Is there a current or future role for pharmacists in the dispensing of marijuana

[pharm4312]

Discuss. Medical clinics are popping up all over the country. Just became legal in NJ. There are reports of RPH run dispensaries in Arizona. Connecticut requires a pharmacist to be present at the dispensary. Will this be a trend that continues? How would one learn more information about it reather than just surfing the internet?

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[WVUPharm2007]

I'd feel much safer standing by myself in the middle of the night next to a safe full of weed compared to the safe full of oxycodone I currently reside by. I'd imagine it would be preferable.

 

[Unchained]

There shouldn't be a role for us but I'm afraid there will be. Marijuana can't do anything clinically that prescription drugs can. Unfavorable SE's also. I don't want to turn this into a merits of marijuana thread. From a standpoint of profiteering however I think it may be difficult given the gov't oversight and restrictions.

 

[Unchained]

I'd feel much safer standing by myself in the middle of the night next to a safe full of weed compared to the safe full of oxycodone I currently reside by. I'd imagine it would be preferable.

I'd prefer to be standing by neither. The potential marijuana robber can't get motivated enough to get off his parents couch in the basement, stop playing WOW for a minute, purchase a firearm, make the trip to the pharmacy and then get mean enough to threaten you. If he did you could probably change his mind by offering him oodles of noodles and a ride in a police car which he would think was cool.

 

[joetrisman]

I'd say eventually yes. But for now, no smart pharmacy board would touch it with a ten foot pole until fed regs change.

 

[WVUPharm2007]

I'd prefer to be standing by neither. The potential marijuana robber can't get motivated enough to get off his parents couch in the basement, stop playing WOW for a minute, purchase a firearm, make the trip to the pharmacy and then get mean enough to threaten you. If he did you could probably change his mind by offering him oodles of noodles and a ride in a police car which he would think was cool.

Nobody is going to steal weed. You can buy it down the street from me at the open air drug market for rock bottom prices. That's like going into 7-11 and armed robbing them for a 12 pack of beer.

I also think you underestimate the potential of cannabinoids in the treatment of epilepsy, anxiety, and as appetite stimulation. There are recorded cases of intractable patients of each effectively using each for their condition. Sure, other drugs could be better, but for every 100 persons on something like Seroquel, they don't get relief until they try something drastic like Clozaril.

Epilepsy has been made pretty famous recently by CNN with that weird strain of marijuana that has trace amounts of THC, but other cannabinoids that have stopped seizures in children that have literally tried every antiepileptic on the market. Sanjay Gupta (who is an idiot) was even on there talking about how these cases have made him do a "180".

I really don't see why a professionally made pharmaceutical (inhaling the remnants of incinerated plants isn't exactly optimal) such as a sublingual tincture (Sativex in Canada) being available in the arsenal is such a bad idea. The side effect profile is pretty weak and it does work in many patients.

 

[pharm4312]

This was not intended to be a debate on efficacy/safety of the substance, merely whether there may be opportunities for pharmacists to play a role in dispensing, now or in the near future.

 

[Old Timer]

There shouldn't be a role for us but I'm afraid there will be. Marijuana can't do anything clinically that prescription drugs can. Unfavorable SE's also. I don't want to turn this into a merits of marijuana thread. From a standpoint of profiteering however I think it may be difficult given the gov't oversight and restrictions.

This a scientifically arrogant statement. This is like the people who find out eating tomatoes or red wine or whatever and think they can get a pill and take it.

I think there a multitude of compounds that when consumed together as marijuana exert a therapeutic affect that is different from Marinol, I don't know why, unless the THC needs these other compounds to work optimally, Maybe we don't know the optimal blood level of THC.

I think we need to study this more. Also, it's wise to note that MJ is much more potent know then 30 years ago.

Whether there will be a role for us will depend on government regulations and profitability, If government allow it and people can make money selling it, you bet it will be sold.

 

[WhiteSnows]

I think there will be a regulation for marijuana and pharmacy will play a role in this. Imagine you can only get marijuana in the same way as pseudoepherine in the pharmacy: need a pharmacist to dispense, sign a log book to verify you can't buy more than a certain amount of marijuana per day. Certainly, you can get it down the street but there will be people who want to go to the pharmacy to get some. The state can still make it illegal to purchase marijuana without a pharmacist.

 

[pharm B]

The state can still make it illegal to purchase marijuana without a pharmacist.

Which is funny to me, since the country can (and does) still make it illegal to purchase marijuana. Regardless of the presence of a pharmacist.

I think this is a great chance to make some money with an independent dispensary, but are you willing to put your license on the line, knowing the feds have every right to shut you down if they ever get the impulse?

