Being a nurse is physically and emotionally taxing. Many nurses experience pain and soreness in their back, legs, and feet from long shifts. Nurses must also contend with the stress, anxiety, and even sleep disturbances that have become more prevalent since the COVID-19 pandemic began. In recent years, the use of cannabis products to treat medical or physical ailments has seen growing acceptance in the health care and scientific community. Cannabidiol, or CBD, a type of cannabinoid derived from oil in hemp plants, was legalized at the federal level in the 2018 Farm Bill. Since its legalization, CBD use has grown in popularity. To comply with federal law, hemp-derived CBD products must contain less than 0.3% of THC, the main psychoactive ingredient found in cannabis plants that causes people to feel high. Although human trials still need to be ramped up on CBD's uses and effectiveness, some research and anecdotal evidence indicate there are at least three potential benefits for nurses from the use of CBD.
Relieving Muscle Pain and Joint Inflammation
Nurses frequently work long hours and do a lot of heavy lifting when helping patients or moving equipment during their shifts, often resulting in a variety of aches and pains. CBD has been shown to be a natural anti-inflammatory that can help reduce neck, back, and muscle pain that nurses experience, according to Morgan Cox, co-owner of CBD Stat, a LGBTQ- and family-owned company that sells products made from CBD, such as oils, topical creams, and muscle roll-ons and is co-owned by her spouse Leah Greenwood, RN, and her father William Cox. While research on the topic remains somewhat limited, some studies support the anti-inflammatory and antioxidant effects of CBD in reducing pain and inflammation. Morgan Cox, who has a bachelor's degree in exercise science and has spent much of her career in athletics, movement, anatomy, and nutrition, said cannabidiol may appeal to nurses and others who don't want to rely on prescription drugs or painkillers to alleviate pain. "It's pretty much a healthier alternative than having to take acetaminophen or ibuprofen every day," she said. "We're trying to create a more natural option [for pain relief]." Tina Vinsant, a travel nurse from Tennessee, has been using CBD products for more than a year to alleviate foot and heel pain caused by plantar fasciitis. She learned about the potential benefits of CBD from a nurse podcast she runs and from a friend, who is also a nurse.
"I've had terrible foot pain for years from standing on my feet for long periods of time during my shifts," she said. "I was just incredibly shocked by how effective it is."
Vinsant said she applies a CBD ointment to her feet before she goes to bed at night, which helps relieve the muscle tightness and pain she often experienced. "It relaxes the tissue so that it's not so tight. I'm just happy it works. I really love it." Greenwood, who works full time as a nurse in addition to being part owner of CBD Stat, said using CBD topicals has helped her with the aches and pains that come with her nursing career. "When I would come home, I would have horrible shin and arch pain, and I would have to elevate my leg for an hour," she said. "Now I massage the topicals into the bottom of my feet at the end of each shift, and I haven't had to elevate my feet since. I no longer have arch pain after a long shift and have noticed a massive reduction in the number of aches and pains I face each day." While CBD is used in topical products to relieve common neck, back, and other pains, Morgan Cox said many of their customers also have given feedback about how it helps them with chronic pain symptoms from conditions such as arthritis, fibromyalgia, and sciatica. Some research also suggests CBD may help alleviate chronic pain. A new study in the July 16 issue of the journal Cureus involved a systematic review of research on the efficacy and safety of CBD for chronic pain over the past five years. The study's authors concluded that, "CBD is an excellent alternative to an opioid in [addressing] chronic pain because CBD is non-intoxicating in its pure form. More clinical trials should be done to prove CBD's significance clinically and statistically."
Easing the Effects of Stress and Anxiety
Anxiety, stress, and burnout are common among nurses, and the COVID-19 pandemic has only exacerbated those issues. William Cox who, in addition to being co-founder of CBD Stat, is also a chemical engineer and vice president of business development at IMPACT Technology Development, the firm that developed the proprietary hemp extraction process for CBD Stat products, said CBD may stimulate the body's endocannabinoid system (ECS), which a mood study recognized as a "prominent promoter of emotional homeostasis, mediating the neurophysiological and behavioral consequences of stress." The stimulation of the ECS can promote improved sleep quality and reduce stress, anxiety, and depression, which can be helpful to nurses, he said. The study acknowledged, however, that more research would be useful to help understand how genetic variability and psychosocial factors could affect an individual's response to cannabinoid-based drugs. Another study suggests that CBD may reduce stress and anxiety among nurses and other healthcare workers. In 2021, Brazilian researchers conducted a randomized trial to study the effectiveness of CBD in alleviating stress among physicians, nurses, and therapists who were treating COVID-19 patients at a Brazilian hospital over a four-week period. A total of 120 healthcare workers were randomized into two groups, with about half receiving a 300-milligram dose of CBD twice a day plus standard care and the rest receiving only standard care. The study found the daily administration of CBD, combined with standard care, "reduced the symptoms and diagnoses of anxiety, depression, and emotional exhaustion among frontline healthcare professionals working with patients with COVID-19." "Cannabidiol may act as an effective agent for the reduction of burnout symptoms among a population with important mental health needs worldwide," the authors wrote. The study did note, however, that a small number of participants treated with CBD experienced severe side effects and cited the need for further study of the benefits and potential adverse effects.
Improving Sleep and Alleviating Insomnia
Another potential benefit of CBD for nurses is improved sleep and reduced insomnia. Greenwood said she started taking CBD oil before going to bed after long nursing shifts to help with the quality of her sleep, and it has helped her tremendously.
"I wanted something that would help me fall asleep quickly and not have me feel groggy the next day," she said. "When I started taking it, I had been working the night shift for years, and the CBD oil helped me get uninterrupted sleep during the day. My sleep quality has been great since using CBD oil, whether I'm on day or night shift."
William Cox said research indicates that CBD can help with a number of sleep disorders including insomnia, REM sleep behavior disorder, and excessive daytime sleepiness disorder. "Determining the exact mechanism of how CBD helps with sleep is still being studied," he said. "Experiences and results are varied and appear to be dose dependent for each individual."
Other Considerations of CBD Use for Nurses
Because CBD is a cannabinoid, some nurses fear it may show up during pre-employment or other drug testing by their employers. But William Cox noted that since CBD oil is now legal for use at the federal level, it should not be an issue for nurses in most cases. "Since CBD is not psychoactive, it should not interfere with normal work activity or cognitive abilities, particularly with transdermal topical CBD used for inflammation reduction," he said.
Since most CBD products are not federally regulated, nurses should check the labeling to make sure the products they are using are THC-free, as some products contain small amounts of THC that can show up in drug tests.
"Typically, healthcare workers who do get tested prefer the THC-free option," said Morgan Cox, noting that all of CBD Stat's products are 100% THC-free. To date, the U.S. Food and Drug Administration has approved only one CBD product -- a prescription drug product that treats seizures -- and is watching for illegal marketing practices in which products containing cannabis or its compounds violate federal law or put consumers at risk. While hemp-derived cannabidiol containing no more than 0.3% of THC is now legal at the federal level, some states and local municipalities may have their own laws and regulations regarding the use of cannabis products. William Cox encourages nurses to review these regulations and to seek prior approval from their employers before using CBD products, if they have concerns. "If they're concerned, we advise people to go to their supervisor and ask them if it's okay to use the product," he said. "I would think they would welcome the use of all natural products that would help their employees work better and feel better." While CBD is generally safe, William Cox said, it can cause drowsiness in some people and diarrhea when taken in large quantities. He said it's important for nurses to follow dosing guidelines, be cognizant of potential side effects, and consult with a physician before use to avoid negative interactions with other medications.
