent that the existing funding is insufficient due to an overwhelming number of tests and inspections (Potter, 2017). Marijuana is still one of the Schedule I controlled substance, which leads to an unprecedented level of control over its production, distribution, and consumption. As far as patients are concerned, one of their major concerns is the high fee of the registration and the high costs of their prescriptions (Collins, 2016). Many find this type of medication inaccessible.
Advocates of the program try to ensure additional federal funding is aimed at improving the program and making it more accessible. The most optimistic supporters of the program and the use of medical cannabis advocate for the inclusion of this treatment to Medicaid and other insurance packages and programs. However, this is unlikely to happen soon due to marijuana’s status as one of the most dangerous illicit drugs.
It is necessary to note that the number of patients enrolled in the program is approximately 1,500 each month, which unveils quite a high demand for this kind of treatment in the state (Collins, 2016). Bonn-Miller et al. (2014) note that over 100 million Americans suffer from chronic pain, and the elderly can be regarded as the group at a high risk of development of the conditions included in the program.
The demographic trends in the USA (aging population) put to the fore the need to come up with cost-effective types of treatment. The use of cannabis is one of these approaches. The reform strategy aims at helping all those in need to access the treatment that can improve their quality of life. Walsh et al. (2017) claim that the use of medical marijuana has proved to be efficient when addressing numerous mental disorders.
Finally, the strategy also implies the development of more cost-effective production and distribution methods. Potter (2017) states that some policymakers try to come up with the legislature that will reduce taxes for marijuana producers. At that, the status of the Schedule I controlled substance makes it impossible to achieve this goal. Therefore, the change in the status of the substance is another area of discussion. This change may lead to a decrease in the number of inspections, which will result in the reduction of costs and prices for patients.
Endorsement
The American Nurses Association is one of the most powerful nursing organizations that can have a substantial impact on policymakers, healthcare professionals, and facilities, as well as public opinion. The mission of the ANA is to improve the health of all people through the development of the profession (American Nurses Association, 2016). The organization is created by and for healthcare professionals who spend more time with patients as compared to other health professions.
The ANA emphasizes that nurses often know their patients’ needs. The organization revealed its updated position concerning the use of medical cannabis in 2016. The ANA stresses that it has advocated the use of marijuana and some other cannabinoids for 20 years.
The organization provides several arguments for the use of this substance (ANA, 2016). First, extensive research reveals definite positive effects of the use of medical marijuana. Furthermore, it is stressed that the major goal of the US healthcare system is to improve people’s well-being through the use of the most cost-effective treatment. Finally, patients have the right to use the treatment they find optimal for them, which is one of the characteristic features of a democratic society.
The association also provides certain recommendations that include the relisting of cannabis from Schedule I to Schedule II controlled substance. The ANA also claims that further research is essential for the evaluation of benefits and possible hazards of the use of this substance. It is also noted that the development of clear standards concerning the prescription, the most effective routes, possible side effects, and the like, is necessary.
It is necessary to note that this position statement, as well as the strategy in question, is consistent with the organization’s mission. The association aims at meeting the needs of the American population, and the use of medical cannabis can be one of the ways to achieve this goal. The reform strategy can also be instrumental in achieving these objectives. For instance, the inclusion of more health conditions on the list can improve the programs’ accessibility as more Americans will benefit from the use of medical cannabis.
Strengths of the Strategy
The strategy is characterized by a number of strengths. First, it will increase the accessibility of the treatment that has proved to be cost-effective in many settings. One of the major benefits is related to effective pain management. Shah et al. (2017) stress that chronic pain is a common symptom millions of Americans have to address. As for Minnesota, cancer is the major cause of death, while other chronic conditions are also common (for example, chronic lower respiratory disorders are the number 4 cause of death) (Minnesota Department of Health, 2017a).
It is important to remember that chronic conditions mainly persist in the aging population. The rate of elderly people in Minnesota is 15%, but it is estimated to almost double in approximately two decades. Hence, the use of medical marijuana and further widening of the list of illnesses and populations eligible to be included in the program will help more people access high-quality healthcare services and improve their well-being.
Apart from the strength mentioned above, the benefit of the strategy is related to the efficacy of health care. The existing types of treatment are associated with diverse side effects, including the development of addictions and increased risks of developing other disorders. Scientific evidence suggests that medical marijuana has fewer side effects and better health outcomes. The patients enrolled in the program mentioned above stress that their emotional state has improved, and the symptoms of their chronic conditions have become less disturbing (Collins, 2016). It can also be stated that the quality of healthcare services provided improves since the treatment provided is beneficial for patients. Therefore, it is possible to assume that the use of medical cannabis will improve people’s overall well-being.
Another important strength of the reform strategy is related to its financial aspect. The reform can have a positive impact on state and federal funds allocation. Potter (2017) states that medical use of cannabis is associated with significant financial losses for the producers of the substance as well as healthcare providers. The control over various processes (production, prescription, distribution, etc.) requires substantial funds. At that, the investigation of the program’s impact can help use funds wisely.
