Medical Cannabis Education Improves Oncology Nurses’ Confidence in Patient Discussions

An educational intervention presented at the 50th Annual Oncology Nursing Society (ONS) Congress demonstrated that targeted education can improve oncology nurses' comfort discussing medical cannabis with patients.

The study, led by nurses at the John Theurer Cancer Center at Hackensack University Medical Center, evaluated whether an educational program could increase nurses' knowledge and confidence regarding medical cannabis. Investigators found that comfort levels increased across all measured categories following the intervention, highlighting the potential role of education in addressing knowledge gaps and reducing stigma surrounding cannabis use in oncology care.

In an interview with CURE, Margaret Hopkins, a level IV staff nurse, and Chendi Li, a clinical level III staff nurse, discussed the study findings, barriers to patient-provider communication and the importance of creating safe spaces for conversations about medical cannabis.

How does the safety profile of medical cannabis influence conversations with oncology patients?

Hopkins emphasized that nurses cannot recommend medical cannabis to patients but can provide education and discuss safety considerations when patients inquire about it.

According to Hopkins, conversations often focus on helping patients understand the relative risks associated with different symptom management approaches and ensuring they use therapies safely.

"We can explain to them the safety numbers and talk to them about how they're able to titrate possibly their opioids to use less opioids if they're using something together," Hopkins said. However, treatment recommendations ultimately belong to the patient's healthcare provider.

The nursing role, she explained, is to support informed and safe decision-making regardless of the treatment approach patients choose.

Which aspects of the educational intervention appeared to improve nurse confidence the most?

The study found increases in comfort levels across all educational categories assessed before and after the intervention.

Although investigators could not determine which specific topics most influenced individual participants because survey responses were anonymous, Hopkins said the information on dosing and routes of administration was particularly valuable from her perspective.

"I learned so much about the dosing and the different routes of administration," she said.

The findings suggest that practical information about cannabis use may help nurses feel more prepared to answer patient questions and participate in symptom management discussions.

How does stigma affect conversations about medical cannabis in oncology care?

Investigators noted that stigma remained a significant barrier to open discussions about cannabis use.

Hopkins said the research team did not specifically ask nurses to describe their perceptions of stigma, but evidence of reluctance emerged in clinical practice.

Medical cannabis use rarely appears on medication reconciliation lists, despite estimates that many oncology patients use cannabis products. Hopkins said this presents a potential safety concern because healthcare teams need accurate information about all substances patients are taking.

"If you're going for surgery next week and you're taking cannabis every day, we should be having that conversation," Hopkins said.

The educational program also revealed knowledge gaps among healthcare professionals. Some nurses initially hesitated to participate because they were unaware that both medical and recreational cannabis are legal in New Jersey. According to Hopkins, education helped address some of those misconceptions and encouraged more open dialogue.

How does federal regulation limit research on medical cannabis?

One challenge highlighted during the discussion was the lack of robust clinical research evaluating medical cannabis in oncology populations.

Hopkins explained that cannabis remains federally classified as a Schedule I substance, creating barriers to conducting large-scale clinical trials.

As a result, much of the available evidence remains observational or anecdotal.

"We're not able to do the gold-standard studies," Hopkins said.

Without large randomized trials, clinicians often cannot definitively tell patients whether cannabis will help specific symptoms. Instead, conversations typically focus on available evidence and reports from patients who have found cannabis beneficial.

What is the first step toward improving communication about cannabis use?

Both nurses stressed that creating opportunities for discussion begins with simply asking patients about cannabis use.

Hopkins noted that studies suggest approximately 40% of oncology patients use cannabis, regardless of whether they disclose it to their healthcare team.

Because products vary widely in potency, formulation and timing of effects, patients often need guidance to use them safely.

For example, patients may not understand how long edible cannabis products can take to produce effects or how different formulations may affect symptom control.

"The first step is asking the question, have you used it?" Hopkins said.

Open-ended conversations can help patients feel comfortable sharing information that may be important for treatment planning, medication management and surgical care.

How can future educational programs reduce stigma and encourage honest participation?

The investigators acknowledged that stigma may have influenced how some participants responded during the study.

To address this limitation, Hopkins suggested that future educational initiatives could be conducted on a larger scale while maintaining anonymity.

Expanding participation across multiple oncology units or health systems could make respondents feel more comfortable acknowledging knowledge gaps or uncertainties without fear of judgment.

Maintaining anonymous feedback mechanisms may also provide a more accurate assessment of educational needs.

Why is it important to evaluate long-term retention of cannabis education?

The research team plans to explore whether improvements in knowledge and confidence persist over time.

According to Li and Hopkins, education should not be viewed as a one-time intervention.

Ongoing education allows nurses to reinforce existing knowledge, stay informed about emerging evidence and apply what they learn in clinical practice.

"It doesn't matter if I learn something if I'm not using it and having an effect on my patients," Hopkins said.

The investigators emphasized that future studies should examine not only whether nurses retain information but also whether increased knowledge ultimately improves patient care and communication.

What message would the nurses like patients to take away?

Li encouraged patients to advocate for themselves and communicate openly about their symptoms, concerns and treatment preferences.

"Be your own advocate, and ask questions," she said.

Hopkins echoed that message, noting that patients should feel empowered to discuss all symptom management options with their healthcare teams.

Both nurses emphasized that treatment decisions should be individualized and that patients should feel comfortable speaking honestly about therapies they are using or considering, including medical cannabis, to help ensure safe and effective care.

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