New Brunswick Pharmacists and Medical Cannabis
I was recently sent the position statement of the New Brunswick College of Pharmacists Position Statement on Cannabis for Medical and Non-Medical Purposes. I would strongly encourage all pharmacists interested in medical cannabis to read this statement. The college firmly feels that there:
Currently available information does not support pharmacy distribution of cannabis.
This Position is Stigmatizing a Population of Patients
Like it or not, many patients throughout Canada are using cannabis for medical purposes. The vast majority of these patients are using cannabis for the management of chronic pain. Many find that it offers superior relief and improvement in outcomes than other analgesics. The use of medical cannabis for chronic pain is supported numerous trials and the National Academies of Sciences, Engineering, and Medicine’s systematic review in 2017 concluded that there is:
- There is substantial evidence that cannabis is an effective treatment for chronic pain in adults
What bothers me about this position the most is the college is saying that patients using medical cannabis should be treated differently than other patients receiving other analgesics. Some of these other analgesics also have limited long-term safety and efficacy data.
Regardless of the treatment, my belief is that patients should have:
- Timely access to medications in the communities they live
- Access to customized patient care and counselling based on their needs
- Their complete medical record accessible at one pharmacy for both safety and monitoring
With the college’s position, the patient cannot access their medication by the healthcare professional with whom they have an established and trusted relationship. This can also lead to delays in treatment initiation while the patient waits to have their cannabis shipped from a licensed producer. This delay would not be tolerated for other medications in Canada.
For some reason, the New Brunswick College of Pharmacists feels that patients using medical cannabis should NOT receive the same expert counselling, education and guidance as other medications in Canada.
Canada is one of the ONLY Countries Where Pharmacists Don’t Have a Major Role
I have had the pleasure of working on some medical cannabis projects in other parts of the world. I recently returned from South America, where medical cannabis legislation is currently being approved. Cannabis in Colombia will be treated like any other medication. The prescriber assesses the risk and benefits for the patient and then the prescription filled by a specially trained pharmacist. This system allows patients to have the expert insight of two healthcare professionals providing education, counselling and monitoring. This is also the same in other parts of the world like Israel.
I don’t understand why the college feels that the people of New Brunswick using medical cannabis cannot benefit from the care, guidance, education and monitoring of pharmacists in the province
Why Does Efficacy and Safety Only Apply to Cannabis?
One of the key concerns with the college is they state that:
- “We must ensure that external pressures are not causing us to bypass normal checks and balances in the health care system”
My interpretation of this is there is a lack of safety and efficacy data with medical cannabis and thus we don’t feel pharmacists should be distributing it.
I would be fine with this statement, if it held true for all products sold in pharmacies. I also do a tremendous amount of work in the vaccine space. Currently, pharmacies across the country are selling nosodes. These are homeopathic vaccines. These nosodes are marketed online as alternative to routine immunizations. Having them for sale in pharmacies, legitimizes these as a safe and effective option for patients. I would argue nosodes distributed through pharmacies can do much more harm to patients and public health than the expert care of patients with chronic pain requiring cannabis.
Even if a product is approved by Health Canada, there can be safety and efficacy concerns.
Patients with Chronic Conditions Need Care and Support
This position from the New Brunswick College stigmatizes patients as they don’t feel the cannabis they are using is an legitimate treatment. They also devalue the care provided by the pharmacists in the province by not allowing them to provide patient-centered care surrounding cannabis.
Bottom Line: I feel this position statement was very short-sighted. There is an opportunity to improve the care provided to these patients and the college does not feel these patients can benefit from the expert care of pharmacists trained in cannabis.