The benefits of medicinal marijuana are being brought to light more and more, but in the state of Colorado where marijuana is legal, should school nurses be able to administer it? One Colorado family brought an amendment to Congress requesting just that. Currently, “Jack’s Law” in Colorado allows designees or parents to administer medical marijuana if appropriate but the amendment is looking to delegate that responsibility to nurses.
The amendment is known as “Quintin’s Amendment” and 9-year-old Quintin and his mother, Hannah, join via Skype to explain why they think it’s needed. Hannah explains that Quintin was diagnosed with epilepsy at 5-years-old. His doctors put him on medications that had both negative social and behavioral implications. A year and a half after being put on the seizure medications, Quintin started showing signs of Tourette Syndrome. The doctor added more medication to Quintin’s regimen and the seizures as well as Quintin’s violent attitude and behaviors returned. When the doctor suggested adding a third medication, Quintin’s parents decided to try something more natural instead.
They gave Quintin cannabis oil and within three weeks his seizures were under control and the Tourette ticks were gone! ER physician Dr. Travis Stork reminds viewers that CBD is the non-psychoactive component of marijuana. Quintin was allowed to have this medication at school but his mother had to come and administer it.
As a mother of five, Hannah says it wasn’t always feasible. It’s recommended that Quintin get three daily doses but because his mother can’t always be at school in the afternoon, he is now only getting two. “What if the school nurse could administer that middle-of-the-day dose?” It was out of that thought that “Quintin’s Amendment” was born. Hannah went to the house representative for her district and he wrote a law. They took it to the capital where it was named “Quintin’s Amendment.” It passed through both the house and senate with flying colors!
The Doctors invite the president of the Colorado Association of School Nurses, Patti Rojec, as well as the founder of the Cannabis Nurse Network, Heather Manus, to discuss their opposing views on this amendment. Patti’s association took a position of opposition to the legislation mostly due to their concerns about the nurses’ ability to safely administer the drugs at school. She explains nurses are expected to operate within a certain scope or standard and the question is, whether this is within that scope.
A major complication is malpractice insurance. Those carriers are not willing to cover this practice. Patti’s carrier told her directly that if administering medicinal marijuana became a part of her school nursing practice, she would be dropped.
Heather says she realizes this puts nurses in a position to work with medicine they haven’t been trained to work with and for that reason, her network takes on the role of educating other nurses to help them understand the importance of cannabis. “From a nursing perspective, when we have children who are medically fragile and seizures are the issues, it’s a lot more difficult to deal with a child having a seizure at school than it would be to just administer a few drops of cannabis tincture under the tongue or something like that.”
While both sides want the best for students with medical needs, dermatologist Dr. Sonia Batra says the nuances in this is, should this responsibility be placed onto school nurses or is it something that should directly be happening between the parent or caregiver and the school? School nurses previously haven’t been put in this position and they may lose their liability insurance.
Dr. Batra explains there is currently only one FDA-approved CBD oil derived medication for the treatment of seizures. The problem is most of these other CBD medications are from medical marijuana dispensaries so the dosing widely varies. The difficulty nurses now have, since it’s not FDA-approved, is that the drugs are not standardized, so it puts a lot of responsibility on the nurses. “I think everybody agrees that medically fragile kids need that extra attention, but is it an undue responsibility to place on the school nurses?” Dr. Batra says.
Dr. Travis asks Patti, how far away are we from school nurses in Colorado being able to feel comfortable from a liability and professional perspective in that they’re not going to lose their jobs for doing what most would consider the right thing?
Patti believes for this to happen, there needs to be more research that supports this medication. Heather argues that while in the U.S. research is limited, that’s not the case in other countries. She says the cannabis plant has been around for 5,000 years and there are tons of medical writings about the medicinal benefits. She points out that no one has ever died from an overdose. She believes once insurance companies can look at this from a risk/benefit perspective, they’re going to understand this is really one of the safest medications nurses could administer to patients.
While there is progress in that kids who need medicinal marijuana to control seizures now have access to it, this entire discussion is a moving target and it still remains to be seen what happens with nurses administering the drugs.