Written by Eloise Theisen, NP and Katherine Golden, RN

Imagine hearing how cannabis can help with pain, anxiety, or sleep. You ponder this information from a friend, relative, or the internet and wonder whether it would be appropriate for or not. You ask your healthcare provider. But they do not know enough about it because it’s not taught in medical or nursing school. They may give you the go ahead to try it, but then what? How do you proceed? Who do you trust to get accurate information? That’s where Leaf411 and the Leaf Nurse Network come in…

Leaf411’s first program, the hotline, launched in 2019. It was our answer to the broken healthcare system of only getting the quality of healthcare you could access and afford. How can everyone, no matter their financial status or location, get the same professional service as others? Even though it seemed like an antiquated solution to some, we stood firm in the phone line concept. Many people suggested an app because younger people would rather type than speak over the phone. Our approach is to enable each and every caller to be fully present while we guide them. We feel that is best achieved via a 1-on-1 conversation. We wanted anyone, at any given moment, to be able to ask their specific questions about cannabis use. We know how deep the stigma still lies within the general public. Now we have nurses covering the hotline and have included a chat service so that those who are uncomfortable speaking in person have an option to get their questions answered.

Nurses remain the most trusted profession 19 years in a row. And worldwide, there are over 28 million nurses which means we out number physicians 3:1.^1,2 It is no wonder that nurses are ready and able to meet the needs of patients. Beyond gaining the public’s trust and respect, nurses are educators, counselors, leaders, and advocates. We promote health and wellness, interpret patient information, conduct research, and improve practices and patient outcomes. And yet nurses are rarely employed by cannabis companies or considered integral to the industry. In addition to offering credibility, nurses can collect data, identify trends, provide training and education, and coach patients through the medical cannabis process.

Cannabis use has grown tremendously in the last decade. Public opinion and acceptance of the plant is at an all time high. As more people consider cannabis for symptom management, healthcare professionals must be prepared to guide them on safe and effective use. But most medical and nursing schools do not teach about cannabinoid sciences. In fact, most providers have a huge knowledge gap around cannabis.

On the other side of the coin, patients rely heavily on cannabis industry professionals to guide them on the best options and demystify the cannabis preparations available. For example, dispensary workers are generally on the frontlines when patients seek cannabis-based medicine. The issue is that dispensary workers are not medical professionals and will likely have a huge knowledge gap around the study of diseases and medications. Patients using cannabis deserve to have qualified, knowledgeable healthcare professionals to guide them through the process.

Leaf411 was created to solve this issue of where to go for trusted, accurate information. With the growing amount of evidence-based information available online, it is difficult and overwhelming for the average consumer to navigate. Leaf411 was started as a public service non-profit to provide consumers with free information from trained cannabis nurses. Now anyone can get the same, professional, high-quality healthcare from cannabis trained nurses without having to worry about costs or whether they are in a legal state.

Cannabis nursing is still being defined. The American Cannabis Nurses Association (ACNA) has released their scope and standards to further move towards credentialing cannabis nurses. In 2018, the National Council of State Boards of Nursing (NCSBN) released guidelines on how to care for patients using cannabis. Over the last two plus years, we have seen schools like Pacific College of Health and Sciences, Thomas Jefferson University, and University of Maryland develop educational programs on cannabinoid science for healthcare professionals. As these organizations grow, there will be more healthcare workers who are educated in evidence-based cannabinoid medicine and prepared to meet the needs of patients. Our organization has cannabis trained registered nurses at the ready.

The Leaf411’s team of nurses are held to a high standard. They go through multiple cannabis education courses with Radicle Health, Healer, and Society of Cannabis Clinicians. Education is always ongoing. With a rapidly evolving field of medicine, it is important that the nurses stay up to date with the science. Recently Leaf411 initiated nursing roundtables to discuss common questions to assess the research and ensure that the responses are evidence-based. The answers may not always be evident. We are committed to keeping up with the science so consumers can use cannabis safely and effectively.

