The Case for Cannabis: Defining a New Standard of Care for Burnout in the Post-ish-Pandemic Era : Emergency Medicine News

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Emergency Medicine News

The Case for Cannabis

Defining a New Standard of Care for Burnout in the Post-ish-Pandemic Era

Yafai, Sherry MD

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doi: 10.1097/01.EEM.0000835284.45876.ce
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    Research from Brazil has found that cannabidiol (CBD) helps reduce emotional exhaustion, anxiety, depression, and burnout for frontline health care professionals. That really grabbed my attention during a presentation in May at the University of California San Diego's annual medical and science conference highlighting the latest in Cannabis research.

    A total of 120 frontline physicians, nurses, and physical therapists were randomized into standard of care v. CBD 150 mg BID for 28 days plus standard of care, which in this study consisted of motivational and instructional videos on low-impact physical exercise and weekly consultation with psychiatrists who offered psychological support (i.e., conversations and spiritual support). (JAMA Netw Open. 2021;4[8]:e2120603; https://bit.ly/3M5M3vv.) Hospitals also maintained “a safe and supportive working environment by repeatedly offering PPE, modifications to work schedules, and ongoing testing as well as hiring new personnel and providing a specific outpatient treatment unit.”

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    CBD and Standard Care (n=59) Standard Care (n=59)
    Elevated liver enzymes (>threefold higher than upper limit) 6.8% 0
    Pharmacodermia 1.7% 0
    Somnolence 25.4% 32.2%
    Fatigue 18.6% 27.1%
    Diarrhea 10.2% 11.9%
    Sore throat 10.2% 1.7%
    Increased appetite 8.5% 23.7%
    Lethargy 6.8% 13.6%
    Weight gain 5.1% 15.3%
    Decreased appetite 5.1% 13.6%
    Source: JAMA Netw Open. 2021;4(8):e2120603; https://bit.ly/3M5M3vv.

    I don't know how helpful these standards of care are unless the schedule modifications resulted in better pay, health insurance coverage for all employees, paid time off for getting sick with COVID, or long-term health coverage for contracting a more morbid version of COVID. These efforts seem unlikely to treat or prevent burnout. But one thing certainly should be highlighted here: Brazil has a standard of care for preventing and treating burnout.

    Physician employees, in my experience during the pandemic, were hostile toward their employers for multiple reasons, including frustration with those who Zoomed in orders during the pandemic from the comfort of their homes and decreased shift hours and pay due to low volume, all with a bunch of lip service, “We are here for you!”

    Not only were we financially disincentivized during the pandemic, we also were not given any real health protections. One would assume that you would be paid for time off until you recovered, paid to be put in a hotel or other isolating environment, or had your medical bills covered as a result of contracting COVID at work.

    But no such thing occurred, so we went into shifts with great trepidation, fearing not only for our own well-being but fearful that we were putting our families at risk. No effort was made for preventing burnout during that period, and even worse was that two to three people, myself included, were let go during the pandemic due to lower volume. The emergency medicine community failed to create any standard of care to help prevent our own burnout, and we continue to perpetuate these inadequacies and wonder why we are a dying breed.

    Back to Pre-Pandemic Calm

    The UCSD research assessed participants weekly for four weeks. They concluded that CBD treatment with standard of care was superior to standard of care alone for reducing emotional exhaustion, anxiety, depression, and diagnoses of burnout syndrome.

    We in medicine tend not to believe a one-off article, so many may roll their eyes at these results, but I would urge you to pay attention. This is one of many articles that is providing us with similar outcomes with similar CBD dosing strategies.

    You'll recall that CBD is a nonintoxicating chemical found in the Cannabis, marijuana, and hemp species. It can be isolated from the plant and has been legal everywhere in the United States since 2019. It is the generic chemical equivalent of the GW Pharmaceuticals drug Epidiolex available across the United States by prescription. Randomized clinical trials using CBD for seizure disorders and anxiety studies are currently in the works.

    Those of you who are emotionally exhausted, burned out, and anxious in this maskless, post-ish-pandemic era, consider closing your browser and using a hemp CBD oil to help you get back to your pre-pandemic level of calm.

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