Massachusetts Marij-thon: Comprehensive Medical Marijuana Course

Just like a marathon, you’ll start at the beginning, quickly cover lots of ground, have an incredible journey of learning AND fulfill the Cannabis Control Commission (CCC) of the Commonwealth of Massachusetts education requirement for certifying patients for medical marijuana!!!

$299.00

Bulk pricing is available! Click here to learn more.

Overview

Just like a marathon, you’ll start at the beginning, quickly cover lots of ground, have an incredible journey of learning AND fulfill the Cannabis Control Commission (CCC) of the Commonwealth of Massachusetts education requirement for certifying patients for medical marijuana!!!

 Your patients will appreciate that you chose to go the extra distance in being prepared to address their health questions related to the endocannabinoid system and the clinical aspects of medical marijuana.

Massachussetts Marij-thon: Comprehensive Medical Marijuana Course provides a total of 4.0 credit hours and includes the following three courses:

1. The Comprehensive Medical Marijuana Curriculum introduces the reader to the endocannabinoid system and its interaction with the components of the cannabis plant, and addresses administration, therapeutic use, drug metabolism, physiologic and cognitive effects, potential risks, and drug interactions.

The use of marijuana in obstetric patients, pediatric patients, adolescent patients and elderly patients is addressed in detail.  Important considerations for patients with ischemic heart disease, hepatic disease, psychotic illness, and those with a history of drug dependence are provided.

2. Health Effects of Marijuana and Cannabinoids in Epilepsy describes how the endocannabinoid system may affect seizure threshold, and reviews the available research and clinical evidence for the use of marijuana or cannabinoids in the treatment of epilepsy.  In addition, there is a discussion about an FDA-approved cannabis-based medicine for the treatment of Dravet syndrome and Lennox-Gastaut syndrome which are two rare and severe forms of epilepsy.

3. Legal and Medical Considerations in the Recommendation of Medical Marijuana provides a thorough review of the considerations associated with the recommendation of medical marijuana, and information on the prescribing of FDA-approved cannabinoid-based medicines.

Subscribers can complete this CME/CE activity and refer back to the content at any point during their 12-month subscription period.

Content provides Accreditation Council for Continuing Medical Education (ACCME),  Accreditation Council for Pharmacy Education (ACPE), American Association of Nurse Practitioners (AANP), American Nurses Credentialing Center (ANCC), and American Psychological Association (APA) credits.

I don’t plan on recommending marijuana…why would I take this course?

Whether or not you have any intention of recommending medical marijuana for patient care, you need to be well educated in this clinical area because your patients will be seeking your expert advice and guidance for this medication. Further, some of your patients may already be utilizing medical marijuana and you will need to be aware of its physiologic effects as well as its  potential drug interactions. As such, expertise in the endocannabinoid system and medical marijuana is paramount for most doctors, pharmacists, nurses, psychologists, and other allied health professionals to remain that respected guide for their patients’ overall healthcare.

Table of Contents:

The Comprehensive Medical Marijuana Curriculum is comprised of 4 lessons:

  • Lesson 1: The Endocannabinoid System and Phytocannabinoids

Lesson 1 introduces the reader to the endocannabinoid system and its interaction with the components of the cannabis plant. Lesson 1 also includes an explanation of the  pharmacological properties of the major and minor phytocannabinoids.

  • Lesson 2: Marijuana Products, Modes of Administration and Pharmacokinetics

Lesson 2  discusses a variety of  marijuana products, various modes of administration and the pharmacokinetic properties of marijuana and cannabinoid-based products.

  • Lesson 3: Precautions: The Use of Cannabinoid-based Drugs in Special Patient Populations and Cannabinoid-based Drug Metabolism and Potential Cannabinoid-based Drug Interactions

Lesson 3 addresses the use of marijuana in obstetric patients, pediatric patients, adolescent patients and elderly patients.  Important considerations for patients with ischemic heart disease, hepatic disease, psychotic illness, and those with a history of drug dependence are provided, as well. Lesson 3 also discusses cannabinoid-based drug metabolism and potential cannabinoid-based drug interactions.

  • Lesson 4: Physiologic and Cognitive Effects of Marijuana

Lesson 4 provides a detailed description of the physiologic and cognitive effects of marijuana.

