Cannabis continues to be classified federally as a Schedule I Controlled Substance (Drug Enforcement Administration [DEA], n.d.); however, with growing cultural acceptance of cannabis, increasing numbers of states have legalized medical and/or recreational usage (National Conference of State Legislatures [NCSL], 2017). This contradiction between federal and state laws has created uncertainty for the school nurse when cannabis products are brought into the school setting for administration to students.
Therefore: it is the position of the National Association of School Nurses (NASN) that only FDA approved cannabis/marijuana medications be allowed in the school setting.
In addition, NASN recommends that school nurses should be knowledgeable in the following principles, which create a foundation for safe and informed nursing care of patients using medical or recreational cannabis (adapted from National Council of State Boards of Nursing (NCSBN) Guidelines for the Nursing Care of Patients Using Marijuana, 2018):
- The school nurse shall have a working knowledge of the current state of legalization of medical and recreational cannabis use in the state/jurisdiction in which they practice.
- The school nurse shall have a working knowledge of their state/jurisdiction’s medical marijuana program, if applicable.
- The school nurse shall have an understanding of the endocannabinoid system, cannabinoid receptors, cannabinoids, and the interactions between them.
- The school nurse shall have an understanding of cannabis pharmacology and the research associated with the medical use of cannabis, and any Federal Drug Administration (FDA) approved cannabis-type medications.
- The school nurse shall be able to identify the safety considerations for patient use of cannabis as it relates to the school setting.
- The school nurse shall approach the student and family without judgment regarding their choice of treatment or preferences.
The NCSBN has provided guidance for nurses across the country regarding the administration of cannabis in a professional setting. School nurses can also benefit from this guidance (NCSBN, 2018).
Considerations for the NASN position include:
- Substances classified as Schedule I Controlled Substances are considered to have no accepted medical value and present a high potential for abuse. Cannabis and its derivatives have been classified as Schedule I Controlled Substances since the enactment of the Controlled Substance Act in 1970. This Drug Enforcement Administration classification not only prohibits practitioners from prescribing cannabis; it also prohibits most research using cannabis except under rigorous oversight from the government’s National Institute on Drug Abuse.
- Research on the efficacy of cannabis for treatment of certain medical conditions is limited and lacking, specifically related to indications, dosage, route, safety, adverse effects, and long-term effects of cannabis (NCSBN, 2018).
- There are limited studies that might show some efficacy for a narrow range of symptoms. Without evidence that is scientifically rigorous, reportable, and based upon the student population, safe administration of cannabis has not been established for use in the school setting (NCSBN, 2018).
- School nurses must be well-informed about cannabis and how it affects the body, so safe nursing care can be provided at school.
- The school nurse must work closely with parents who are using cannabis-based products for their children, so that appropriate planning and care coordination may occur, as based on the foundation of the 21st Century Framework for School Nursing Practice (NASN, 2016).
Adopted: January 2019
Controlled Substances Act (CSA), 21 U.S.C. § 801, et seq. (DEA). Retrieved from: https://www.dea.gov/drug-scheduling
National Council of State Boards of Nursing. (2018). The NCSBN National Nursing Guidelines for Medical Marijuana. Journal of Nursing Regulation, (9) 2, S6-S21. Supplement. doi.org/10.1016/S2155-8256(18)30083-8
National Conference of State Legislatures. (2017). State medical marijuana laws. Retrieved from: www.ncsl.org/research/health/state-medical-marijuana-laws.aspx
National Association of School Nurses. (2016). Framework for 21st century school nursing practice. NASN School Nurse, 31(1), 45-53.doi: 10.1177/1942602X15618644
Suggested Citation: National Association of School Nurses. (2019). Cannabis/Marijuana (Position Brief). Silver Spring, MD: Author.
All position briefs from the National Association of School Nurses will automatically expire 18 months after publication unless renewed and recommended for position statement or other NASN document development.