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What is cannabis? And is it the same thing as marijuana?
The cannabis industry has taken over mainstream media with the expansion of regulations within several states and the increase of medical and recreational facilities opening across the US. Cannabis is also known as marijuana and can be referred to by many other terms, but whatever you want to call it, it is medicine. Cannabis is a broad therapeutic medicine that can be an ideal treatment modality for several medical conditions to promote overall health, healing, and well-being.
Qualifying health conditions to medical programs may include a wide array of disease states, where pharmacist intervention, providing patients with education and product recommendations, help to ensure the most optimal treatment plan and results. The goal is to mediate homeostasis through the endocannabinoid system to promote health and balance throughout the body and tissues. These benefits can be seen in the brain, organs, musculoskeletal system, and immune system.
Like pharmaceutical medications, cannabinoids such as THC and CBD have potential drug interactions due to CYP450 enzyme activity and protein binding. There have been few dedicated drug interaction studies performed, but pharmacists can use their knowledge to recognize whether drugs are enzyme substrates, inducers, or inhibitors to prevent clinically significant interactions from occurring. Side effects are mediated by dose, which can differ from patient to patient, but the list is much less exhaustive than what is seen within many pharmaceuticals.
Dispensing cannabis as a pharmacist
Not all state regulations mandate pharmacists for dispensing cannabis, nor require consultations to be mandatory, but there are significant advantages to providing this valuable information to patients. Dispensing and consulting are norms in my day-to-day interactions, as the state I practice within does require both.
During the initial consultation, the pharmacist will discuss the following:
- Symptoms associated with their diagnosis plus additional symptoms that could benefit from cannabis
- Additional health conditions
- Current medications and OTC supplements
- Marijuana use history
- Strain diversity and pharmacology
Follow-up consultations occur frequently to ensure patients are receiving optimal effects. Specific dosing, formulation change, or product selection may be adjusted. Although product information dispensed is downloaded into the Prescription Drug Monitoring Program database, patients are encouraged to keep their physicians informed of cannabis addition to treatment regimens to assist in recognizing interactions, side effects, and improve overall health outcomes. Pharmacists outside of the cannabis setting can use this information as well to be equipped with an overall view of a patient’s regimen, which may provide valuable insight to pharmaceutical medication adjustments, changes, or in discussion in relation to a drug utilization review.
Where the cannabis market is headed in 2023 and beyond
As this industry evolves, I foresee more research developing to assist in managing disease states and outcomes, and aid as an alternative therapy source. Pharmacists currently practicing within the cannabis space will be a crucial component within the profession to assist in the education of fellow pharmacists and physicians new to the industry.
It will be vital for pharmacists who do not currently practice within the industry to begin exploring educational resources to expand their knowledge base about the power of cannabis, as the popularity of usage is increasing in all demographics of patients who willingly choose to incorporate this as a part of their treatment plans.
Leading into 2023, there will continue to be more access to obtaining cannabis, as medical and recreational facilities continue to bloom. As a pharmacist, knowledge and education surrounding pharmacology, common uses, clinically significant drug interactions, and side effects can assist in managing a patient’s overall health condition. My hope is for you to feel more comfortable in using this information as another “tool” in your toolbox for treating patients with a condition where benefit may be seen or who may be refractory to traditional medicine.
Pharmacists are now even more interested in alternative ways to help their patients manage chronic pain. Read the article, “How pharmacists can prevent opioid use disorders.”