NJSNA FACT Sheet: Medical Marijuana in New Jersey

Nurses are encouraged to visit one of the 7 current Alternative Treatment Center (ATC) websites to obtain additional information and education related to registration for medical marijuana patient, education related marijuana products and potential side effects, caregivers of medical marijuana patients, and much more.

The ATC’s are accessible through the New Jersey Department of Health: Division of Medicinal Marijuana https://www.nj.gov/health/medicalmarijuana/ .
The patient registration/caregiver registration site can be accessed at https://njmmp.nj.gov/njmmp/

The National Institute on Drug Abuse (2019) offers an informational fact sheet on marijuana that can help in answering questions about the use of marijuana and your health. https://www.drugabuse.gov/publications/drugfacts/marijuana

Hospitals, Nursing Homes, etc. who received federal funds, e.g Medicaid/other federal grants, etc. likely have a policy that does not allow for use of medical marijuana in their setting due to current federal guidelines related to marijuana. Therefore, patients would not be allowed to bring, use, or store their medical marijuana at any facility with a written policy related to federal funding and the Schedule I DEA rule. The DEA considers Schedule I drugs substances, or chemicals defined as drugs with no currently accepted medical use and a high potential for abuse. Some examples of Schedule I drugs are: heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), 3,4-methylenedioxymethamphetamine (ecstasy), methaqualone, and peyote https://www.dea.gov/drug-scheduling

All nurses working in a home environment, schools, or other public places or nurse designated caregivers or should avoid exposure to marijuana delivered by vaping or smoking, and wear gloves when handling oils, edibles, patches, tinctures, capsules or other products/food containing marijuana.

The NJ Board of Nursing definition:

“Impairment means an inability to function at an acceptable level of competency, or an incapacity to continue to practice with the requisite skill, safety, and judgment, as a result of alcohol or chemical dependency, a psychiatric or emotional disorder, senility or a disabling physical disorder”. (New Jersey Board of Nursing Law Department of Law and Public Safety, 2019, NJSNA, 2020)

Any nurse who demonstrates behavior and/or evidence of positive drug testing related to marijuana should be referred to the Institute for Nursing Recovery and Monitoring Program (RAMP) for impaired nurses. RAMP services offer impairment evaluation, counseling, and supportive rehabilitation programs to promote safe nursing practice in their employment. https://njsna.org/ramp/about-ramp/

(New Jersey Board of Nursing Law Department of Law and Public Safety, 2019; NJSNA, 2020)

The following are potential effects of marijuana use depending on the type of marijuana used, potency, amount, and experience of the user:

• Short term memory problems
• Impaired thinking/delayed decision making
• Loss of balance and coordination
• Decreased concentration
• Changes in sensory perception/distortions in time.
• Impaired ability to perform complex tasks
• Decreased alertness
• Decreased reaction time
• Paranoia
• Drowsiness
• Increase appetite
• Impaired of tracking ability

Although detectable amounts of THC may remain in the body for days or even weeks after use, the noticeable effects of smoked marijuana generally last from one to three hours and those of marijuana consumed in food or drink may last for many hours ( National Institute on Drug Abuse, 2019). https://www.drugabuse.gov/search/marijuana

In New Jersey, nurses cannot assist a patient with the administration of their medical marijuana unless they are a “registered caregiver“ for the patient. Currently, the 2 designated caregivers for a person registered with the NJ Medical Marijuana Program may assist the person with administration of the marijuana product as needed. Similarly, school nurses are not allowed to administer medical marijuana to a student or store marijuana products on campus for a student. The product must be administered by 1 of the 2 designated caregivers.

A licensed Advanced Practice Nurse (APN) may recommend and refer a patient to an Alternative Treatment Center for consideration of use of medical marijuana. The APN does not prescribe medical marijuana as it is listed by the DEA as a Schedule I drug. APNs’ can serve as medical care providers for a medical marijuana patient, similar to their other patients and assess the patient for recertification for the medical marijuana program when needed.

Drug screening:

Currently, many employers screen for drugs, including marijuana, as part of their pre-employment physicals. Drug screen policies vary and are established by each employer.
NJSNA recommends drug screening when evidence of impairment exists.

If my medical provider recommends use of medical marijuana, can I use medical marijuana and still practice?

It is important to remember that all licensees have a responsibility to ensure that their use of medical marijuana does not impair their ability to practice safely. Any use of medical marijuana while practicing that results in impaired practice should be reported to the Board of Nursing. Some health care facilities have a zero tolerance policy related to use of medical marijuana at work.

NJ Nurses are expected to demonstrate safe nursing practice following the ANA Code of Ethics 3.4, 3.5, and 3.6 in relation to the care of medical marijuana patients as well as nurses themselves who are prescribed medical
marijuana.

• ANA CODE OF ETHICS
  • Ethics 3.4 Professional Responsibility in Promoting a Culture of Safety
    • Nurses should participate in the development, implementation and review and adherence to policies that promote patient health and safety…. while assuring nurses are held accountable for individual practice
  • ANA 3.5 Protection of Patient Health and Safety by Acting on Questionable Practice
    • Nurses must be alert to and take appropriate action in all instances of incompetent, unethical, illegal or impaired practice …..and follow established practice and policy for reporting and handling questionable practices…
  • ANA 3.6 Patient Protection and Impaired Practice
    • Nurses must protect the patient, the public and the profession from potential harm when practice appears to be impaired….. take action to protect patients and to ensure that the impaired individual receives assistance…( ANA, 2015). https://www.nursingworld.org/coe-view-only

It is the nurse’s responsibility/decision to inform their employer that they are a registered medical marijuana patient. If indicated, NJSNA suggests the nurse be evaluated as “ FIT for duty “ from an independent health care provider who is capable of assessing FIT for duty.

References: 

American Nurses Association (ANA). (2015). ANA Code of Ethics for Nurses with Interpretive Statements.
https://www.nursingworld.org/coe-view-only 

DEA United States Drug Enforcement Administration. (n.d.). Drug Scheduling. Retrieved
https://www.dea.gov/drug-scheduling

National Institute on Drug Abuse (2019, December 24). Marijuana.
https://www.drugabuse.gov/publications/drugfacts/marijuana

New Jersey Board of Nursing Law Department of Law and Public Safety (2019, October 22)
https://www.njconsumeraffairs.gov/Statutes/nursinglaw.pdf#search=Board%20of%20Nursing

New Jersey Department of Health: Division of Medicinal Marijuana. (n.d.). Retrieved March 18, 2020, from
https://www.nj.gov/health/medicalmarijuana/

New Jersey State Nurses Association: Recovery and Monitoring Program (2020). Retrieved from
https://njsna.org/ramp/about-ramp/

State of New Jersey: Medicinal Marijuana Program. (n.d.). Retrieved March 18, 2020, from
https://njmmp.nj.gov/njmmp/

Verywell Mind. (2019) . Marijuana Detection Times.
https://www.verywellmind.com/how-long-does-marijuana-stay-in-the-system-67791

Written by:                                          Beth Knox DNP, APN
Formulated:                                        3/18/2020
Reviewed:                                           NJSNA Board Review 3/24/20
Revised:
Approved:                                           3/24/20