Pharmacists Need a Role in Medical Marijuana
The following article was published on October 31, 2016 by The SunSentinel.
By Paul R. DeMuro and Jose Valdes
Pharmacists may well be the best equipped to assist in closing the knowledge gap doctors face as states approve medical marijuana laws.
Who might better determine how marijuana interacts with the nervous system and other medications, as well as its side effects, than those in the pharmacy profession who spend years in academic and practical programs, studying medications, their interactions, and side effects?
Some states are catching on to this idea, requiring that a board certified pharmacist be involved in the dispensing of medical marijuana. Soon pharmacists’ asking their patients if they use marijuana may become an important question as it becomes more widely researched and used.
How will the federal government and its agencies fund and/or facilitate the funding of such research if the Drug Enforcement Agency still classifies marijuana as a Schedule 1 drug? Currently, the University of Mississippi is the only university authorized to grow the drug for use in medical studies so this has limited the supply of marijuana for federally approved research purposes.
Under new plans proposed by the Obama administration, any institution that has an approved research protocol and the security measures needed to store dangerous drugs can apply. This will increase the supply and variety of marijuana available for research, ultimately expediting the research process.
For clinicians to be more comfortable prescribing marijuana, they need to have data that demonstrates the safety and efficacy of what they are prescribing. However, this requires substantially greater research, contributing to evidenced-based medicine.
The pharmacy profession, being the experts in medication utilization, should be one of the leaders in such a response. Pharmacists can help decide if marijuana is the right way to treat an ailment, what dose is appropriate, and in what form.
In Minnesota, pharmacists select and dispense medical marijuana for patients after discussing what their disease state is and goals of therapy, to ensure that appropriate doses and formulations can be selected. This allows the physician to focus on identifying who is eligible to benefit from medical marijuana, while empowering an equally evidence driven pharmacist to help collaboratively decide how to best treat the patient.
Certainly, additional policies are warranted that make navigating and staying within the confines of the law clearer, and perhaps adopting certain language similar to that of some states (e.g. Connecticut), that grant immunity to those involved in prescribing, dispensing, and utilization of marijuana from state, criminal, and civil penalties.
A recent ruling from the Ninth U.S. Circuit Court of Appeals may quell concerns as the ruling finds that the Department of Justice cannot spend funds from relevant appropriations for the prosecution of individuals who have engaged in conduct permitted by state medical marijuana laws and who fully complied with said laws.
Patient’s access to the now-legal drugs in many places may be stymied, and researchers in this area may find their efforts thwarted in many respects. However, marijuana holds great promise, and the time is now to further explore its benefits, interactions, and side effects.