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Initial Assessment and Treatment  

 

Initial visit checklist (regular pdf)

Provider Decision Tree

Medicinal Cannabis for Chronic Pain Provider Decision Tree

 

 

Research in the Use of Medical Cannabis

Medical marijuana research comes out of the shadows PBS Hour                                July 2016

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Model Guidelines for the Recommendation of Marijuana in Patient Care Report of the FSMB Workgroup on Marijuana and Medical Regulation Adopted as policy by the Federation of State Medical Boards April 2016

This policy document is intended as a resource to state medical boards in regulating physicians and physician assistants (or other licensees regulated by the board) with a full and unrestricted license participating in marijuana programs and may also be valuable in educating licensees as to the board’s expectations when recommending marijuana to a patient for a particular medical condition. The guidelines should in no way be construed as encouraging or endorsing physicians to recommend marijuana as a part of patient care.

 

 

 

Use of Cannabis in the Management of Neurocognitive Disorders:  Dementia & Neuropsychiatric symptoms (NPS) (Cannabis Rx) 

 

 

 

Cannabinoids for Medical Use: A Systematic Review and Meta-analysis

JAMA. 2015;313(24):2456-2473. doi:10.1001/jama.2015.6358

 

Understanding Cannabis in Psychiatry: Pharmacology and Synthetic Cannabinoids

What Can't Medical Marijuana Do?

Recent studies indicate that the drug is making seniors healthier and helping stem the tide of the opioid epidemic—all while making their health care cheaper.

 I didn't go to medical school to Rx Weed
 

What Pain Specialists Need to Know About Medicinal Cannabis

By Barth Wilsey, MD and Lisa Ellis

 

A growing number of states have approved medical marijuana (cannabis) to treat a variety of conditions, including neuropathic pain, spasticity, and pediatric epilepsy. Despite the increasing popularity of these treatments, there’s been an absence of uniform standards and guidelines in place to help medical professionals navigate the rapidly changing landscape in the most effective way. As a result, many pain specialists are left grappling with a host of important issues when it comes to incorporating cannabis into a broader pain treatment strategy. Here is some insight from an experienced practitioner on treating pain with cannabis.

Aim: Pain practitioners would seem to have an obligation to understand and inform their patients on key issues of the evidence base on cannabinoid therapeutics. One way to fulfill this obligation might be to borrow from concepts developed in the prescription of opioids: the use of a written agreement to describe and minimize risks. Regrettably, the widespread adoption of opioids was undertaken while harmful effects were minimized; obviously, no one wants to repeat this misstep.


Conclusions: Undoubtedly, the knowledge base concerning risks will be an iterative process as we learn more about the long-term use of medicinal cannabis. But we should start the process now so that patients may be instructed about our current conception of what the use of medicinal cannabis entails.

Links to websites and online publications:

National Institute on Drug Abuse (NIDA). NIDA Research on Marijuana and Cannabinoids. (last update March 2016)

 

A Report of the National Academies of Sciences, Engineering, and Medicine.  The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. 2017

 

Developed as part of the online training "Medicinal Cannabis and Chronic Pain" for health professionals, this toolkit contains a variety of resources and tools to assist providers with decision-making and patient care related to the use of medicinal cannabis for the treatment of various conditions, with a focus on chronic pain. These resources may be downloaded and used freely, with attribution as noted on each document, but may not be altered in any way or used commercially.

AMERICAN ACADEMY OF CANNABINOID MEDICINE

The AACM is a clinical medicine, scientific association. Its members are clinicians and researchers active in the field of endogenous, plant-derived and synthetic cannabinoids and those who support the medical use of cannabinoids. It is the gold standard for the education and dissemination of clinically relevant information in the emerging field of cannabinoid and endocannabinoid medicine.

Our focus is on the application of clinical and physiological studies of cannabinoids and the endocannabinoid system. We provide professional and legal support in the field of cannabinoid medicine. We educate both professionals and the lay public on cannabinoids and the endocannabinoid system.

Learn About Marijuana: Science-based information for the public

 

The CCIC is committed to engaging health care practitioners regarding therapeutic issues surrounding cananbinoids through access to on-line learning tools. This will serve to foster continued professional development of its members. The general public may also access general information on cannabinoids and links to other credible organizations.

