Seeking Solutions for Patient Safety in the Cannabis Space

Purpose of this paper

This paper will discuss some of the challenges faced by patients and adult users of cannabis in terms of inadequate guidance and counseling from qualified health providers, the less than clear scope of practice for dispensing agents and caregivers, and some of the negative impacts this lack of clarity presents for many of the players in the cannabis space. A discussion of the discontinuity of care between recommending healthcare providers and the medical marijuana dispensaries will be included. Recommendations for possible solutions to some of these issues and challenges will also be discussed.

The dispensary experience

It’s a common occurrence in the cannabis space — patient or adult user visits a dispensary. The product menu reads like a doctrine delivered from a foreign planet. Kush, cookies, OG, haze, indica, sativa, hybrid, oils, topicals, vapes, tinctures, edibles, flower, terpenes, vaporizers, water pipes, papers. To a cannabis naive patient, one glance at such a menu may be all things overwhelming and confusing. Realistically, a menu like this can be all things confusing for even the most experienced users, especially if they are seeking relief from symptoms. Which products help with pain? Which products work to relieve insomnia? Are there any products that can help someone experiencing anorexia related to chemotherapy treatments? These are just a few of the common medical questions that patients and adult cannabis users alike bring into the dispensaries.

For patients who registered with the Medical Use of Marijuana Program, they may have spent a short time with a recommending healthcare provider discussing what some of these terms mean. They may have come away from their recommending healthcare provider consultation with a brief guide to choosing cannabis products and have a few suggestions for choosing cannabis products jotted down. But then they enter a dispensary and their help guides from their qualified health provider are insufficient to help them negotiate the menu and make decisions that may benefit them.

Enter the dispensing agent

Also known as budtenders in other states, dispensing agents are dispensary staff members responsible for helping patients and adult users to decipher the menu by providing information about the various cannabis products. Whether or not the strain or chemovar leans sativa or indica, the lab testing results, how a product is best consumed, the terpene profile, patient experiences with the product may all be discussed in the span of a few minutes. Dispensing agents may also fulfill the patient or customer’s order, and complete the sale at the register. They are often not healthcare professionals, more often they are people with retail, customer services, and sales backgrounds.

Here’s where their role gets tricky — in order to help patients and adult users make decisions about which products to purchase based on symptoms reported, dispensing agents very often give medical advice that is far out of the realm of their skill set, training, and knowledge-base. It’s not the dispensing agent’s fault that they are in such predicaments, but the fact that the majority of dispensing agents are giving medical advice in some way, shape, or form is disconcerting from a medical and health perspective. Conveying unauthorized medical advice without a license is also a criminal offense. For the purposes of this article, we’ll stick with the risks faced by patients. There are valid risks associated with cannabis use, just as there are risks with the use of any substance, drug, or medicine. Some of these risks can certainly be perpetuated by inaccurate advice conveyed by a non-medical person, in this case, dispensing agents and caregivers.