California resident Bob (not his real name) admits that “back in the day,” he used to use pot just for fun- “like a lot of us did,” he says, with a sheepish grin. Over time, however, adult responsibilities, including running his own business and having kids, caused him to stop using marijuana for over two decades.
Then, about two years ago, medical cannabis became his saving grace. After a lifetime in the construction industry, Bob was suffering from more than his fair share of aches and pains. When he decided to use marijuana for medical purposes in 2014, he obtained a card and was sent out the door with a list of local dispensaries. As a medical cannabis user in his late 60’s, he realized that a lot had changed, including himself.
“Most of the dispensaries I went to at first definitely seemed to cater to a ‘younger’ crowd, so after the first visit, I tended to avoid them,” said Bob.
A few months of searching and many hours scrolling the internet later, Bob eventually found a couple of dispensaries in his area that were more his style.
“One dispensary is run by the owner, an older gentleman, and he really knows what he is talking about because he has ailments that he uses cannabis for himself. The other has a trained RN on staff sometimes. When he is there, I can ask him guidance andsuggestions.”
Like most medical marijuana patients, Bob had to conduct his own research for the most part to find out what strains of cannabis as well as which strengths, ratios and methods of administration were best for him. Unlike many consumers, however, Bob was lucky in that he was able to find a dispensary with a staff member trained in cannabinoid therapy.
The Lack of Training Amongst Dispensary Staff is Alarming – And Potentially Dangerous
Those who run businesses in the ever-changing cannabis industry are being faced with a rapidly-growing market while at the same time trying to meet the increasing demands of those whose health may depend on cannabinoids for relief from everything from acute joint pain like Bob’s to PTSD and even cancer.
“It’s not a one-size-fits-all,” says United Patient Group’s John Malanca, who started UPG after doing his own research about the healing benefits of marijuana for his father-in-law who had lung cancer that had metastasized to his brain. “He had a heart arrhythmia so he couldn’t have a sativa strain. He had to have his oils made out of an indica strain.”
Malanca explains that initial research caused him to go “low and slow” when first administering the cannabis oil he obtained for his father-in-law. That initial micro dose amount helped the older man gain his strength and appetite in order for his own body, and the cancer-killing agents within the cannabinoids, to kick in the healing response. Anything stronger, according to Malanca, may have potentially had a devastating effect.
Study Recommends More Training for Dispensary Workers
The current growth of the medical cannabis industry as well as changing demographics is finding most medical dispensaries ill-equipped educationally.
As of the 2014 census, there were approximately 75.4 M “Baby Boomers” in the United States, many of whom are considering using cannabis for medical reasons as they age and as the laws around using marijuana become more relaxed. As of March 2016- before the November election which saw seven more states turn legal for either recreational or medical use- there were approximately 1.3 million card-carrying medical marijuana users. This same source estimates that if medical marijuana were legal in all fifty states, that number would more than double.
At the same time, a study conducted by researchers at Palo Alto University in California found that pot shop workers at both medical and non-medical dispensaries often go into the job with little or no training in cannabinoids. The researchers surveyed workers in Colorado, California, Arizona, Oregon, Connecticut, Rhode Island, Massachusetts, Maine and DC. They found that only 20 percent had received any training as to the health effects of marijuana and only 13 percent had received training on the general science of cannabis.
According to the laws in most states where medical marijuana is legal, dispensary workers are not allowed to give medical advice nor recommendations unless they are also trained medical professionals. Still, a whopping 94 percent of survey respondents admitted that they had given advice to customers as to which cannabis strains customers should use for particular symptoms.
The good news is that, according to the study, some of this advice was actually in line with expert recommendations, especially when it came to PTSD, Crohn’s disease, ALS, epilepsy and muscle spasms, indicating perhaps an initiative on the part of some workers to do their own non-official research on cannabinoids for health.
Other advice given, however, was definitely not in line with expert recommendations. Ten percent of staff members surveyed admitted that they had recommended high-CBD marijuana for those who want to increase their appetite while current research shows that it is THC, not CBD, that can help people in that arena. The study also showed that 13 percent of workers had recommended types of cannabis that are high in THC to patients who intend to use it to treat anxiety. This is in contradiction to current research which shows that, in general, low levels of THC given consistently is the protocol that is effective in treating anxiety for most patients while some individuals with certain genetic dispositions cannot tolerate any THC at all (but do have success with strains that contain THC-V).
UPG Offers Vital Cannabis Education for Everyone
For John Malanca and others who are at the forefront of cannabis education, what is of particular concern is how marijuana can interact with certain pharmaceutical drugs. For example, some studies show that marijuana can sometimes inhibit cytochrome P450, a liver enzyme. In turn, this could effect the ability of the drug Viagra to break down in the blood of someone who is also using marijuana, causing heart problems.
And cannabis has also been known to enhance the effect of certain opiate pain killers; studies have found that ingesting marijuana may increase the potency of certain opiate drugs such as oxycodone by up to four times the amount.
“When you go into a CVS, for example, they will tell you a drug to drug interaction,” explains Malanca, who believes that pharmacological professionals have some role to play in medical dispensaries of the future. “They have a section there that tells ‘what is this’ and ‘what is that.’ “
Then there is the increasing strength of the cannabis being sold in general these days. A 2016 study by the University of Mississippi measured levels of THC in more than 38,000 samples of marijuana from 20 years ago. They found that across the board THC levels had risen from roughly 4 percent in 1995 to about 12 percent for the same basic strains in 2014. This, coupled with new, high-octane administration techniques such as edibles and oils, may present a reality that seniors such as Bob may not be prepared for without proper education.
“[This is why] our [consultant] education is so important. It shows you why formulations are so important and why having a medical specialist involved is vital,” says Malanca. “They can give guidance on dosing. Our medical professionals look at age, weight, current health condition, any medication and supplements they may be on and then they go from there because, again, [cannabis] is not one-size-fits-all.”
The best advice that Malanca and other responsible educators have for consumers who decide to shop at dispensaries is to make sure to do your own research beforehand, using the resources of a trusted site such as United Patients Group. For cannabis use for more serious conditions, consider seeking the advice of a trained professional such as those available through United Patients Group Medical Professional Consultations, where professionals trained in both conventional medicine and cannabinoid therapy can work with you and your doctor to develop a healing plan that is best for you.