The Journal of School Nursing2024, Vol. 40(6) 595© The Author(s) 2023Article reuse guidelines:sagepub.com/journals-permissionsDOI: 10.1177/10598405221151087journals.sagepub.com/home/jsn
Dear Editor,
I am writing in regards to the article by Jochen and Holben, “School Nurse Perspectives of Medical Cannabis Policy in K-12 Schools: An Explorative Descriptive Study.” Key safety considerations for the school nurse (SN) were omitted. When an SN administers a prescription medication, they can rest assured that the FDA has approved the medication for human consumption and regulated its purity, concentration, and safe manufacturing process.
Cannabis sale and distribution remains illegal at the federal level due to its Schedule 1 designation. In the absence of FDA oversight, the burden falls on individual states to regulate and inspect cannabis products. While some states do authorize and regulate dispensaries, this is not true for all and the protections and restrictions of these regulations vary greatly by state (National Conference of State Legislators, 2022). A parent may acquire medical cannabis from a private source, through the internet, or an out of state seller. This means that there may not be a correlation between the label and the product contents delivered to school. Impurities may exist in the preparation and potential interactions with prescribed medication are unknown.
The absence of FDA approval also means that an appropriate, safe dosage has not been established (U.S. FDA, 2019). Instead, parents are left to determine their child’s dosage based on sources such as online parent forums, experimentation, or the advice of dispensary staff. Until December 2, 2022 when President Biden signed into law the “Medical Marijuana and Cannabidiol Research Expansion Act,” physicians could not legally discuss the potential harm and benefit of CBD, marijuana, and its derivatives with patients (H.R. 8454, 2022).
It is my hope that this article will challenge school nurses to become more familiar with federal and applicable state laws regarding medicinal cannabis and to support family choice whether or not they administer doses at school. Consider as well your state license implications and your duty to educate staff before the first request comes to administer medicinal cannabis during the school day.
Respectfully submitted,MaryAnn T. Strawhacker, MPH, BSN, RN, SEN Special Education Nurse Consultant, Iowa
MaryAnn T. Strawhacker https://orcid.org/0000-0003-3053-1358
All Info—H.R.8454—117th Congress (2021–2022): Medical Marijuana and Cannabidiol Research Expansion Act. (2022, December 2). https://www.congress.gov/bill/117th-congress/house-bill/8454/all-info
National Conference of State Legislators (NCSL). (2022). State medical marijuana laws. http://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx
U.S. Food and Drug Administration. (2019). FDA, FTC warn company marketing unapproved cannabidiol products with unsubstantiated claims to treat teething and ear pain in infants, autism, ADHD, Parkinson’s and Alzheimer’s disease. https://www.fda.gov/newsevents/press-announcements/fda-ftc-warn-company-marketingunapproved-cannabidiol-products-unsubstantiated-claims-treat-teething