 

[WhiteSnows]

Which is funny to me, since the country can (and does) still make it illegal to purchase marijuana. Regardless of the presence of a pharmacist.

I think this is a great chance to make some money with an independent dispensary, but are you willing to put your license on the line, knowing the feds have every right to shut you down if they ever get the impulse?

The fed would be happy since the state makes more money to pay back their deficit.

 

[iamaninja]

I think the most likely scenario for Cannabis to come out of the shadows from the archaic and idiotic federal laws is for pharmacists to hold the key. Until the federal laws change I think its probably a really bad idea for pharmacists to be involved since we are still overseen by federal laws and the DEA. If Cannabis gets de-classified to another schedule I think treating it like any other medication is a safe and logical route at first and would instantly create a ton of jobs for pharmacists and drive up wages.

 

[owlegrad]

If Cannabis gets de-classified to another schedule I think treating it like any other medication is a safe and logical route at first and would instantly create a ton of jobs for pharmacists and drive up wages.

Brilliant!

 

[knight on horse]

I've long thought about this

Considerations of crime are in order, luckily, like benzos, abusers of weed tend to be weak and lame. If violent crime were an issue I would rather be an actual drug dealer

I despise weed, but as long is it has good benefits to harm ratio medically and there's no second hand smoke or other danger of exposure, then I in my majesty will deign to allow it

 

[type b pharmD]

Two states are in the process of requiring medical marijuana to be overseen by the BOP.. I know Connecticut is one.. I think maybe Nevada is the other?

Wild stuff.

 

[pharm4312]

Bump, lets keep discussing.

 

[eagles22]

I don't understand why we drop the requirements for filling rxs when talking about medicinal pot. Would any of you be comfortable just filling an rx that says "Marijuana"? We don't just fill rxs that say lisinopril or ibuprofen. We need a dose, frequency, route of administration, dosage form, etc. I don't see pharmacists being ethically able to just dole out as much pot as the person wants in an unknown potency. It goes against everything the pharmacist is supposed to do. So until marijuana is standardized and comes in known doses and the doc has to prescribe the form it's taken in (no more going to the dispensary and getting brownies since you can't go get an amoxicillin brownie), I think pharmacists need to stay away to maintain standards of the profession.

On the other hand, if we drop the medicinal charade and just admit this is a facade to allow recreational pot to be legal, then all this becomes moot.

 

[rxlea]

I don't understand why we drop the requirements for filling rxs when talking about medicinal pot. Would any of you be comfortable just filling an rx that says "Marijuana"? We don't just fill rxs that say lisinopril or ibuprofen. We need a dose, frequency, route of administration, dosage form, etc. I don't see pharmacists being ethically able to just dole out as much pot as the person wants in an unknown potency. It goes against everything the pharmacist is supposed to do. So until marijuana is standardized and comes in known doses and the doc has to prescribe the form it's taken in (no more going to the dispensary and getting brownies since you can't go get an amoxicillin brownie), I think pharmacists need to stay away to maintain standards of the profession.

On the other hand, if we drop the medicinal charade and just admit this is a facade to allow recreational pot to be legal, then all this becomes moot.

I'll dispense it when I'm required to do so, and when it's in standardized doses, and when it's prescribed by a legit physician for a legit reason (HIVcancer assoc anorexia/wasting disease, chemo assoc NV, pain in palliative care/cancer, etc).

Until then, I won't touch it. I'm not philosophically opposed to people using pot for whatever reason as long as it doesn't infringe on my rights or freedoms or personal safety. Regulate it, tax it like alcohol.

It's their choice to blow out their lungs like any smoker. I don't care. But when someone is my patient, I am concerned with their safety and until the compound is considered safe and standardized, I won't be doling it out. Use marinol. That's what it's for.

 

[Amicable Angora]

I wonder if that day will come soon, where we dispense marijuana.

 

[owlegrad]

Who says pot brownies do not fall under "compounding"?

 

[Sparda29]

IMO it should be legal for recreational use. Big pharm companies would probably start growing it, and making different strains and with different brand names and marketing it for different purposes. You walk into CVS, go to the pharmacy, pharmacist brings out a binder with the different strains and what they are good for, sort of like on: http://www.leafly.com and then you pick what strain you want based on the effect you're looking for (OG Kush vs Sour Diesel vs Purple Haze, etc) pay the pharmacist, sign the log if necessary and go home.

