Pharmacists take on medical cannabis dispensing role in three states

Medical Cannabis

Pharmacists in Connecticut have been dispensing medical cannabis for more than a year now. The state’s medical cannabis law requires that a board-certified pharmacist be onsite to dispense the product at a medical cannabis dispensary, of which there are currently six in Connecticut. 

But Connecticut is not the only state with this model. In July 2015, Minnesota pharmacists began dispensing medical cannabis under the state’s 2014 cannabis legislation, and now New York’s law, also passed in 2014, includes language requiring pharmacists to dispense. 

“There are now three states that have a solid health care model [with a pharmacist to dispense],” said Joseph Friedman, BSPharm, founder of a medical cannabis dispensary in Illinois. Friedman is a vocal supporter of pharmacists’ role in the growing industry. No mandate under Illinois’ medical cannabis law requires pharmacists to dispense, however.

An article from a 2015 three-part Pharmacy Today series examining the role of pharmacists around cannabis focused on Connecticut pharmacists in this role. 

CT, MN: Learning as they go

In Minnesota, three dispensaries are currently up and running, with cannabis supply coming from two growers in the state. Pharmacists select and dispense the product for patients, while physicians identify who is eligible. Minnesota’s law authorizes medical cannabis for the treatment of nine medical conditions.

“The pharmacist is the only one who can dispense cannabis,” Ann Philbrick, PharmD, an assistant professor at University of Minnesota College of Pharmacy, told Today. “They will sit down with a patient and talk about what their disease state is, the goals for therapy, and then determine appropriate dose and formulation.”

She said pharmacists decide the amount of tetrahydrocannabinol (THC) and cannabidiol (CBD)—which control the psychoactive effects of cannabis—in the cannabis they give to patients. 

As in Connecticut, pharmacists in Minnesota are learning as they go. With limited scientific studies available, Philbrick said it’s a “best-educated guess with a lot of trial and error.”

Under federal law, cannabis is a Schedule I drug, but Connecticut’s law reclassifies it as a Schedule II drug. Because of this change, medical cannabis goes through the same process as other controlled substances in Connecticut, meaning it’s tracked through the Connecticut Prescription Monitoring and Reporting System, a statewide database updated weekly with patients’ prescription data. 

The database also allows participants to include notes about the effects of cannabis on a patient’s symptoms and conditions, as well as how cannabis interacts with other drugs the patient might be taking. 

Connecticut’s law authorizes medical cannabis to be used for the treatment of 15 medical conditions.

Unlike in Connecticut, medical cannabis in Minnesota cannot be sold in plant form for smoking. 

Although the medical cannabis program has been slow to take off in Minnesota, more dispensaries are expected to be up and running within a year. Philbrick said the University of Minnesota College of Pharmacy is also looking into incorporating education courses about medical cannabis into the pharmacy curriculum. 

NY dispensaries set for new year

New York legislators passed the Com-passionate Care Act of 2014, which licenses five companies to grow and sell medical cannabis. Under the law, each company can operate up to 4 dispensaries, totaling 20 throughout the state, with pharmacists in the dispensing role. According to the law’s language, any facility that dispenses medical cannabis cannot open or operate unless there’s a New York state–licensed pharmacist on the premises.

The U.S. Department of Health & Human Services requires that manufacturers make medical cannabis available within an 18-month window after state laws are passed, and licensed growers in New York are expected to have dispensaries up and running in January 2016. 

As in Minnesota, medical cannabis in New York cannot be sold in plant form for smoking. New York’s law also bans edibles and covers 10 conditions for which patients may receive a prescription from a physician. 

Including New York, 23 states and the District of Columbia currently have laws that legalize and regulate cannabis for medicinal purposes. It’s uncertain, at this point, if and how pharmacists will be part of other states’ dispensing operations.