Pharmacists tread carefully into the world of medical cannabis

 In Medical Marijuana

Pharmacy Today/ January 2018

The Healing Corner, a medical cannabis dispensary located in Bristol, CT, could pass for a spa. A potted sedge and weeping fig tree stand between padded chairs and loveseats. The walls are painted a cool taupe, and a blue tabletop fountain softly burbles in the reception area. There’s even a smiling Buddha statue in the consultation room, where David Slomski, PharmD, or one of the other three Healing Corner pharmacists reviews a menu of the dispensary’s offerings to select a product that will best suit a patient’s disease state and treatment goals. But make no mistake—the Healing Corner is devoted to the care of patients who have tried and failed to find relief through traditional medications.

When Connecticut finally allowed medical cannabis dispensaries to begin seeing patients in 2014, Slomski didn’t waste any time jumping on board. Fresh out of University of St. Joseph School of Pharmacy in Hartford, Slomski—now dispensary manager at the Healing Corner—was eager to seize the opportunity to be an entrepreneur and pioneer in the industry. “My license number is three,” he said. Slomski is also chair of the Connecticut Pharmacists Association (CPA) Medical Marijuana Dispensary Academy, a continuing education creator and presenter, and winner of CPA and Pharmacists Mutual’s 2015 Distinguished Young Pharmacist Award.

Connecticut was certainly the right place to do it. It was the first state in the nation to mandate that a registered pharmacist be onsite at all medical cannabis dispensaries.

Pharmacists get in the game

The law permitting the use of medical cannabis in Connecticut was enacted in 2012, and it took 2 years to work out issues such as how to license dispensaries and pharmacists, where medical cannabis providers would obtain their products, and what conditions would qualify patients for a card.

Four more states—Arkansas, Minnesota, New York, and Pennsylvania—went on to mandate pharmacist involvement in the provision of medical cannabis. Though pharmacists are a common thread, the laws vary widely in what qualifying conditions make patients eligible for the program, how pharmacists and prescribers become authorized to prescribe or dispense, whether pharmacists or physicians must be onsite at dispensaries or be available as a consultant only, and more.

Here’s how it works in Connecticut. To get a medical marijuana card, a patient must be diagnosed by a Connecticut physician or advanced practice registered nurse as having one or more qualifying conditions. The only stipulation is that the provider has an active controlled substance registration in good standing and has access to the Connecticut Prescription Monitoring Program.

“They don’t need any special certification; they just need to register with the State of Connecticut to certify patients,” Slomski said. To work with patients using medical cannabis, however, pharmacists are encouraged to educate themselves by participating in continuing education and keeping up to date on any developments in the medical cannabis field. A dispensary pharmacist must be onsite at the dispensary facility during business hours.

The legal outlook is hazy

Joseph Friedman, RPh, MBA, is chief operations officer at PDI Medical, a dispensary located in Buffalo Grove, IL. Illinois does not mandate that pharmacists be involved with the dispensing of medical cannabis, but Friedman has been an active participant and advocate for pharmacists as providers of medical cannabis and is a frequent presenter at health conferences across the country.

Among pharmacists, one question he said he gets a lot is, “I’d love to get into this industry. Am I going to be taken away in handcuffs?”

“There are questions that have to do with federal law versus state law, and which one really takes precedence, even in a particular state where medical cannabis is legal,” Friedman said.

States that allow medical cannabis typically treat it as if it were a Schedule II drug, based on the rules and regulations imposed to dispense it—the Oregon Board of Pharmacy even officially reclassified it as Schedule II in 2010—so it can be used therapeutically. Even so, no one can say for certain how or if the federal government will take any legal action against pharmacists and other dispensers of what remains a Schedule I drug federally. The picture is even hazier since U.S. Attorney General Jeff Sessions has indicated his Department of Justice may be willing to crack down on cannabis.

Source: National Conference of State Legislatures

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