The Health Effects of Marijuana and Cannabinoids in Epilepsy is comprised of 1 lesson:

  • Lesson 1: The Health Effects of Marijuana and Cannabinoids in Epilepsy

Lesson 1 describes how the endocannabinoid system may affect seizure threshold, and reviews the available research and clinical evidence for the use of marijuana or cannabinoids in the treatment of epilepsy.  In addition, there is a discussion about an FDA-approved cannabis-based medicine for the treatment of Dravet syndrome and Lennox-Gastaut syndrome which are two rare and severe forms of epilepsy.

Legal and Medical Considerations in the Recommendation of Medical Marijuana (Along with Information on the Prescribing of FDA-approved Cannabinoid-based Medicines) is comprised of 3 lessons:

  • Lesson 1: The Laws, The Rules and The Regulations

Lesson 1 discusses the legal issues impacting the production, distribution and use of medical marijuana.  Specifically, this lesson describes the statutes, judicial decisions, and administrative efforts which have shaped the federal posture and influenced the ability of individual states to enact medical marijuana programs.

  • Lesson 2: Recommending Medical Marijuana

Lesson 2 begins with a discussion of the Federation of State Medical Boards’ “Model Guidelines for the Recommendation of Marijuana in Patient Care” and then transitions into a discussion about the medical literature on the health effects of marijuana use.  Specifically, the National Academies of Science, Engineering and Medicine’s 2017 publication, The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research will be described in detail.  Lesson 2 also addresses interpreting the results of studies that examine the effects of marijuana use.

  • Lesson 3: The FDA Drug Approval Process and FDA-approved Cannabinoid-based Medicines

Lesson 3 reviews the United States Food and Drug Administration’s (FDA) drug approval process, and provides a description of cannabinoid-based medications that have been approved by the FDA.

 

Editorial Team

Editor-in-Chief:
Meredith Fisher-Corn, MD

Founding Editor-in-Chief:
Stephen B. Corn, MD

CME-Certified Activity

Target Audience

The educational design of this activity addresses the needs of physicians, nurses, nurse practitioners, pharmacists, and psychologists interested in the use of cannabinoids.

CME Certification

Content provides Accreditation Council for Continuing Medical Education (ACCME), Accreditation Council for Pharmacy Education (ACPE), American Association of Nurse Practitioners (AANP), American Nurses Credentialing Center (ANCC), and American Psychological Association (APA) credits.

This curriculum offers up to 4 hours of ACCME, ANCC, ACPE, AANP, and APA credit. Full accreditation information is available upon purchase.

Educational Objectives

After completing this activity, the participant should be better able to:

