Medical Cannabis Patients and Pharmacist Guidance

With our new pharmacy services, Harvest Medicine can now put you in directly in touch with a cannabis-trained pharmacist for additional medication guidance.   

For more on the importance of pharmacists’ involvement, Carole Chan, who is a pharmacist and Chief Commercial Officer at VIVO Cannabis offers her insights on the growing intersection between medical cannabis and pharmacy:

Carole Chan

Cannabis is Medicine, and Pharmacists are Trusted Drug Experts

Access to Medical Cannabis has been available since 2001, and there are currently over 377,000 registered patients in Canada who rely on cannabis as medicine.1  Pharmacists specialize in medication management, with expertise in a broad range of therapeutic areas and the various treatment options available. In 2020, Ontario pharmacists were required to take a continuing education course on medical cannabis as part of their annual license renewal, and Canadian Pharmacy Faculties are incorporating cannabis into their curriculums as the body of evidence and knowledge on its therapeutic application evolves.2 

Pharmacists Provide Evidence-Based Counselling and Recommendations

  • Based on your individual medical history and in partnership with your physician and healthcare team, pharmacists will make personalized recommendations. 
  • This includes assessing whether cannabis may be appropriate to help manage your symptoms or reduce traditional pharmaceuticals (such as opioid pain medication).  
  • These recommendations are based on the latest scientific literature, weighing potential benefits with its risks.  
  • There are some contraindications for medical cannabis, meaning there are some cases where cannabis is not safe or indicated. 
Pharmacy services available to medical cannabis patients

Pharmacists Can Assist with Dose Optimization

  • Medical cannabis can interact with existing medications possibly altering their effect (via your liver enzymes) and may have additive effects with other medications.  
  • Depending on other prescription, over the counter, and/or herbal medications you may be taking, your pharmacist may make recommendations to increase or decrease your dosage or alter your dosing schedule.  
  • For all new medical cannabis patients, careful dose optimization is required for therapeutic effectiveness. Most people don’t realize that similar to anti-depressants, CBD can take weeks to reach therapeutic effect. 
  • Cannabis is not the only medication that follows a titration schedule, and pharmacists can help with increasing your dose a little bit every day.  We always say, ‘start low, and go slow.’ 

Pharmacists Can Help Monitor & Manage Side Effects

  • THC and CBD are often described together as ‘cannabis’ but they are different cannabinoids which have differing effects and have distinctive side effect profiles. THC is impairing and may lead to feelings of intoxication, where CBD is considered non-impairing.   
  • Adverse events can be short-term or long-term in nature, ranging with common and expected, to rare.  
  • It is also possible to develop tolerance to THC, and as well as THC dependence.  
  • Pharmacists counsel on side effects as part of their medication counselling services and can support you with what to look for when using medical cannabis to assess its effectiveness. 
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Pharmacists Are Extremely Accessible

Recent studies of Canadian patients suggest that up to 64%, or 2/3 of individuals using cannabis for medical purposes currently self-medicate without proper medical oversight or guidance.3  To underscore the importance of working within the legal medical system, 74% of those who have had a medical document go to a healthcare practitioner or a pharmacist for guidance on cannabis use for medical purposes.4 Although pharmacies are currently not in the legal distribution stream for providing over-the-counter medical cannabis products for patients, pharmacists are easily accessible and available to answer all your health & wellness medication-related questions.  

Carole Chan practiced for over a decade as a community pharmacist at Shoppers Drug Mart. She is a member of the International Society of Cannabis Pharmacists (ISCPh) and a preceptor at the University of Toronto for 4th year Pharmacy students.Carole is currently the Chief Commercial Officer at VIVO Cannabis. In her previous role as President of Harvest Medicine, she oversaw the evolution beyond a traditional cannabis clinic network to a center of cannabinoid excellence. 

References:

1. Data on Cannabis for Medical Purposes. Government of Canada, 18 Dec. 2020, www.canada.ca/en/health-canada/services/drugs-medication/cannabis/research-data/medical-purpose.html#shr-pg0

2. Tang, G., Schwarz, J., Lok, K., & Wilbur, K. (2019). Cannabis content in Canadian undergraduate pharmacy programs: A national survey. Canadian Pharmacists Journal : CPJ = Revue des pharmaciens du Canada : RPC, 153(1), 27–31. https://doi.org/10.1177/1715163519890629

3. Self-Medicating with Cannabis: A complex and concerning issue. Public Health Wellington-Dufferin-Guelph, Nov. 2019, https://www.wdgpublichealth.ca/sites/default/files/file-attachments/basic-page/cannabis_facts_nov_2019_-_self-medicating_with_cannabis.pdf

4. Medical Cannabis Patient Survey. Medical Cannabis Canada, 2021, https://www.patientaccess.ca/wp-content/uploads/2020/10/Medical-Cannabis-Patient-Survey-Topline-Results-FINAL-1.pdf

Do you have questions about how your current pharmaceutical medications may impact your dosage amounts or product choices? Harvest Medicine can help! Just reach out to our Patient Care Team at 1-844-488-4633 or email info@hmed.ca for more information.
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