Abstract

Abstract Many pediatric oncology patients report medical marijuana (MMJ) and hemp-based cannabidiol (CBD) use. Nearly 4,000 minors are registered users of marijuana in Colorado, the first state in the United States of America (USA) to legalize recreational marijuana. Medical marijuana is legalized in 37 states and four territories in the USA. Additionally, due to the bipartisan Farm Bill passed in December of 2018, hemp is federally legal. Forty-three countries have also legalized medical marijuana. With increased legality and many countries decriminalizing marijuana, the use of MMJ and hemp-based CBD is also increasing. This upsurge in use raises significant concerns with pharmacological interactions with CBD and the medications routinely administered to children with cancer (including chemotherapy). Cannabis-derived pharmaceuticals can also have pharmacological interactions. Nurses are the frontline for discussions with patients about MMJ and must be aware of the emerging field of MMJ in pediatric cancer. Education including the difference between tetrahydrocannabinol (THC) and CBD and their indications, extraction methods and safety, product types, infection control, and dosing considerations are important for nurses to learn. Nurses with increased knowledge will then help patients and families make educated and safer choices in treating their children for tumor treatment and side effect management with MMJ and hemp-based CBD. Additionally, nurses can influence patient care protocols and processes for alternative therapy administration enabling an open dialogue between providers, parents, and patients regarding treatments, symptoms, adverse effects, and drug interactions.

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