On any given day, our organization receives calls from the general public looking for answers regarding cannabis consumption. No two days are the same. When the hotline opens at 8am MT, the calls and chats are already coming in. Sometimes there are voicemails from the night before. Some days, the phone is ringing and the chats are coming in simultaneously. It is typical to have 5-10 calls and chats come through in the first few hours of operation. We triage up to 20 each day on average. Our nurses are often juggling numerous inquiries at once. It can be a high paced environment. Leaf411 nurses need quick access to policies, procedures, evidence-based research, and state laws and regulations. This is because our callers come in from over 44 different states with a wide variety of questions.

Over 65% of our callers are older adults who are seeking guidance on how to safely and effectively incorporate cannabis into their treatment regimen. Many of them are new to cannabis and trying to figure out where to begin. Their typical questions include:

• Do I take CBD or THC for pain?
• Does cannabis interfere with the medications I am taking?
• What is the best product for sleep?
• My doctor approved of me using cannabis but they do not know anything about it- where do I begin?
• Is cannabis safe?
• Will CBD get me high?

On occasion, there is a call that requires some further investigation. Cannabis nursing is an emerging specialty and it is important to stay up to date and informed. But sometimes, the research is not available. Most recently, we have seen an increase in Delta-8 THC products sold over the counter under the guises of ”hemp”. There are still a lot of unknowns with Delta-8 THC and yet there are many consumers purchasing and consuming gummies, tinctures, and vaporizer products. A recent caller had unknowingly ingested Delta-8 THC gummies and was concerned that he would then fail a drug test. The nurse that spoke with him was able to do a quick search and provide the caller with some information and reassurance. Within 20 minutes, the caller had his questions and concerns answered. He was able to make informed decisions about how best to proceed, all at no cost.

Having a free, anonymous cannabis hotline gives the consumer the confidence to call with personal questions that result in honest answers. Leaf411 nurses are on the frontlines of consumer usage. We are able to identify trends, collect information, and provide resources to ensure consumers are accessing cannabis safely and effectively. Without a trusted resource, many consumers are at risk of using cannabis inappropriately. Cannabis can be a powerful tool. Those who use it, or would like to try, deserve a qualified healthcare professional to guide them.

The hotline gave us an opportunity to truly get to know the cannabis consumer across the country. While we are documenting our calls and chats, we are learning about the average cannabis consumer. We collect non-identifying personal data from each and every caller, all anonymous, all optional. We ask questions like, zip code, ethnicity, annual household income, gender, if they have a medical cannabis card in their state, details about their cannabis use, and what were their successes and failures. We are able to collect valuable information that indicates market trends to better understand the cannabis consumer. This is useful not only on the local level, but also internationally. We have taken calls from almost all 50 states and have taken chats from consumers outside of the USA. Our future is focusing on fast and precise growth with increased data points to share that we collect from our hotline, a chat feature, a virtual Leaf Learning Series, and our Affordability Program.

We will continue hearing about the cannabis consumer and how Leaf411’s data helps the industry learn about market trends by allowing the nurses to do what they do best….triage.

Katherine Golden, RN

Katherine Golden, RN, has served the medical community for over 26 years and for the past 6 years has worked as a cannabis nurse educator. She the CEO, Executive Director & Founder of Leaf411. Katherine has obtained several cannabis-nursing certificates through The Medical Cannabis Institute Global, Radicle Health Cannabis Therapeutics of Medical Professionals and is Healer Certified. She is a proud member of American Cannabis Nurses Association, Cannabis Nurse Network, Americans for Safe Access and a member of numerous other cannabis related patient and professional advocacy groups to ensure she is up to date on the latest science and the most current issues.

Eloise Theisen, RN, MSN, AGPCNP-BC

Eloise Theisen is an adult geriatric nurse practitioner living in Northern California. Eloise continues to advocate for patients at the local and national levels and has successfully increased access in local cities. Eloise continues to develop continuing cannabis education for healthcare professionals, and worked with over 25 nurse practitioner students who have shown a special interest in cannabis medicine. She is currently the President of the American Cannabis Nurses Association.
 

Further Reading

• Cannabis Nurses Share Info from the Front Lines
• Cannabis Nurses Answer Common Patient Inquiries
• A Day in the Life of a Cannabis Nurse
• Patient Education is a Phone Call Away: An Inside Look at a Cannabis Nurses Hotline
• Cannabis use in palliative care – an examination of the evidence and the implications for nurses