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21 cannapatientcare.com march/april 2021 | cannabis patient care nurse focus chronic pain issues from the illness or cancer treatments. When she f irst began seeing patients using cannabis, she didn't have much of a curiosity to explore it fur ther. How- ever, seven years ago she saw an increase in patients inter- ested in using the medicinal plant as par t of their cancer care treatment plan and decided to use the knowledge she gained from her personal experience with cannabis to help patients. Thus began her journey into the medical cannabis landscape. "It became really clear to me that most healthcare profes- sionals did not have good knowledge of cannabis and how to help patients access it safely and ef fectively," said Thei- sen. "Because of my personal experience, I decided to cre- ate a practice designed to help patients navigate cannabis as a medicine." Cancer patients suf fer from treatment side ef fects such as chemotherapy-induced peripheral neuropathy or severe bone pain related to their cancer diagnosis. Through the help of the internet, patients were doing their own research to f ind alternatives to alleviate or manage their symptoms. Theisen mentioned that patients were also turning to her for guidance. "I star ted to really help these patients answer questions, help them determine how to f ind a safe product," she said. "This was prior to legalization in California. We didn't have good regulations in place around testing." Before the legalization of cannabis in California, there weren't quality control (QC) or quality assurance (QA) reg- ulation standards to ensure that customers were being of- fered a safe product. "Products could be sold to patients and they could have high levels of molds or bacteria in them," said Theisen. Conventional treatment options have started to lose some of their appeal to those suffering from chronic pain condi- tions. More and more patients have been seeking out medical cannabis to treat their conditions rather than use traditional methods. Over the past seven years, Theisen has witnessed a lot of chronic pain patients who were on treatment plans con- taining medications such as opioids to manage their pain, be- come ineffective or have extreme side effects that greatly di- minish their quality of life. Cancer patients were being told to reduce their opioid prescriptions due to the growing epidem- ic of overdoses and addiction. With these reductions, patients weren't being offered any alternatives to help ease their dis- comfort. Being in pain, this was spurring the uptake in pa- tients looking into medical cannabis as a treatment option. "When my patients come to me for cannabis, for chronic pain, many of them are looking to also reduce their pharmaceutical intake," Theisen explained. "I see them improving their symp- tom management and also reducing their overall pharmaceutical burden." By helping patients switch over to the medicinal plant, Theisen was seeing their quality of life and medical conditions improve. Medical Cannabis Challenges: Stigma, Dosing, and More Due to the stigma surrounding cannabis, there are still patients who are hesitant to try it. Often, these kinds of patients have gone through conventional treatment plans and are at their last resort for seeking relief. Theisen said that there is still a part of them that carries the stigma of pot heads or stoners. "Most of my patients are older adults, so their average age is around 76. They were the generation that really did tell their kids to say no to drugs. They generally had harsh consequences if they found their kids were consuming drugs, particularly marijuana. They really struggle with allowing themselves to try it because they feel guilty about all these years that they demonized cannabis and now they're trying to come to it for their own condition management, symptom management," said Theisen. "It's often their grandkids that are trying to encourage them to use it, to look at it differently. It can definitely inhibit their ability to really explore the plant. That stigma can carry over in ways. For example, they may try it and they don't get results right away. They just say, see, I knew it and then they give up." For new patients, Theisen goes through their health his- tor y and inquires if they've used cannabis in the past such as in high school or college and if so how they reacted to the plant, negatively or positively. Par ticularly, most nega- tive experiences she heard were from edibles containing tet- rahydrocannabinol (THC). Most patients who come to Theisen though, haven't tried cannabis prior to seeing her. Occasion- ally, there are also patients who come in and are reluctant to use cannabis due to little information on medication reac- tions with the plant. When this situation occurs, Theisen de- scribes the experiences she has had with the more than 6500 patients she has treated. She also monitors her patients Eloise Theisen speaking at an American Cannabis Nurses Association (ACNA) conference in 2019.