  • Describe the endocannabinoid system
  • Discuss the components of the endocannabinoid system 
  • List some of the many functions of the endocannabinoid system
  • Define cannabis
  • Define marijuana
  • Define hemp
  • Define phytocannabinoid
  • Describe some of the phytocannabinoids
  • List a variety of marijuana products
  • Describe various modes of marijuana administration
  • Describe the pharmacokinetic profile of marijuana for several modes of administration
  • Discuss the use of cannabinoid-based drugs in patients with a history of psychotic illness
  • Discuss the use of cannabinoid-based drugs in patients with ischemic heart disease
  • Discuss the use of cannabinoid-based drugs in patients with hepatic disease
  • Discuss the use of cannabinoid-based drugs in patients with a history of drug abuse
  • Discuss the use of cannabinoid-based drugs in patients with a hypersensitivity to cannabis-based products
  • Discuss the use of cannabinoid-based drugs in obstetric patients 
  • Discuss the use of cannabinoid-based drugs in pediatric/adolescent patients
  • Discuss the use of cannabinoid-based drugs in elderly patients
  • List the enzymes responsible for the metabolism of three phytocannabinoids (THC, CBD and CBN)
  • Identify clinically significant drug interactions that may occur with cannabinoid-based drugs
  • List multiple factors that influence the physiologic and cognitive effects of marijuana
  • Discuss the physiologic effects of marijuana
  • Discuss the cognitive effects of marijuana
  • Describe how marijuana affects CNS function
  • Describe how marijuana affects appetite and metabolism
  • Describe how marijuana affects gastrointestinal function
  • Describe how marijuana affects cardiovascular function
  • Describe how marijuana affects the reproductive system
  • Describe how marijuana affects the eye
  • State the National Academies of Sciences, Engineering and Medicine’s conclusion on the use of cannabinoid-based products for the treatment of epilepsy that is published in The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research
  • Describe the available research examining the health effects of marijuana and cannabinoids in epilepsy
  • Explain how the endocannabinoid system is involved in epilepsy
  • Describe the ways in which CBD could possibly affect seizure activity in animal models of epilepsy
  • Describe the epidemiological evidence regarding marijuana use and seizure risk
  • Discuss an FDA-approved cannabis-based medicine for the treatment of two rare and severe forms of epilepsy
  • Describe Dravet syndrome
  • Discuss the Controlled Substances Act’s scheduling system
  • Discuss federal court cases involving the production, distribution and/or recommending of medical marijuana
  • Discuss the Cole Memorandum and other Department of Justice position memorandums regarding marijuana
  • Recognize the Federation of State Medical Boards’ (FSMB) “Model Guidelines for the Recommendation of Marijuana in Patient Care” as a policy document that is intended as a resource for state medical boards in regulating physicians and physician assistants
  • Recognize the Federation of State Medical Boards’ “Model Guidelines for the Recommendation of Marijuana in Patient Care” as a resource for physicians
  • Describe the National Academies of Science, Engineering and Medicine’s 2017 report, The Health Effects of Marijuana and Cannabinoids: The Current State of Evidence and Recommendations for Research
  • Recognize the National Academies of Science, Engineering and Medicine’s 2017 report, The Health Effects of Marijuana and Cannabinoids: The Current State of Evidence and Recommendations for Research as a resource for clinical information on the effects of marijuana and  cannabinoid use
  • Explain why the findings from studies examining recreational marijuana use may not be applicable to medical marijuana use
  • Describe the FDA drug approval process
  • Discuss the cannabinoid –based drugs approved by the FDA
  • Discuss the indicated uses of the FDA-approved cannabinoid –based drugs

Global Contact Information

For information about the approval of this program, please contact Global at 303-395-1782 or cme@globaleducationgroup.com.

Instructions for Obtaining Credit

In order to receive credit for this activity, the participant must complete the activity, pass the posttest with a score of 70% or greater, and fill out the activity evaluation.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Global Education Group (Global) and The Answer Page do not recommend the use of any agent outside of the labeled indications. 

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities

State-Specific Resources

Information for MA Practitioners Wishing to Certify Patients

Some FAQs about the Massachusetts Medical Marijuana Program

  • Which clinicians may register as a certified provider in the state of Massachusetts?
  • What are the criteria for registering with the Massachusetts Medical Use of Marijuana Program?
  • What are the rules for writing certifications for qualifying patients?
  • For how long does the healthcare provider’s registration last?
  • What are the qualifying debilitating medical conditions for which a healthcare provider can certify a patient?
  • What modes of medical marijuana administration are allowed?
  • What is the contact information for the Massachusetts Cannabis Control Commission?

Which clinicians may register as a certified provider of the Massachusetts Medical Use of Marijuana Program?

Physicians (MD and OD), Certified Nurse Practitioners, and Physician Assistants.

What are the criteria for registering with the Massachusetts Medical Use of Marijuana Program?

Generally, an active full Massachusetts license with no prescribing restrictions, and a Massachusetts Controlled Substances Registration. In addition, the registrant must have at least one established place of practice in Massachusetts. The Commission may also request additional information.

Certified nurse practitioners (CNP) must also provide 2 documents:

  • An attestation by the supervising physician that the CNP is certifying patients for the medical use of marijuana pursuant to mutually agreed upon guidelines between the CNP and the physician supervising the CNP’s prescriptive practice
  • Board Authorization by the Massachusetts Board of Registration in Nursing

Physician assistants (PA) must also provide 2 documents: 

  • An attestation by the supervising physician that the PA is certifying patients for the medical use of marijuana pursuant to mutually agreed upon guidelines between the PA and physician supervising the PA’s prescriptive practice
  • Board Authorization by the Massachusetts Board of Registration of Physician Assistants

What are the rules for writing certifications for qualifying patients?