The Association of Cannabis Specialists needs your involvement. It’s your voice that we seek to represent and it’s your dedication that’ll get us where we need to go. Both clinicians and non-clinicians are welcome.

 

Information for Health Care Professionals Cannabis (marihuana, marijuana) and the cannabinoids

 

Clinical Tools (From UW and CCIC)

 

Medicinal Cannabis for Chronic Pain Provider Decision Tree This tree can be used to determine whether medicinal cannabis is appropriate for your patient and assist in the development of a treatment plan. Adapted from Grant et al, 2012.

 

Patient Dosing Journal - Journal for patients to use when beginning treatment to record dose, frequency of use, pain levels, and functionality. From Healthy Whole Solutions.

 

Patient Treatment Agreement - A sample agreement, modified from an opioid treatment agreement, for use when establishing a treatment plan and guidelines with your patient.

Authorization Form - Documentation of health care professional's authorization to engage in the medical use of marijuana in Washington State (as required by RCW 69.51A.010(5). Must be printed on tamper-resistant paper.


 

UW Pain Tracker - This tool can be used to track improvements in pain-related symptoms over the treatment period.

Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) - This 8-item tool, developed by the World Health Organization (WHO), screens patients for substance use and related problems.

Marijuana Problem Scale - This 19-item assessment helps the patient identify areas in his or her life negatively affected by marijuana use, including social relationships, self-esteem, work/finances, motivation, physical health, memory, and legal problems.


 

Checklist for the Medical Assessment of the Patient Asking about Medical Cannabis (PDF)

This checklist is intended to be a reference tool for the evaluation of a patient for medical cannabis by a health professional. This is not intended for use as a screening questionnaire. This is not a validated clinical guideline. It is intended to provide a basis for a thorough assessment of the patient, their health status, risk factors, contraindications and expectations, to guide specific examination strategies, and to establish goals for medical cannabis use and monitoring.

Clinical Decision Tree — This tree can be used to determine whether medicinal cannabis is appropriate for your patient and assist in the development of a treatment plan. Adapted from Grant et al, 2012.

Cannabinoid Checklist — This intake checklist from the Canadian Consortium for the Investigation of Cannabinoids provides a simple outline for patient assessment, cannabinoid initiation, treatment objectives, and follow-up.

Checklist for the Medical Assessment of the Patient Asking about Medical Cannabis — This checklist is intended to be a reference tool for the evaluation of a patient for medical cannabis by a health professional. This is not intended for use as a screening questionnaire. This is not a validated clinical guideline. It is intended to provide a basis for a thorough assessment of the patient, their health status, risk factors, contraindications and expectations, to guide specific examination strategies, and to establish goals for medical cannabis use and monitoring.

Follow Up Assessment for Patients Treated with Cannabis 

Patient Dosing Journal — Journal for patients to use when beginning treatment to record dose, frequency of use, pain levels, and functionality. From Healthy Whole Solutions.

Patient Treatment Agreement — A sample agreement, modified from an opioid treatment agreement, for use when establishing a treatment plan and guidelines with your patient.

Authorization Form — Documentation of health care professional’s authorization to engage in the medical use of marijuana in Washington State(as required by RCW 69.51A.010(5). Must be printed on tamper-resistant paper.

Pennsylvania Medical Marijuana Program

Screening Tools (From UA)

UW Pain Tracker — This tool can be used to track improvements in pain-related symptoms over the treatment period.

Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) — This 8-item tool, developed by the World Health Organization (WHO), screens patients for substance use and related problems.

Marijuana Problem Scale — This 19-item assessment helps the patient identify areas in his or her life negatively affected by marijuana use, including social relationships, self-esteem, work/finances, motivation, physical health, memory, and legal problems.

 The Place of Cannabis in Treatment

 

Cannabis Recommendations

 

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Cannabis RX Checklist

 

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Pain related challenges

 

Continuing medical education (Lambert Center)

Cannabis Care Certification

Welcome to The Lambert Center for the Study of Medicinal Cannabis and Hemp, in the Institute of Emerging Health

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