In some states allowing medical cannabis, Utah being one of them, only doctors who have undergone specialized training and registered with the state can legally prescribe the drug. But there is now a movement afoot to change that. Medical cannabis proponents want to take some of the responsibility away from doctors and shift it to expert cannabis pharmacists instead.
Is there justification for doing so? Perhaps. It is commonsense that the sheer volume of prescription medications now on the market makes it impossible for doctors to be familiar with every drug they prescribe. So that concern, in relation to medical cannabis, is a red herring. The lack of understanding, combined with current prescribing practices, make a compelling case for specialist cannabis pharmacists.
Obtaining Medical Cannabis in Utah
In keeping with Utah as an example, imagine being a patient in need of medical cannabis. You can only obtain it from a registered dispensary by way of a state medical cannabis card. Deseret Wellness, a Provo medical marijuana dispensary, explains how the process works.
They say a patient must first visit a qualified medical professional (QMP) for an initial evaluation. A QMP is a doctor, nurse practitioner, or physician assistant who has undergone online training and registered with the state. The QMP determines whether or not the patient qualifies for a cannabis card and would benefit from prescription marijuana.
The QMP fills out the necessary paperwork during the visit. The patient then submits that paperwork along with a completed application and the required fee. It is up to the state to review the paperwork and issue the card.
Only card-carrying patients can enter Utah marijuana dispensaries. In many cases, patients meet with cannabis pharmacists on their first visit to a dispensary. They work with these pharmacists to determine dosage, delivery method, etc.
Let Pharmacists Be the Experts
The move to transfer more of the responsibility to pharmacists is about one thing: letting them be the experts. They already know more about cannabis and the human cannabinoid system than most doctors. This is not a knock against doctors or the work they do. It is more of a reality check. Doctors cannot be expected to know everything about every drug they prescribe.
As a case in point, consider PEW research from 2017 showing that doctors routinely prescribe antibiotics unnecessarily. The research shows a number of reasons doctors do so, ranging from time constraints to uncertain diagnosis. If something as simple as penicillin is being prescribed improperly, what does that say for all of the other prescription drugs on the market?
Unlike medical doctors, pharmacists are drug specialists. It is what they had been trained in. We would expect them to know a lot more about cannabis and the human cannabinoid system. So shouldn’t they be the ones to write the actual prescriptions? Many medical cannabis proponents think so.
Shared Responsibility
There is legislation now working its way through Utah’s state government, legislation that would encourage doctors and cannabis pharmacists to work together. Doctors would still see patients for the purposes of helping them obtain their medical cannabis cards. But then they would turn those patients over to cannabis pharmacists for the prescription portion. The idea is one of shared responsibility between them.
We already know that current prescribing practices do not necessarily work well for everything from penicillin to fentanyl. To expect them to work in the medical cannabis arena is probably unrealistic. Moreover, prescribing practices make the case for expert cannabis pharmacists taking on a larger role in writing prescriptions and overseeing the dispensing of medical marijuana.