There are multiple rules by which the certifying health care provider must abide:

  • A certifying healthcare provider may not issue a written certification until completion of designated programs explaining the proper use of marijuana, including side effects, dosing, and contraindications, as well as with psychotropic drugs, and also on substance abuse recognition, diagnosis, and treatment related to marijuana. For physicians, this requires a minimum of 2.0 Category 1 continuing professional development credits; for CNPs a minimum of one program meeting the requirements for nursing continued education; and for PAs, a minimum of 1 program meeting the requirements of the Board of Registration of Physician Assistants.
  • Certifying healthcare providers must comply with generally accepted standards of practice in their respective fields.
  • Diagnosis of a patient as having a debilitating medical condition may not be delegated to any other person. 
  • A written certification may be issued only if there is a bona fide healthcare provider-patient relationship.
  • Before issuing a written certification, a certifying healthcare provider must review the qualifying patient’s prescription history in the Massachusetts Prescription Monitoring Program, unless otherwise specified by the Commission.
  • A patient with a past diagnosis of a debilitating medical condition, but the condition is not active, is not considered to be suffering from a debilitating medical condition, unless symptoms of the condition are mitigated by medical marijuana and the patient is not undergoing treatment for such condition.
  • An initial written certification may not be written before a clinical visit. A renewal certification may be submitted following a clinical visit or telephonic consultation. However, a clinical visit must occur no less than once per year.
  • A certification must indicate the period for which it is valid, from 15 days to 1 year.
  • A 14 day supply of marijuana is 2.5 ounces and a 60 day supply is 10 ounces. A certifying healthcare provider may determine and certify a different amount and must document the amount and rationale in the medical record and in the written certification.
  • A qualifying patient younger that 18 years may receive a written certification upon diagnosis by 2 Massachusetts licensed certifying physicians, at least one of which is a board-certified pediatric subspecialist or a board-certified pediatrician, of a debilitating life-limiting illness. If the illness is not life-limiting those physicians must determine that the benefits of medical marijuana outweigh the risks. There must be a discussion of the potential negative impacts on neurological development with the parent or legal guardian and their written consent. The rationale must be recorded in the medical record and the written certification.
  • There are conflict of interest restrictions on a certifying healthcare provider and co-workers, employees, and immediate family members. – They may not: directly or indirectly exchange anything of value with a Registered Marijuana Dispensary (RMD), or anyone associated with the RMD, nor with a personal caregiver; offer a discount or anything of value to a qualifying patient based on the patient’s choice of RMD; deal with a patient at an RMD; have a financial interest in an RMD; or benefit from a patient obtaining a written certification, save for charging an appropriate fee for a clinical visit.
  • Certifying healthcare providers may not issue written certifications for themselves or immediate family members. They may do so for employees or co-workers in accordance with all regulations, including a clinical visit, documentation of a full assessment of the patient’s medical history and condition, explaining the potential benefits and risks of marijuana use, and maintaining a role in the ongoing care and treatment of the patient.

For how long does the healthcare provider’s registration last?

Once issued, a registration can be retained indefinitely except in cases of license, authorization or controlled substances registration revocation; voluntary agreement not to practice in Massachusetts; fraud; failure to timely complete required continuing professional development credits; or surrender of registration.

What are the qualifying debilitating medical conditions for which a healthcare provider can certify a patient?

Cancer; glaucoma; positive status for human immunodeficiency virus (HIV); acquired immune deficiency syndrome (AIDS); hepatitis C; amyotrophic lateral sclerosis (ALS); Crohn’s disease; Parkinson’s disease; and multiple sclerosis (MS) when such diseases are debilitating; and other debilitating conditions as determined in writing by a qualifying patient’s healthcare provider.

Note: Debilitating means causing weakness, cachexia, wasting syndrome, intractable pain or nausea, or impairing strength or ability, and progressing to such an extent that one or more of a patient’s major life activities is substantially limited.

What modes of medical marijuana administration are allowed?

Medical marijuana patients can consume the medical marijuana products via multiple modes of administration, including vaporization, smoking, topical, oral (pills, tinctures, and edibles) and suppository. 

What is the contact information for the Massachusetts Cannabis Control Commission?

If you have questions about the Massachusetts Medical Marijuana Program, you can contact MedicalMarijuana@State.MA.US or (833) 869-6820.

Additional Details

Credits: 4 CME/CE credits.
Mobile-friendly: Yes