The program can also have certain implications for the existing legislature. For instance, the allocation of additional funds is likely to result in a wider discussion of the problem. The number of tests and inspections can be reduced, while more effective ways to control the production and use of medical cannabis can be developed. Importantly, scientific evidence, clinical trials, and the position of healthcare providers can have an impact on the status of marijuana. Eventually, it can become a Schedule II controlled substance, which, in turn, will lead to fewer inspections, lower costs, increased accessibility of this type of treatment.
Weaknesses of the Reform Strategy
Although the benefits of the strategy are obvious, it still has certain weaknesses. First, it requires the allocation of additional funds that are often scarce. The federal and state budgets have been decreased, which has put a certain pressure on the development of various programs. Such debatable topics as the use of medical cannabis often receive less funding as opponents try to downsize the relevance and positive impacts of programs (Potter, 2017). To address this weakness, it can be effective to address charities, individuals, and some health-related corporations to donate or contribute to the development of the program.
Besides, many researchers and practitioners note that further research into the matter is crucial as many aspects of the use of medical cannabis are still obscure. For example, the increased use of medical marijuana can be associated with the rise of its use among the American youth (Stolzenberg, D’Alessio, & Dariano, 2016). Shah et al. (2017) note that some studies show that patients using medical cannabis are at a higher risk of developing substance addiction though it is also added that further research is needed to explore the possible correlation.
Bonn-Miller et al. (2014) note that the effectiveness of the use of medical marijuana as compared to other pain management strategies is not sufficiently explored. Clearly, the only way to address this gap is to continue investigating various effects of the medical use of cannabis, its cost-effectiveness, and so on.
One of the most significant weaknesses of the strategy is associated with the development of a dialogue with the public as well as other stakeholders (governmental institutions, cannabis producers, etc.) (Potter, 2017). Even the program itself is not properly publicized. The lack of such communication contributes to the development of negative attitudes towards the use of medical marijuana, although the majority of those who use it view this type of treatment positively.
This weakness can be addressed through the launch of a wide-scale campaign aimed at informing people about the program as well as its possible improvements. Such media as television and the Internet can be used. Social media can become the primary platform for sharing information and facilitating the discussion. Of course, it is critical to involve healthcare facilities, patients, their close ones, officials, and so on in the discussion.
Conclusion
On balance, it is possible to state that the program, as well as the associated reform strategy, can help many Americans suffering from chronic diseases, improve the quality of their life. Pain management can become more effective as medical marijuana has proved to be an effective type of treatment. The strategy is characterized by several strengths that include the focus on the accessibility of treatment, possible financial outcomes for the stakeholders, as well as positive changes in the legislature. At the same time, it is necessary to mention certain weaknesses. These include the need for substantial investments, insufficient scientific and clinical evidence, and the lack of proper communication between the stakeholders.
The use of medical cannabis has been a debatable issue for decades, and many heal-related organizations have developed certain statements concerning the matter. For instance, the American Nursing Association is one of the proponents of the program and the reform strategy in question. The organization claims that the use of medical cannabis can significantly improve patients’ well-being and the quality of health care. At the same time, there are still numerous opponents to this type of treatment, as many still regard marijuana as one of the most dangerous illicit drugs. The debate is unlikely to stop anytime soon.
However, it is clear that further research is needed. It is also important to ensure the development of an effective dialogue among health-related organizations, governmental institutions, patients, charities, and individual donors, as well as the entire American society. People should choose whether marijuana use can be a type of treatment, or it should be banned. This kind of decision will result in more effective methods of funds allocation and the overall improvement of the healthcare system.
References
American Nurses Association. (2016). Therapeutic use of marijuana and related cannabinoids. Web.
Bonn-Miller, M., Babson, K., & Vandrey, R. (2014). Using cannabis to help you sleep: Heightened frequency of medical cannabis use among those with PTSD. Drug and Alcohol Dependence, 136, 162-165.
Collins, J. (2016). Medical marijuana is helping, patients say, but it’s unaffordable. MPR News. Web.
Minnesota Department of Health. (2017a). 2015 Minnesota county health tables. Web.
Minnesota Department of Health. (2017b). Minnesota medical cannabis program: A guide for patients. Web.
Potter, K. (2017). Minnesota’s medical marijuana program needs more money. MPR News. Web.
Shah, A., Craner, J., & Cunningham, J. (2017). Medical cannabis use among patients with chronic pain in an interdisciplinary pain rehabilitation program: Characterization and treatment outcomes. Journal of Substance Abuse Treatment, 77, 95-100.
Stolzenberg, L., D’Alessio, S., & Dariano, D. (2016). The effect of medical cannabis laws on juvenile cannabis use. International Journal of Drug Policy, 27, 82-88.
Walsh, Z., Gonzalez, R., Crosby, K., S. Thiessen, M., Carroll, C., & Bonn-Miller, M. (2017). Medical cannabis and mental health: A guided systematic review. Clinical Psychology Review, 51, 15-29.