Rachael Speegle, RN, has worked with thousands of medical cannabis patients in New Mexico over the past nine years.
She has been working as a cannabis cultivator and dispensary owner – and also as a registered nurse.
Being on the frontlines of cannabis medicine through the Verdes Foundation, she has experienced countless inspiring stories as well as important mistakes and lessons learned.
Now she, along with other healthcare professionals, is bringing these lessons to the new online Cannabis Patient Care Certificate Program, designed for nurses, healthcare providers, caretakers, and even policy regulators around the world.
In celebration of the program, we talked with Speegle about her journey in cannabis as a registered nurse.
The First Big Lesson about CBD
Speegle recalls one of her first pediatric clients, who was only three years old when she first met her and her young mother. The girl had multiple forms of epilepsy.
“We had first started treating her with CBD products with quite a bit of CBD in them and started to see results,” Speegle recalls. “And because of our limited plant count in New Mexico, we were unable to keep up with her product on a consistent basis, so we needed to outsource some of that CBD.”
The outsourced product that showed up was a gold, clear color. It was a CBD isolate that looked nothing like the rich, dark, whole-plant extract they’d been using.
“We did the calculations based on milligrams of CBD, and she converted over to this product, and all of a sudden the seizures returned to the point where she was having catatonic seizures every couple minutes and needed to be hospitalized,” Speegle notes.
“We figured out that the difference between isolate and whole-plant CBD was kind of a life-or-death difference for this kiddo. That was my first interaction with whole-plant versus isolate CBD products about eight years ago.”
The Thing about Using Cannabis for Parkinson’s
In another case, Speegle recalls a gentleman who came in with Parkinson’s – also about eight years ago – and he was one of her first Parkinson’s patients.
“His muscle spasms and his tremors were so extreme, and we just kept trying to give him inhalants of CBD. CBD, CBD, CBD. Let’s try more CBD. There was absolutely no literature at the time about THC being the component that works for tremors, and we threw a Hail Mary and tried this high-dose THC.”
What happened?
“It was the first time we learned that THC works in the center of the brain that controls those tremors, and it didn’t overly intoxicate him because Parkinson’s patients seem to have a much higher tolerance to THC levels,” Speegle explains.
“And it really helped control the diaphragmatic spasms as well, which were especially concerning because they were restricting his airways.”
These are just a few examples, stories where cannabis is not only saving lives but also improving the quality of life for countless people.
“You use whatever information you have, and you use your deductive reasoning, and you take a chance, and all of a sudden you learn something,” Speegle says.
“I think that’s true with all medicine, and it’s why we are where we are with our development because somebody took a chance.”
It would be really nice to work with more providers, she continues, who are willing to take those chances and help guide the nursing services through collaboration and communication.
“It’s my hope that this will become more of a possibility in the future.”
The Road to Cannabis Advocacy
Like a lot of people, Speegle was not always a cannabis advocate. She had equated cannabis intoxication with some of her first experiences right out of nursing school, watching young people die from alcohol abuse disorder – too late to change their life or lifestyle.
“With a lot of abuse disorders, what starts as a way to dull pain becomes a quick fix to numb the human experience.”
Speegle was – and to some extent still is – concerned that people would abuse cannabis in the same way, to disassociate and numb out.
However, it wasn’t until Speegle began to do her own research, that she recognized cannabis had an entirely different potential.
She saw how there are “levels at which people can consume quite regularly without being at risk for habitual or addictive use, and it can actually help people lean into their life.”
Cannabis can help people find opportunities to go to therapy, to get out of the house, to take control of their life and feel empowered in doing so, she says.
These initial cannabis realizations were a big turning point for Speegle as she realized many of her former biases against this herbal plant were deeply rooted within the political culture of the country.
Supporting Patients in the Best Way
Today, Speegle and her team at the Verdes Foundation interact with approximately 600 medical cannabis patients per day, all of whom have access to the dispensary’s free nursing service.
It’s important to recognize that these aren’t just medical cannabis patients – they are patients, Speegle notes. “It is important to me that everybody in this community has access to a nurse and that we are accessible for those frontline questions.”
For Speegle, working with patients through that nursing lens is all about supporting them and the medical choices they make. “I don’t need to agree with every client’s choices, but I do need to find ways to support them and to help them utilize what their choices are, whether it’s pharmaceuticals or alternatives,” she explains.
“No matter what their choices are, it’s my job to educate them and give them safe access to those products.”
The program, she continues, has really become a gateway into community health nursing, partnering with other resources in the area, where they can refer people as needed and help them live a better quality of life.
Spreading Cannabis Education Across the Community
Cannabis education is an essential component of the Verdes Foundation mission. The team spends a great deal of time educating patients, physicians and other healthcare providers.
“Education is the biggest part of our brand, and it’s our greatest commitment to the community, and we consider clinicians to be part of that community,” Speegle says.
Speegle agrees that among clinicians, there is a tremendous amount of curiosity, however the state-by-state cannabis regulations make things really confusing for healthcare providers to know what they’re allowed to do.
For example, in New York you have to pass a CME course before you can recommend for cannabis, and in New Mexico you don’t, she says.
On top of that, there is a ton of misinformation circulating on search engines and social media.
“All you have to do is read a headline and get wrong information, and that becomes a truth to somebody,” she explains. “So, it’s our responsibility to be out in the community and to re-educate these providers. There is a curiosity, they just don’t always have accurate information.”
In addition to patients and care providers learning the ins and outs of medical cannabis, there is, Speegle strongly believes, another group who also needs to spend more time on credible cannabis education: the people who are creating cannabis policies and regulations.
“To truly serve the patient population and the community at large, our regulators need to do more to understand the importance of this industry,” she notes.
“One of the biggest problems in the state of New Mexico is that our regulatory body, which is the Department of Health, seems to see the industry which it regulates as an enemy and treats us as though we’re a stepchild that is a burden to them.”
For Speegle, that’s like saying ‘I care about the patients, but I don’t care about the hospital.’ However, there is no way to separate the two. “If we’re the ones that are providing safe access to quality medicine, then we have to be included in the conversation, and there needs to be an effort to continue to improve and bolster the economic growth of this industry.”
Speegle makes a great point in that when dispensaries struggle to stay afloat amidst tough regulations, it directly affects the community’s safe access to legal, responsibly grown cannabis.
Advice for Care Providers and Nurses
“On the nursing side, I would love to encourage RNs to not be afraid and to really lean into the part of our license that is education-focused. We are licensed to educate the community,” Speegle says.
“Be cautious that you’re not prescribing or dosing people, and make sure the terminology that you use is centered around education and helping people learn where to find this education for themselves.”
Advocacy is another area where care providers can get involved. “There’s so much value in role-playing and helping patients advocate to their family, advocate to their providers, and feel comfortable and confident in the choices they make. That’s a big piece of this.”
And on the other side, always reach out to your regulatory bodies for your license, Speegle advises.
Early on in her own medical cannabis journey, Speegle made a point to engage with the New Mexico Board of Nursing, ensuring all parties were on the same page and comfortable with the dispensary’s programs and completely understanding any restrictions or compliance factors.
“It is our job to learn, and it is our job to educate no matter what your specialty is or what your license is,” she adds.
“I encourage everybody to educate themselves. There’s a lot of information out there these days. You can’t get by anymore and say that there is no information and no studies or no access to any research. There is. You just need to know how to find it and pass it along and make sure you’re disseminating the truth.”
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