Cannabis Patient Care - March/April 2022

Cannabis Patient Care March/April 2022

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31 march/april 2022 | cannabis patient care nurse focus care providers, and mental health providers for veterans with spine pain and related mental health conditions. The Benefits of Integrative Medicine Integrative health care may include chiropractic therapy, yoga, meditation, and more. Integrative providers could include medi- cal doctors, Doctors of Osteopathy (DO), Physician Assistants (PA), or Nurse Practitioners (NP). Some are board-certified in integra- tive medicine, meaning they passed rigorous exams. Others are licensed therapists. Integrative health brings conventional and complementary ap- proaches together in a coordinated way. That approach empha- sizes multimodal interventions, which are two or more interven- tions such as conventional medicine, lifestyle changes, physical rehabilitation, psychotherapy, and complementary health ap- proaches in various combinations, with an emphasis on treating the whole person rather than, for example, one organ system. Casale discovered that that's the key for an integrative ap- proach using cannabis—it's all about trying to find whole per- son health. Whole person health refers to helping individuals improve and restore their health in multiple interconnected domains—biological, behavioral, social, and environmental— rather than just treating disease. Research continues on whole person health, including ex- panding the understanding of the connections between these various aspects of health, and connections between organs and body systems (such as the endocannabinoid system). One current NCCIH-funded study is testing the effects of adding mindfulness meditation, self-hypnosis, or other com- plementary approaches to pain management programs for veterans. The goal is to help patients feel and function better and reduce their need for pain medicines that can have seri- ous side effects. Building on Commitment In 2015, Casale completed her Diploma in Nursing Education from the University of Dundee and in 2018 she obtained her Master Science in Nursing Administration at Capella University, based in Minneapolis, Minnesota. Her husband, Stoly, a veteran, had gone through all the alternative interventions at the VA, such as epidurals and chiropractor adjustments. "They told him the only thing left is back surgery," she said. "He didn't want back surgery." Casale had been hearing about how some of the vets she was working with had used cannabis. "They kept coming in and saying that cannabis is really helping them, especial- ly with anxiety, PTSD, and their pain symptoms. So, I thought, when I graduate, I'm going to find out about this cannabis stuff because I know it really works," she said. "And I've just been diving into it." She has taken three certification courses: two were self-in- structed and the other was a 6-month course at the Pacific College of Health and Science based in Chicago, on a compre- hensive program of medical cannabis and she is learning more about it all the time. "It's one of those things where the more you know, the more you know you don't know." Casale has also been taking classes with Dr. Dustin Sulak at (4), who has a whole section on cannabis and opiate withdrawal. Dr. Sulak is an integrative medicine physician based in Maine, whose practice balances the principles of osteopathy, mind-body medicine, and medical cannabis. Regarded as an ex- pert on medical cannabis nationally, Dr. Sulak educates medical providers and patients on its clinical use, while continuing to ex- plore the therapeutic potential of this emerging medicine. Casale's given four presentations at Pacific College of Health and Science and is also an adjunct professor at Palm Beach Atlantic University School of Nursing, helping to mentor students during their psychiatric mental health nursing rota- tion in the clinical environment. She does the clinical for nursing students psych rotation with psychiatric mental health faculty, while the department chairperson does the didactics (lectures and theory) (5). "The department chairperson told me that during her didactics on substance abuse, I could come in and talk about the opioid epi- demic and cannabis," Casale said. "So, I gave a whole presenta- tion to students there. And the next day as I was doing clinical work, I was told that people paid more attention to my pres- entation than they had to anything all semester. I was glad to hear that. But I thought to myself: 'I don't think it was for me or my presentation. I think it was about the content.' These stu- dents are just hungry to learn about it. And there's no curricu- lum or even mention of cannabis in any nursing schools." That gave Casale an idea: Let's get the discussion about can- nabis going as soon as possible in teaching new nurses. "I called the NCSBN (the National Council of State Boards of Nursing), the Figure 1: Linda Casale, MSN, RN, PMHN-BC, the CEO, president, and founder of Whole Health Action Management (WHAM) veter- ans program.

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