Now that medical cannabis can be treated like other medications, the College of Licensed Practical Nurses of Alberta (CLPNA) has updated guidance for Alberta’s Licensed Practical Nurses. The Fact Sheet on Cannabis for Medical Purposes, in place before legalization, is no longer applicable. The section in the Practice Guideline: Medication Management that addresses cannabis for medical purposes has been updated with new authorizations and will continue to be the resource for anyone seeking guidance about the LPN role in relation to medical cannabis.
The use of cannabis for medical purposes is governed by an evolving regulatory framework. The most recent change was on October 17, 2018 when the Cannabis Act and Cannabis Regulations came into effect and legalized recreational cannabis in Canada. These new pieces of legislation also govern medical cannabis in Canada and replace the previous Access to Cannabis for Medical Purposes Regulation.
The change in legislation has allowed for a change in the role of the LPN when caring for clients who use medical cannabis. Under the old framework, LPNs were limited to assisting clients with self-administration in non-hospital settings. However, under the new legislation, LPNs are authorized to administer medical cannabis in all practice settings if the following requirements are met:
- the client has a medical document and client-specific order,
- the medical cannabis is appropriately packaged and clearly labeled,
- the LPN’s employer has authorized the use of medical cannabis within the practice setting, and
- the individual LPN has the competencies required to administer medical cannabis (i.e., the indications for use, routes of administration, dosing, adverse effects and contraindications).
Frequently Asked Questions
Can LPNs administer medical cannabis in a hospital setting?
Yes, as long as access to cannabis is permitted in the facility and employer policy supports the LPN in this role. Employers may establish policies and guidelines around the use of medical cannabis in their facility and LPNs have a responsibility to follow any employer requirements or limitations on the use of medical cannabis.
Under the Cannabis Regulations, cannabis products that are properly received from a licensed seller can be administered or distributed to an inpatient or outpatient of the hospital and hospital employees can possess cannabis products in connection with their position or role. The legislation allows hospitals to decide whether medical cannabis use is permitted and to establish parameters for its use.
What is considered a hospital?
A hospital is defined in the Cannabis Regulations as a facility that is
- licensed, approved or designated by a province to provide care or treatment to individuals suffering from any form of disease or illness; or
- owned or operated by the federal or provincial government and provides health services.
This definition is almost identical to the definition of hospital used in the Narcotic Control Regulations which means that LPNs who had previously been able to administer medical cannabis in their facility, can continue to do so.
What about administration in home care or other settings that are not a “hospital”?
The new framework provides a general authorization for the administration of medical cannabis in all settings, including home care settings, to clients who have appropriate authorization to use it. The legislation allows for administration and possession of medical cannabis in both a “hospital” and a “public place.” The definition of “public place” from the Cannabis Act includes any place that the public has access to by right or by invitation.
This means that LPNs who provide homecare to clients are authorized to possess that client’s medical cannabis in order to administer it or to provide assistance with administration since they have been invited into that client’s home to provide care. Previous legal restrictions that limited the LPN’s ability to administer medical cannabis outside of hospital settings are no longer applicable. However, as with all practice settings, the employer has the ability to establish requirements or restrictions around medical cannabis and LPNs have a responsibility to follow employer policy.
Other important information
As with any other medication, it is important for LPNs to understand the indications for use, routes of administration, dosing, contraindications and potential adverse effects of medical cannabis prior to administering it. Health Canada is a good resource for LPNs seeking additional information about medical cannabis.
LPNs should be aware that there are restrictions around where cannabis (including cannabis used for medical purposes) can be consumed and smoking restrictions generally apply to medical cannabis as well.
The LPN has a responsibility to seek clarification before administering medical cannabis if they are unsure whether the medical cannabis has been legally obtained, if the packaging does not clearly indicate the product, or if the medical document and client-specific order is unclear or missing key information. Although the Cannabis Act has legalized cannabis, some forms of possession and distribution are still illegal and there are limits on the amount of cannabis (medical or recreational) that can be legally possessed.