What Pharmacists Need To Know About Cannabis

On October 17, 2018, the use of cannabis (marijuana) for recreational purposes is expected to be legalized across Canada. In Ontario, as of the date of legalization, recreational cannabis will be available for purchase through the provincial Ontario Cannabis Store to persons 19 years of age or older. As of October 17, 2018, no prescription will be necessary to obtain cannabis or marijuana. 

The legalization of recreational marijuana does not replace the regulatory framework for access to medical marijuana. Persons who hold a valid prescription for medical cannabis can continue to obtain the product through federally-regulated Licensed Producers (LPs), as long as they have a valid prescription.

The use of recreational and medical marijuana by patients has the potential to impact the pharmacy profession, among other health professions. In anticipation of these developments, the Council of the Ontario College of Pharmacists (OCP) approved a Position Statement on Cannabis as well as a Cannabis Strategy for the profession. Below are some highlights from these two strategic documents. 

The use of cannabis for medical purposes

According to the Cannabis Strategy, the OCP recognizes that the landscape of recreational and medical cannabis continues to evolve. Because of this, pharmacists are likely to face a situation where they must consider the issue of cannabis use – medical or recreational – in the context of patient care. According to the College, “pharmacists will need to plan how to respond to the potential increase of patients seeking advice associated with cannabis,” including “being prepared to inform them of when evidence based knowledge is not available to provide conclusive advice.” As with alcohol and other substances, pharmacists are expected to have a foundational understanding of how cannabis affects the body, including interactions and side effects. This is consistent with the pharmacist’s duty to provide education to the patient. 

Pharmacy dispensing 

According to its Position Statement, the Ontario College of Pharmacists “would not oppose any federal or provincial legislation that would permit the dispensing of non-smoked forms of cannabis for medical use within pharmacies.” However, the College would not support the distribution by pharmacies “of any forms of cannabis for the exclusive use or purpose of smoking.” 

Harm prevention

As with other medications, the College expects the pharmacy profession to continue to participate in harm prevention efforts, in order to ensure that the patient’s medication does not harm the patient. According to the College’s Cannabis Strategy, there are specific harm prevention issues which arise in the case of cannabis, including potential for addiction, self-medication, and youth access. As with the issue of tobacco, pharmacists should be prepared to counsel patients on smoking cessation and administration of cannabis through other forms.

In summary, impending legalization of recreational marijuana, and continued availability of marijuana for medical purposes, will likely lead to pharmacists facing novel patient care challenges. Pharmacies and pharmacists who are faced with such issues should consider obtaining legal advice on how best to approach these issues, so as to ensure that all laws, ethical obligations, and standards of the profession are complied with.