 

[eagles22]

IMO it should be legal for recreational use. Big pharm companies would probably start growing it, and making different strains and with different brand names and marketing it for different purposes. You walk into CVS, go to the pharmacy, pharmacist brings out a binder with the different strains and what they are good for, sort of like on: http://www.leafly.com and then you pick what strain you want based on the effect you're looking for (OG Kush vs Sour Diesel vs Purple Haze, etc) pay the pharmacist, sign the log if necessary and go home.

Pharmacist don't do that with BP meds or pain meds, why should it fall under the scope of a pharmacist to be a pot sommelier? No one says something like "if you want a good, clean quick drop in you BP then HCTZ is for you, but if your looking for a longer lasting, heavier BP drop, then go to lisinopril". That's just not how medicine is done in the country. If it's a controlled medicine, you don't get to pick what you want, the doctor prescribes it for you.

The way that medicinal marijuana is dispensed now is like you describe which is a veiled attempt at having legalized recreational marijuana.

 

[pharm4312]

has anybody heard anecdotal stories of registered pharmacists working in dispensaries and selling the product? anywhere in writing on boards of pharmacy sites that your license would be protected in such situations, considering its schedule 1 status?

 

[Sparda29]

The way that medicinal marijuana is dispensed now is like you describe which is a veiled attempt at having legalized recreational marijuana.

That's fine with me, except don't hide that you only want it for medicinal use. I'm all for full blown recreational marijuana.

 

[eagles22]

That's fine with me, except don't hide that you only want it for medicinal use. I'm all for full blown recreational marijuana.

I'm in agreement that we shouldn't go about hiding that is recreational if that's the ultimate intent. If we're gonna make it recreational, then pharmacists shouldn't have any role in it. They don't have to dispense alcohol or tobacco, so why should they be dispensing marijuana.

If it's medicinal, then the strains, flavors, discretionary dosage forms all go away and the doc pretty much says "marijuana x mg THC/gram" and you get whatever brand/flavor/strain the pharmacy stocks just like you do for all other meds.

 

[Digsbe]

If medical marijuana is going to be classified as a prescription medication then a pharmacist absolutely should be involved in the dispensing. Do the states that legalize marijuana for medical purposes have a prescription system set up for it? From my understanding you just get a card that authorizes you the ability to buy marijuana products and present that to a dispensary that is not run by a pharmacist nor is medical counsel given upon dispensing. Then again I admit that my knowledge on the matter is limited.

 

[Sparda29]

I'm in agreement that we shouldn't go about hiding that is recreational if that's the ultimate intent. If we're gonna make it recreational, then pharmacists shouldn't have any role in it. They don't have to dispense alcohol or tobacco, so why should they be dispensing marijuana.

If it's medicinal, then the strains, flavors, discretionary dosage forms all go away and the doc pretty much says "marijuana x mg THC/gram" and you get whatever brand/flavor/strain the pharmacy stocks just like you do for all other meds.

What if I own a pharmacy? I might as well add a dispensary component to the business.

 

[eagles22]

What if I own a pharmacy? I might as well add a dispensary component to the business.

If you ran a dispensary as they are currently being run, then I'd argue you aren't practicing pharmacy. There's nothing wrong with taking in a new revenue stream, but people need to stop pretending that they're dispensing medicine rather than helping people get high. There is no other drug where you get a card that says you can have as much as you want as often as you want in an unknown strength. I view dispensaries more akin to liquor stores than pharmacies (again, nothing wrong with selling liquor in your pharmacy, but that isn't considered pharmacy practice either).

 

[Sparda29]

If you ran a dispensary as they are currently being run, then I'd argue you aren't practicing pharmacy. There's nothing wrong with taking in a new revenue stream, but people need to stop pretending that they're dispensing medicine rather than helping people get high. There is no other drug where you get a card that says you can have as much as you want as often as you want in an unknown strength. I view dispensaries more akin to liquor stores than pharmacies (again, nothing wrong with selling liquor in your pharmacy, but that isn't considered pharmacy practice either).

I already have an idea for this place.

Pharmacy section in the back. Marijuana section on the side. An old-school grill with a bar-like set-up and stools on the other side and a soda fountain. OTCs/cosmetics in the middle. Cashier up front for front store stuff.

 

[Dred Pirate]

Just want to hear other pharmacists viewpoint in regards to the debate out there?

