Cannabis, what’s next for Pharmacy? | Do you have a coherent strategy?
Non-medical cannabis became legal in Canada as of October 17, 2018.
Cannabis can be used for medical or non-medical purposes. People may choose to use cannabis for its therapeutic effects. But it can also harm your health. I’ve heard both sides from practicing Pharmacists and Doctors. Both situations are true. Cannabis affects everyone differently.
Before I continue, I should state my personal position on marijuana. I am fully supportive of the legalization of marijuana for recreational use and support regulation and taxation, treating it along the lines of alcohol or tobacco. I should also state that I have no “skin in the game” when it comes to marijuana in pharmacies, or medical marijuana more generally – I work in retail pharmacy, and while pharmacy professional associations seem enamored with the idea of medical marijuana in pharmacies, I have no personal opinion on it, other than wanting pharmacies to be places that offer and promote science-based and medically useful products, not pseudoscience or harmful/ineffective products.
The race to the starting line for non-medical cannabis is winding up
The companies and individuals who’ve prepared themselves for The Cannabis Act are out in front. It’s kinda like the beginning of a marathon where the lead elite runners at the front have completed their warm up and running in place eager to go as soon as the horn sounds; then there are those in the middle who are warming up and finally those at the back who are just arriving. While the elite are already out front running the back of the pack are still warming up.
As far as the medicinal market is concerned it doesn’t need to change right now; it’s working just fine. We have a world class medical cannabis system that’s been in place since 2001. There are countries from around the world coming to Canada to learn from us. My understanding is that it might take up to another 2 years before the present ACMPR system changes. Which means that there is likely another starting line down the road. While there are predictions of all hell breaking loose as of Oct 17th; I don’t think much is going to change in the retail Pharmacy world unless someone gets involved in the recreational market.
Consumer preferences tilt towards oils and extracts
The opening opportunity is more likely to be with CBD. Once legalization is in place I’m not aware of any College that has by-laws or plans to prevent the display and sale of CBD products. The category to pay attention to is the emergence of “canaceuticals”. From cannabidiol (CBD) capsules and cannabis based topicals to flavoured oils and down the road, in a year or so, to infused edibles, it’s hard to talk about the future of cannabis without mentioning the tremendous shift in consumer demand from smoking joints to vaping oils and extracts and the host of new products beyond bud.
Patients deserve clarity. They deserve to get the facts on keeping people and communities safe
Where can you go in the community and talk to a Health Care Professional (HCP) – that’s where Pharmacists fit in. There are many questions concerning the effects of cannabis use and although “reefer madness” is in the distant past, there are still remnants of its impact in the cultural perception of cannabis.
Public education efforts will need to be developed to transparently share key messages around correlations related to the use of cannabis and long-term impacts. This represents an opportunity for Pharmacists to be a community leader in ensuring public health and safety through consumer education. Consumer education messaging will need to centre around providing clear and understandable information with respect to the contents of the product, its associated regular effects as well as abnormal ones, and how it may interact with prescribed or OTC medication or prior conditions of users.
Myths debunked and a fact
Yet there are Pharmacists who are adamant in their belief that there’s no evidence; when that’s not the case. A simple Google search using the key words *scholarly articles for evidence based research on medical cannabis* yielded about 143,000 results in 0.07 seconds. Refining the key words yields more precise results. Post-legalization there will be more studies including clinical trials by recognized global pharmaceutical companies; the money has already started to flow. To prepare for the next couple of years of change Pharmacists would be wise taking the initiative to educate themselves with the scientific evidence, dosing and different strains of THC and CBD.
That’s Ok that any Pharmacist isn’t confident about evidence and their own level of knowledge of research and evidence, one can’t blame them for being careful; however, a patient focused Pharmacist would understand that patients will use or try regardless of what the Pharmacist thinks. I suppose there’s no way to “convince” any Pharmacist who believes there’s no evidence. It takes time to deal with new information.
I recently saw a heart wrenching video of a Mom with an epileptic child that used THC/CBD drops; her child was having up to and beyond 100 seizures per day; every day. Now has few or none. Beyond her child being able to be a kid again, she was happy to be a Mom again and not a nurse/caregiver. This child was on so much medication; that wasn’t working. And now off it. It was impossible to not to shed a tear. Very emotional.
What’s next? And a new reality
To succeed in this rapidly evolving category, Pharmacists will need to grasp the realities of the marketplace and quickly develop a focused, disciplined plan of attack. One key to success at this early stage is recognizing that the cannabis marketplace will remain changeable for some years, so Pharmacy businesses must remain adaptable to change.
Our goal as an industry and our social responsibility to society is to develop self-regulation that demonstrates to the community that we are working towards on-boarding with the government and are ready to work with our provincial and municipal politicians to develop a regulatory structure that allows patients to access these products.
Here are a few places to start…
CPhA has webinars ( https://www.cpha.ca/cannabis-resources-webinars) and a CPhA CE Course; ( https://www.pharmacists.ca/education-practice-resources/professional-development/medical-cannabis-ce/ )
Follow Tilray; ( https://www.tilray.ca/ ) And this study for epilepsy ( https://business.financialpost.com/pmn/press-releases-pmn/business-wire-news-releases-pmn/tilray-2100-product-shows-promise-in-canadas-first-pediatric-study-of-mixed-thc-cbd-medical-cannabis-oil-for-children-with-drug-resistant-epilepsy )
Health Effects of Cannabis ( https://www.canada.ca/en/health-canada/services/drugs-medication/cannabis/health-effects/effects.html )
Canada’s lower-risk cannabis use guidelines ( https://www.camh.ca/-/media/files/lrcug_professional-pdf )
Cannabis in Canada | get the facts ( https://www.canada.ca/en/health-canada/services/drugs-medication/cannabis/resources.html?research-data )