The Canadian Pharmacists' Association says they are disappointed that new legislation to regulate cannabis for ‘adult use’ does not include references to pharmacies.
In a press release, the national association said they were pleased to see that the government followed the task force suggestion of maintaining a separate medical regime as the government establishes a non-medical, adult use market. They expressed disappointment, however, that the legislation made no reference to ‘clinical oversight in the management and dispensing of medical cannabis in Canada’.
“CPhA believes that a frontline role for pharmacists in the management and dispensing of medical cannabis is in the best interest of patient safety,” the organization said. “Pharmacists have the necessary expertise to mitigate the potential risks associated with using medical cannabis, including harmful drug interactions, contraindications and potential addictive behavior. By not moving to ensure appropriate clinical oversight, CPhA believes that patient health will continue to be at risk under the current system.”
After initially opposing pharmacy-distribution of medical cannabis when it was first included in rules back in 2013, last April the Canadian Pharmacy Association (CPhA) announced that they believe pharmacies are the safest way to dispense medical cannabis in Canada.
The CPhA formerly opposed the inclusion of pharmacy distribution in 2013 when it was included in an early version of Health Canada’s Marihuana for Medical Purposes Regulations (MMPR). The opposition cited a “lack of evidence” and concern with the possibility for associated crime.
The release concluded, “there remains the concern with pharmacists dispensing a product that does not have adequate safety and effectiveness evidence. In addition, the potential security risks to pharmacies due to robberies would need to be considered.”
The question of who should dispense medical marijuana is hotly contested, with dispensaries, liquor stores, pharmacies and licensed producers all seeking to stake their claim of expertise as being essential for the market.
The CPhA’s pre-Budget 2017 submission last summer included a request for $10 million to support cannabis education. Pharmacists who wish to dispense medical cannabis will likely have to attend cannabis education courses.
Jonathan Cox, a pharmacist in Victoria BC, told Lift he attended such a course in the past on his own volition. He says he’s been interested in being able to work with cannabis for many years, due in large part to patient demand, but the provincial and national colleges have been slower to respond to this need, and the associated demand for continuing education for pharmacists on emerging cannabis research is forcing interested pharmacists to seek their own education on the subject.
“I’ve been asking the BC College of Pharmacists for probably the last five years what their position is on medical cannabis, but they just keep deferring to Health Canada and said they don’t have a position on it.
“There should be some kind of program set up through the College of Pharmacists (of BC), to train pharmacists in patient education about cannabinoids and the endocannabinoid system in general. They should have a comprehensive training process to really get pharmacists up to speed to a point where they can counsel patients adequately.”
Cox says he took it upon himself in the past to take an Advancing Practice Medical Cannabis certification program that is accredited by the Canadian Council on Continuing Education in Pharmacy (CCCEP). Other regions and agencies, like Dalhousie, have put on similar programs, but no such program through the CPhA currently exists. Nonetheless, pharmacists remain a better choice than producers or dispensaries or compassion clubs, Cox says, as they don’t have the sort of medical training he and his colleagues have.
Increasingly, many of the 40,000 pharmacists in Canada are arguing that they represent one of the best methods of dispensing, and possibly even prescribing cannabis for medical purposes. Their expertise in understanding drug interactions and dispensing measured, specific dosages is generally the primary reasons cited, as well as a storage and distribution system that is used to dealing with controlled and highly regulated products.
Pharmacies originally carried cannabis products in Canada up until about the 1920s, when cannabis was placed on a list of controlled substances like opium, morphine and cocaine. As cannabis regulation changes, the argument for putting cannabis back into pharmacies seems to be gaining momentum.
Changes to Canada’s existing medical cannabis regime, the ACMPR (Access to Cannabis for Medical Purposes Regulations) are expected to include pharmacy distribution in the future. Major chains like Shoppers Drug Mart and PharmaChoice have announced their intentions.