When it comes to getting a prescription filled, many of us are no stranger to hanging around the drugstore while we pepper the pharmacist on duty with a host of questions. After all, part of their job is consulting with patients on their various medical needs — so it actually makes perfect sense that some cannabis dispensaries are bringing pharmacists on board to do the same thing when it comes to medical marijuana.
Currently, out of the 30 states — plus the District of Columbia — that have legalized medical marijuana, only six require dispensaries to have some sort of professional relationship with a pharmacist. Connecticut, New York, Pennsylvania and Minnesota all require pharmacists to dispense medical cannabis, while in July the Oklahoma State Department of Health voted to require pharmacists in dispensaries, and Arkansas passed House Bill 2190, requiring dispensaries to appoint a pharmacist consultant.
With only a handful of states requiring a pharmacist to be a part of the medical cannabis process, the benefits that come with this obligation may not be readily obvious. But speak with any pharmacist that works in a dispensary and you’ll soon realize that having medical professionals engaged in this groundbreaking arena is incredibly important.
Pharmacists Are Leaning Across the Counter To Help You With Your Cannabis
Aashna Satija is a pharmacist at Vireo Health, a medical cannabis company in New York. As required by NY state law, Vireo has pharmacists working at all its medical marijuana dispensaries throughout the state. For Satija, it was a natural career progression. Before moving to the Big Apple, she was a pharmacist in California, where many of her patients would come to her for medication counseling and would reveal they also consume marijuana. These patients — many of them older and seeking treatment for serious issues, like cancer — would ask her about any possible cannabis interactions with other medication they were prescribed. It fueled her to learn more about the plant and its applications.
Now, working at Vireo, Satija sees just how instrumental it is for pharmacists to be a part of the medical cannabis industry.
“There is a huge advantage to having pharmacists,” Satija tells Big Buds. Beyond the standard medical information you would expect pharmacists to have a deep knowledge of — dosing, side effects, drug interactions — they also have a particular skill set when it comes to patient relationships. Not only do pharmacists understand this important information, they are also very good at communicating this intel in ways the patient can easily understand.
“A pharmacist can explain side effects without scaring a patient from using the medication,” explains Satija, “and being realistic about what those side effects are, how often they occur, and how to manage them.”
For Satija, having a pharmacist on staff at a dispensary is a win for the patients and for Vireo. The company is able to provide high-quality care with skilled professionals at the helm, while patients feel more secure, having a trained pharmacist help handle their medication. “Patients become more comfortable, particularly about telling you their medical history, because they know you’ll understand,” Satija shares. “There’s definitely less stigma. Patients can also talk about what they’ve gone through, what treatments they’ve tried and failed before walking in our door, what medications they’ve tried, and what [meds] they’re currently on.”
For many patients, particularly older ones or those who have been in the traditional health care setting for a while, it can be reassuring that a board licensed pharmacist is on hand to guide their cannabis decisions. While medical marijuana has been legal in a variety of states for several years, there is still a negative stigma and stereotype surrounding the plant that can be difficult for some new patients to shake, and having a pharmacist — that is, a health care professional they’ve had previous experience interacting with — can help ease any concerns or uncertainties.
And, according to Satija, many patients have already dealt with pharmacists for their conditions, using traditional pharmacies for their various prescriptions, so they feel comfortable with the same type of health care professional at the dispensary — a smooth continuation of care. This is important for individuals with a lot of health and medication needs.
In New York, one of the benefits of the cannabis law currently in place is that everything is integrated when it comes to medical marijuana. For instance, Vireo Health doesn’t just dispense the medication, it also grows its own product. This is not only a plus for the pharmacists on staff, but also for the patients.
For instance, at a traditional pharmacy, if a patient with a gluten allergy asked about a particular medication’s contact with gluten, a pharmacist would need to contact the company that manufactured it for answers, and that can be an arduous, sometimes futile task. At Vireo, however, since the company is in charge of the entire process, the manufacturing team can answer all sorts of questions about what exactly went into the product — including processing, any potential filler ingredients and more.
What Are The Downsides To Having A Dispensary Pharmacist?
While it’s clear pharmacists can be an important and integral part of medical cannabis, this system is not without its challenges. When it comes to having a pharmacist on staff, one problem is that it can be difficult to stay current with cannabis information. Because the plant is still illegal at the federal level, it’s not as easy to look up peer reviewed information on cannabis as it is for prescribed medications. The same is true for pharmacists who want to take continuing education courses regarding the plant. While some companies have started to offer up a course here and there, they remain few and far between. However, with limited studies and data accessible, it can be difficult for pharmacists to do their job to the fullest.
“Sometimes it’s tough, and sometimes we don’t get the answer, which is frustrating,” explains Satija about patient inquiries. She notes that there are some resources where pharmacists can look things up, including Medscape, which has a drug interaction checker, and is one of the few clinician-facing sites to include cannabis data. Satija says that if it does come up with a drug interaction, the data is fairly accurate, but this information is not as clear when it says “unknown.” So, the medication in question can either have no interaction with cannabis, or they simply don’t know — which is more likely the case.
Most national pharmacy organizations either have no comment when it comes to cannabis and pharmacy, or are still trying to figure out how to discuss it. For instance, the National Community Pharmacists Association’s statement on cannabis is explicit:
Compliance with federal law – The federal government continues to classify marijuana as a schedule I controlled substance. Drugs listed in schedule I have no currently accepted medical use in treatment and may not be prescribed, administered, or dispensed for medical use. Therefore, under federal law, no individuals, including pharmacists, can legally dispense medical marijuana, even in those states that have passed medical marijuana legislation.
The statement continues on, acknowledging that pharmacists are a required part of the law when it comes to dispensing medical cannabis in various states. It says that pharmacists should not be placed “in a position of legal or contractual jeopardy.”
This gray area between the federal and state level can be tricky. Federally, cannabis is still considered a Schedule I drug — one not allowed to be prescribed for medication. However, eight states have policies reclassifying it as a Schedule II drug.
“Pharmacist licenses are regulated by each individual state’s board of pharmacy and not by the federal government,” explains Satija, when asked how they handle these issues in New York. “This is why pharmacists are not assigned DEA numbers and are required to obtain licensure for each individual state.”
While more states legalize medical marijuana and the push for legal recreational cannabis grows, the hope is that federal change soon follows suit, making these legal gray areas moot. Because, at the end of the day, it’s certainly more beneficial to everyone to have a medical professional on staff dispensing cannabis and cannabis advice to patients.