The Iowa 4-hr Medical Cannabis Course

The Iowa Medical Cannabis Course helps doctors, nurses, pharmacists and psychologists prepare to care for patients using cannabis for therapeutic reasons. This comprehensive course 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 cannabinoid-based products in obstetric, pediatric, adolescent and elderly patients is addressed in detail, too.  In addition, important considerations for patients with ischemic heart disease, hepatic disease, psychotic illness, and those with a history of drug dependence are provided. Legal and medical considerations associated with the recommendation of medical cannabis are discussed in this course, as well.

$189.00

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Overview

The Iowa 4-Hr Medical Cannabis Course is composed of 3 components:

  •       The Comprehensive Medical Marijuana Curriculum
  •       The Health Effects of Marijuana and Cannabinoids in Epilepsy
  •       Legal and Medical Considerations in the Recommendation of Medical Marijuana

This course 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 discussed in detail. In addition, the health effects of marijuana and cannabinoids in epilepsy are reviewed.  Important considerations for patients with ischemic heart disease, hepatic disease, psychotic illness, and those with a history of drug dependence are provided.

This course also informs the reader about the legal and medical considerations in the recommendation of medical marijuana.

Subscribers can complete the curriculum 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), American Psychological Association (APA) credits, and American General Dentistry (AGD) PACE 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.  And, 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.

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, psychologists, and dentists 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), American Psychological Association (APA) credits, and American General Dentistry (AGD) PACE credits.

This curriculum offers up to 4 hours of ACCME , ANCC, ACPE, AANP, and AGD PACE credits. This curriculum offers up to 3.5 APA credits.

Expires May 21 , 2021. 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

What are the qualifying health conditions for participation in Iowa’s Medical Cannabidiol Program? 

An Iowa resident may qualify for Iowa’s Medical Cannabidiol Program if their healthcare practitioner certifies that the patient has one of the following qualifying debilitating medical conditions:

  • Cancer – if the illness or its treatment produces one or more of the following: severe or chronic pain, nausea or severe vomiting, cachexia or severe wasting
  • Seizures
  • Crohn’s disease
  • Chronic pain
  • Multiple sclerosis with severe and persistent muscle spasms
  • AIDS or HIV (as defined in Iowa Code, section 141A.1)
  • Amyotrophic lateral sclerosis (ALS)
  • Parkinson’s disease
  • Post-Traumatic Stress Disorder (PTSD)
  • Any terminal illness with a probable life expectancy of under one year – if the illness or its treatment produces one or more of the following: severe or chronic pain, nausea or severe vomiting, cachexia or severe wasting
  • Ulcerative colitis
  • Severe, intractable pediatric autism with self-injurious or aggressive behaviors
  • Severe, intractable autism with self-injurious or aggressive behaviors
  • Cortico-basal degeneration

Which type of clinicians can write a cannabis recommendation? 

  • MD/DO
  • Advanced Registered Nurse Practitioner (ARNP)
  • Physician Assistant (PA)
  • Podiatrist (DPM)

Can pediatric patients participate in the program or does the patient have to be at least 21 years old?

A patient of any age can be certified. Patients under 18 must have a designated caregiver who is authorized to purchase and possess products for the patient.

What are the allowable forms of medical cannabinoid products in Iowa?

Iowa’s manufacturers produce medical cannabis products in different forms and strengths.

The allowable forms of medical cannabinoid products in Iowa are:

  • Oral forms- tablets, capsules, liquids, tinctures and sublingual forms
  • Topical forms- gels, ointments, creams, lotions and transdermal patches
  • Nebulizable inhaled forms
  • Suppositories- rectal and vaginal
  • Vaporization

How much THC can a patient purchase at one time?

  • Patients are able to purchase 4.5g THC per 90-days
  • If the health care practitioner determines that 4.5 grams of total tetrahydrocannabinol in a 90-day period is insufficient to treat a patient’s qualifying debilitating medical condition and the patient has participated in the medical cannabidiol program, the health care practitioner may recommend a higher total THC cap. The health care practitioner shall indicate the higher total THC cap on the written certification.  Note: Other than for patients who are  certified as terminally ill, this waiver can only be completed for patients who have participated in the program; newly-certified patients are not eligible for this waiver. This form and information about the process can be found at: https://idph.iowa.gov/omc/Patient-Registration

How does a clinician register a patient in the cannabis program?

Can an individual grow cannabis at home?

No

How does a patient obtain cannabis from a dispensary? What documents are needed? Can a caretaker purchase the cannabis? 

Patients must check-in to the dispensary with a valid registration card issued by IDPH, which is dual-verified by a patient’s government issued ID.  Dispensary staff are required to verify the patient’s card using a web-based portal provided by IDPH.

If a patient is immobile or otherwise unable to visit a dispensary, the patient may qualify for a designated primary caregiver as certified by the patient’s healthcare practitioner. Information on the caregiver process can be found at: https://idph.iowa.gov/omc/Caregiver-Registration

What is the phone number for the Iowa Office of Medical Cannabidiol?

The phone for the Iowa Office of Medical Cannabidiol is  515-725-2076.

More information about the Iowa medical cannabis program can be found at can be found at:  https://idph.iowa.gov/omc.

 

Legal Considerations

What Affirmative Defenses do Iowa laws provide for certifying practitioners?

  • A healthcare practitioner and their agents and employees are not subject to (1) criminal prosecution, or (2) any civil or disciplinary penalties by the Board of Medicine or other licensing board for activities related to certification, possession, or use of medical CBD in the treatment of a patient as authorized under chapter 124E.
  • These affirmative defenses broadly cover a health care practitioner’s certification of a patient’s debilitating medical condition to receive a registration card, certifications required to exceed the 4.5g/THC purchase limit, and designation of a total THC cap deemed appropriate by the practitioner.

How may a certifying practitioner encounter license sanctions?

  • Disciplinary action against a health care practitioner is authorized only when a provider acts inconsistently with chapter 124E or violates other laws, for example – writing certifications for persons whom they have never examined.

Will my DEA Registration be impacted?

  • The Federal government will not revoke a DEA registration for a physician’s involvement in state medical cannabis programs, if the physician complies with state law (2013 DOJ guidance)
  • A related case is Conant v. Walters (2000), where a ruling was made that the federal government cannot revoke a DEA registration, when a physician recommends marijuana to a patient, if the recommendation was based on sincere medical judgment

Are there malpractice concerns?

  • There are no reported US cases of malpractice brought against physicians for activities related to medical cannabis
  • Legal experts view the legal risk as minimal because physicians are merely certifying that the patient has a qualifying condition; they are not prescribing. Physicians who choose to participate should discuss their role in certifying patients with their legal counsel and malpractice carrier.

Additional Details

Credits: 4 CME/CE credits (*3.5 APA credits).

Mobile-friendly: Yes