Pharmacy's Role in Medical Cannabis

OCTOBER 07, 2016
After working in a traditionally conservative state’s House of Representatives as a student assisting a pharmacist and representative who was attempting to pass marijuana legislation, I was exposed to medical cannabis as a political topic and saw first-hand the polarization associated with it. In fact, a separate legislator opposed to the law actually visited California in an attempt to quickly obtain a license simply to prove that their system wasn’t legitimate and that medical licensing shouldn’t be adopted.
 
With the entrance of pharmacist requirements on some states’ cannabis legislation, our health profession is obligated to keep an open mind toward the subject. The most complex part about state legislation is the fact that marijuana is still a Schedule I substance, making it illegal at the federal level. At this point, it’s becoming more difficult to argue that there’s no medical benefit associated with cannabis to justify that scheduling. Keeping that in mind, medical professionals will have more difficulty turning a blind eye to the subject.
 
Three states currently have requirements for pharmacists to be onsite at medical cannabis dispensaries: Connecticut, Minnesota, and New York. Although pharmacy requirements unite these state laws under one umbrella, there exist steep differences between them. Connecticut allows marijuana to be sold in plant form to smoke, unlike the other 2 states. Minnesota represents the fewest eligible medical conditions covered, 9, while New York covers 10 and Connecticut accounts for 15. New York’s legislation wrote in eligibility for 20 dispensaries while Minnesota had 3 currently operating in early 2016 with plans to expand. Connecticut’s law is unique in that it reschedules marijuana to a class 2 substance, which includes it in the Connecticut Prescription Monitoring and Reporting System.
 
Ohio House Bill 523, effective September 8, 2016, legalized medical cannabis; however, details regarding license requirements and obtaining the medication are still unknown. During the legislative process, a section of the bill requiring that every dispensary be run by a pharmacist was eliminated. The main argument against allowing pharmacists to be in charge was that it would inhibit patient access. The state pharmacy board, Department of Commerce, and state medical board will simultaneously be in charge of registering and hiring dispensaries as well as managing patient-caregiver registration in Ohio.
 
Different states have been trying to meet advocates’ and adversaries’ demands somewhere in the middle. For example, in Georgia, the law decriminalizes the possession of cannabis in patients with specific conditions but provides no route of production or supply. This bill provides no real assistance to patients in need, but provides an opportunity for future state legislation to do so. Politics seemed to play a larger role than actual patient care here, and this predicament isn’t unique to Georgia.
 
When medical professionals and politicians discuss medical marijuana, they often defer to the “more research is needed” argument. This may be true; but in the past, and still today, barriers are in place that complicate research approval, including difficulty accessing legitimate supply. Health care providers interested in what research has been completed on medical cannabis should visit online resources such as NORML and the Center for Medicinal Cannabis Research. Other organizations provide education with modules and certification courses, such as the Medical Cannabis Institute.

David Book, PharmD
David Book, PharmD
David Book graduated with a PharmD from Drake University. After completing a Drug Information Residency in the greater Atlanta area with Mercer University's College of Pharmacy and InpharmD, he now works full time at an independent pharmacy. Drawn towards innovation and entrepreneurship, his interests include the business of pharmacy, healthcare advocacy, diet & nutrition, and health information technology.
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