The following is a summary of “Cannabis dispensary staff approaches to counseling on potential contraindications to cannabis use: insights from a national self-report survey,” published in the July 2023 issue of Primary Care by Slawek, et al.

Legal cannabis is available in more than half of the United States. Still, healthcare professionals (HCPs) often lack the knowledge or ability to provide recommendations on the dosing or safety of cannabis due to policy limitations. Consequently, customer-facing cannabis dispensary staff communicate these recommendations without HCP guidance, including pharmacists, nurses, and physician’s assistants. However, little is known about how dispensary staff approach individuals with complex medical and psychiatric conditions. For a study, researchers sought to describe how cannabis dispensary staff counseled customers with medical and psychiatric comorbidities on cannabis use and examine the association between state-specific cannabis policy and customer advice.

The national, cross-sectional online survey study occurred from February 13, 2020, to October 2, 2020. The survey targeted dispensary staff at dispensaries selling delta-9-tetrahydrocannabinol-containing products. The survey measured responses to questions about how staff approach customers with medical and psychiatric comorbidities, state medicalization scores (indicating similarity to the regulation of traditional pharmacies), and whether adult-use cannabis is legalized in the state. Multiple mixed-effects multivariable logistic regression analyses were conducted to understand the relationships between state medicalization, dispensary staff perspectives, and recommendations.

Out of the 434 eligible respondents, the majority were budtenders (40%) or managers (32%), while only a minority were clinicians (18%). The state medicalization score did not show significant associations with most survey questions. However, it was found to be associated with certain recommendations. Specifically, a higher medicalization score was linked to an increased likelihood of encouraging customers with medical comorbidities to inform their traditional healthcare providers about their cannabis use (Odds ratio [OR]=1.2, 95% CI 1.0-1.4, P=0.03). On the other hand, it was associated with a reduced likelihood of recommending cannabis for individuals with cannabis use disorder (CUD) (OR=0.8, 95% CI 0.7-1.0, P=0.04). Additionally, working in a state where adult-use cannabis is legalized was associated with a preference for recommending traditional health care over cannabis for individuals with serious mental illness (OR 2.2, 95% CI 1.1-4.7, P=0.04). 

Furthermore, the survey revealed that less than half of the respondents believed they had encountered cases of CUD (49%), and over a quarter did not believe that cannabis is addictive (26%). The findings highlighted the dispensary staff’s diverse perspectives and beliefs regarding cannabis use and its potential risks.

Dispensary staff preferred involving individuals’ traditional HCPs when managing cannabis dosing and safety for customers with medical and psychiatric comorbidities. Staff also held skepticism about cannabis addiction. State regulations of dispensaries did not significantly impact the recommendations given to customers, suggesting other factors, such as regional or store-level variations, may influence staff recommendations.

Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-023-02095-5