Will pharmacist/pharmacy in general have a future role? .. (role as whenever it becomes legal both federal and state)
Drug/marijuana interaction
Patient counseling
Special pharmacist certification to dispense marijuana
Pharmacist certifying potency
Board of Pharmacies having something like USP certified stamp on marijuana


With some states ( Alaska, Colorado) allowing marijuana recreationally, I think it is a matter of years where some big pharma company would find some therapeutic use at a reasonable potency/concentration.. get lobbyist and make marijuana something commonplace and less restrictive.. may be a schedule II?

until the feds change the laws, pharmacists will NEVER be involved. Not saying I agree, but now way the DEA will continue to give a permit to a place that sells a schedule I drug

 

[Dred Pirate]

I already have an idea for this place.

Pharmacy section in the back. Marijuana section on the side. An old-school grill with a bar-like set-up and stools on the other side and a soda fountain. OTCs/cosmetics in the middle. Cashier up front for front store stuff.

where will the liquor be?

Oh wait, you are in NYC where you have to go to a liquor store, when I lived in Illinois Liquor was the biggest money maker in the pharamcy

 

[504poboy]

well well, to all the naysayers, never say never!!!

check out www.indeed.com, search pharmacist in the position and minnesota in the "where" field

Pharmacist, Medical Cannabis Dispensary
Minnesota Medical Solutions LLC - Minneapolis, MN
Head Pharmacist, Medical Cannabis Dispensary
Pharmacist Job Responsibilities:
Serves patients eligible for cannabis-based medications.

Part-time: Must be willing to work 2-3 days per week.

Pharmacist Job Duties:

• Be part of our startup team as we apply for a state-sanctioned medical cannabis distribution license, developing state-specific policies, medications and systems.
• Prepares cannabis-based medications based on physician recommendations; detecting therapeutic incompatibilities.
• Trains Pharm Techs, other pharmacists and health care professionals on the use of cannabis-based medicines. Dispenses cannabis-based medications based on our formulary.
• Controls medications by monitoring drug therapies; advising interventions.
• Completes dispensary operational requirements by organizing and directing technicians' work flow; verifying their preparation and labeling of pharmaceuticals; verifying order entries, charges, and inspections.
• Provides pharmacological information by answering questions and requests of health care professionals; counseling patients on drug therapies.
• Develops hospital staff's pharmacological knowledge by participating in clinical programs; training dispensary staff, students, interns, externs, residents, and health care professionals.
• Complies with state laws as regulated by the state board of dispensary, by monitoring nursing unit inspections; maintaining records for controlled substances; removing outdated and damaged drugs from the dispensary inventory; supervising the work results of support personnel; maintaining current registration; studying existing and new legislation; anticipating legislation; advising management on needed actions.
• Protects patients and technicians by adhering to infection-control protocols.
• Maintains safe and clean working environment by complying with procedures, rules, and regulations.
• Maintains pharmacological knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies.
• Contributes to team effort by accomplishing related results as needed.

Pharmacist Skills and Qualifications:
Analyzing Information, Administering Medication, Judgment, Verbal Communication, FDA Health Regulations, Pharmacology, Managing Processes, Legal Compliance, Productivity, Quality Focus, Attention to Detail

Salary: $100,000.00 /year

Required experience:

• Pharmacist: 5 years

 

[504poboy]

http://minnesotamedicalsolutions.com/faqs/

 

[gwarm01]

I wish we had a role in dispensing marijuana. Aside from the obvious potential for profit, it is concerning that something is being labeled as a medicine and yet dispensed by non-medical professionals. I know marijuana is pretty much at the bottom of the list of harmful substances, but there is still a lot of misinformation out there. This is anecdotal, but I've seen people tell cancer patients that marijuana cures all cancer. Stop your chemo, just eat pot brownies! I believe there have been some studies showing that marijuana can slow growth of certain types of cancer, but come on. At least if I was involved I could tell them to take the chemo THEN eat the pot brownie.

This kind of sounds tongue in cheek, but I really do support medical marijuana. It's a drug that has many potential uses, and who knows where research will take it. We've basically ignored an entire chemical pathway in the human body for the greater part of a century, and for no good reason. I'd just rather there be a pharmacist dispensing the medicine and information rather than some hippy.

 

[bacillus1]

Well, apparently roles are starting to open up. Saw this posting in Baltimore: http://www.indeed.com/cmp/Clinical-Scribes-LLC/jobs/Head-Pharmacist-f9ea71f03879794d

 

[genesis09]

I wouldn't get a job involved with marijuana. It will put your license at risk.

 

[Swishers]

APhA actually had a webinar not too long ago discussing the possible role of pharmacists in the sale of cannabis. Basically, we'd be in a good position to counsel and ensure safe use since we know the possible drug interactions and side effects (some of us through first hand experience ).

Here's a link to the webinar slides: http://pharmacist.com/sites/default/files/files/Cannabis_CPE_Webinar.pdf